Coalition 21: Trying to find a solution for health insurance costs

Vermont Business Magazine, Dec 01, 2004 by Kelley, Kevin

The current state of the American health care system might be likened to lateautumn weather in Vermont: Everyone complains about it, but no one can do anything about it.

A wide array of Vermont interest groups is determined to show, however, that the health care crisis in at least one small state is not quite as impervious to improvement as a typical December day in northern New England.

Calling itself Coalition 21, this collection of business associations, advocacy groups and professional organizations has been meeting since mid-summer with the aim of drafting a comprehensive plan ensuring access to affordable, highquality health care for all Vermonters.

No proposals have been drafted to date, nor has the 28-member grouping set any timetable for reaching its goals. And even though the coalition faces some seemingly insurmountable obstacles, many of its members express optimism that this initiative will eventually succeed.

Some promoters of the Winooski Dome of yesteryear (putting the entire city under glass) were equally upbeat, however.

Coalition 21's premise, according to its conveners, is that previous efforts to redesign health care, both nationally and in Vermont, failed because those proposals did not command sufficiently broad support.

State Senator James Leddy, a lead organizer of this latest quest, points to Bill and Hillary Clinton's multi-faceted reform plan, which was stymied in Congress in 1994, and to Vermont's own attempt around the same time to devise a system guaranteeing universal coverage.

Vermont's ambitious undertaking collapsed because "some of the major players were not at the table," Leddy recounts. He referred specifically to small business interests, which, he says, "suddenly realized that they were going to be asked to pay for health care."

Leddy, the chairman of the Senate Health and Welfare Committee, says he spent much of the past two years consulting all the players about how to restart the effort to restructure Vermont's health care system. He became convinced that any new initiative had to be "bottom-up rather than top-down." He says he argued for a grassroots process that, initially at least, would have no direct government involvement.

Coalition 21 is the result.

The group is staffed by the non-partisan Snelling Center and meets under the auspices of the Windham Foundation, a sponsor of projects intended to benefit the general welfare of Vermont. The coalition can call -upon fiscal and legislative experts from state government, and it has studied plans developed in other states for reforming parts or the entirety of their respective health care systems.

The Vermont business community was willing to sign on to this endeavor, says co-convener Lisa Ventriss, because it has come to the conclusion that the current system is unsustainable.

Ventriss said even coming up with the formal name was difficult, which reflects the task ahead: "Coalition 21: Transforming Vermont's Health Care System."

She said it is very much a coalition of different individuals and groups; it must be relevant to the 21st century, inasmuch as the current system dates back to WWII; and, "This coalition is not about tinkering around the edges. So it wasn't about health care RE-form, it was about TRANS-forming the health care system."

Agreeing that a crisis point had been reached, members of the Vermont Business Roundtable, which Ventriss directs, "felt compelled to take risks in our own thinking," she says. Ventriss recalls "a eureka moment" at one roundtable session a few months ago when participants decided in unison that new ways of addressing the perennial health care quandary had to be found.

Windham Foundation president Stephan Morse, the coalition's facilitator, says it has come into existence as the result of an "awakening." All parties now acknowledge that "we are indeed in a crisis," Morse says, "and various players not used to sitting at the same table are coming together to address it."

He himself approaches the issue from "the frustrated employer point of view." Morse says he recently calculated what it costs to provide health insurance to his 45 employees at the Old Tavern at Grafton and 20 others at the Grafton Village Cheese Co. He says he was stunned to discover that the cost of health coverage equates to 1,600 room nights and 50,000 pounds of cheese.

Mark Neagley, head of Neagley & Chase Construction, affirms that the burden is too heavy for either his company or its employees to continue shouldering. Until about five years ago, Neagley recounts, his business paid the full costs of health insurance policies for its 40 covered workers. Relentless rate rises then required, however, that workers be asked to pay 10 percent of their premiums, Neagley relates, adding that the employees' share has since climbed to 30 percent. Neither the company nor many of its workers can continue paying that much, he says, warning, "I think we're right at the edge now."

Concern over health care costs and gaps is so acute and widespread that Coalition 21 has had to expand beyond the size that was originally envisioned, Ventriss says. She and Leddy had wanted to cap the group at 13 members, Ventriss notes.