Health Care for All

AS A SPECIALIST IN INTERNAL MEDICINE, DR. HOWard Dean knows that the quality of care soars when patient and physician trust each other. As Governor of Vermont -- and the only Governor in the Union who is a doctor -- Dean also knows that trust has to be earned. So the Governor knew he had his work cut out for him when he set out to persuade insurance companies, physicians and increasingly savvy medical consumers all to agree on a health-care reform plan. Last week Dean succeeded. With the blessings of the state legislature, the Vermont Medical Society, and Blue Cross and Blue Shield of Vermont, the Governor signed a bill that will guarantee basic medical treatment to all Vermonters by 1995. In doing so, he made Vermont one of the few states to break the deadlock on health-care reform.

The plan calls for the establishment of a new Health Care Authority, which will consolidate the work now being done by several different agencies. Any savings that result from cutting overhead will be used to help finance coverage for the poor. In addition, the three-member panel will negotiate prices with the state's doctors and hospitals and try to contain costs by limiting the number of expensive specialty procedures.

Poor mothers and their children will be the first to benefit. In addition, the Health Care Authority has two years to develop two different proposals for implementing and paying for the state's universal coverage. Under one plan, a select group of insurers would negotiate for the state's business. Under the other, Vermont would adopt a Canadian-style health-care program in which the state acts as its own insurer.