While all eyes are on the federal government activity to overhaul health care, here are a few bills recently signed into law in our state:

REFORMING HEALTH CARE:  H.444 was signed into law on June 2nd as Act 61.  This is a 124 page omnibus bill which positions Vermont to receive ARRA (federal stimulus) money for health information technology.  A partial list of features of this bill is as follows: 1) allows farmers and self-employed people to use depreciation as an allowable business expense for reporting income; 2) people who have lost their insurance no longer have to wait twelve months for state-sponsored insurance; 3) asks providers to develop recommendations to coordinate treatment of stroke patients in Vermont;  4)  sets up a pilot program to provide vaccines at no cost;  5) bans the use of the flame retardant known as “Deca” which has been found, ironically, to be highly toxic when it burns.

PRESCRIPTION DRUG MARKETING:  S.48 was signed into law on June 8th as Act 59.  One of the great contributors to rising health care expenses is the cost of prescription drugs.  Alarmingly, one-third of every dollar spent on prescription drugs goes into marketing. In 2002, Vermonters spent $377 million on prescription, over-the-counter and nondurable medical supplies.  In 2007, this number grew to $572 million or an average increase of 8.7% per year.

According to the April 2009 report of the Vermont Attorney General’s office, pharmaceutical manufacturers reported spending almost $3 million in Vermont on fees, travel expenses and other direct payments to Vermont physicians, hospitals, and universities for the purpose of marketing their products.  Testimony cited considerable research that shows that marketing does affect prescription practices.

This act attempts to reduce the real or perceived conflict of interest between manufacturers and providers by increasing transparency and placing limits on gifts.  Free samples of prescription drugs resulted in considerable debate in the House.  Free samples have been found to affect physician’s prescribing patterns, however, contrary to popular belief, these samples do not go primarily to low-income patients.  The House bill required manufacturers to report free samples given to providers however a last-minute compromise with the Senate resulted in exempting free samples from disclosure.  It is hoped that these measures will help control costs and improve care.  This bill received support from the Vermont Medical Society, the AARP and the mental health community.

PALLIATIVE CARE:   H.425 was signed into law on May 18th as Act 25.  The purpose of this Act is to improve the quality of life and management of pain for patients facing serious medical conditions.  Palliative care addresses relief from symptoms such as pain, nausea, anxiety, shortness of breath, which may be caused by the underlying disease or by side effects of more aggressive interventions.  It also addresses physical, cognitive, emotional, psychological and spiritual needs, while facilitating patient autonomy, access to information and choice.

This act works toward expanding access to palliative care for children and adults across the state and ensures that Vermonters are aware of their rights and care options through a patient’s “bill of rights.”  In addition, it sets a plan to improve the knowledge and practice of health care professionals with respect to palliative care and pain management.

Feel free to contact me at KLWebb22@mac.com or 985-2789.  I have posted my previous Shelburne News articles on my website.  www.KateWebbVt.com.

It is a sad day for Vermont when the Governor vetoes a budget and calls the Legislature back in session; it is sadder still when the Legislature chooses to override that veto.  While the media and various pundits characterized this as a “Showdown in Montpelier,” this does not accurately reflect the seriousness and grief felt by many that this could not have been worked out through negotiation.

Most of us held out until the last minutes, hoping for an agreement between the administrative and legislative leadership.  The last day, we heard the closest they had come was to postpone some decision-making.  It was time to move forward with the 2010 budget, warts and all, make some corrections with the “Companion Bill” and encourage both leadership teams to begin in earnest to address the challenges in FY2011 and FY2012.

Make no mistake about it.  Both the Governor’s proposal and the Legislature’s budget, cut programs, cut spending, used ARRA (Federal Stimulus) funds, raised some revenues, cut some taxes and looked for savings.  Both budgets were balanced for FY2010 but faced difficulties in FY2011 and more so in FY2012.   The major difference between the budgets had to do with how FY2010 was balanced.  The Legislature left future burden on the General Fund while the Governor left the burden on the Education Fund, i.e. property taxes.

I voted to override the veto.  When I ran for election, I promised many people that I would work for quality education while also containing our distressingly high property taxes.  A vote to sustain the veto would have re-opened the discussion to shift the teachers’ retirement fund to the Education Fund, creating a huge, unfunded, and ongoing cost to property tax payers.  In addition, 216 Shelburne homeowners with incomes between $75,000 and $90,000 would have seen an average property tax increase of $944 with some adding more than $7,000 to their yearly property tax bill. Another spreadsheet comparing the effect of the two different budgets on the 265 towns in Vermont showed Shelburne to be one of the towns to suffer the most under the Governor’s budget.  Testimony from school board members and superintendents across the state expressed strong opposition to this shift. These issue, along with my concern with Administration’s near elimination of the Vermont Housing Conservation Board led me to vote for the override.

After reading the Governor’s budget, however, some valid concerns came to light. First, the Legislature’s attempt to close some capital gains loopholes would be tough on farmers and loggers.  Many of us objected to this so it was corrected in the Companion Bill.  Second, Administration wanted to see tax credits for research and development so this was added for FY 2011.  Third, the Administration raised concern about the lack of accessibility to college scholarships.   The Companion Bill thus transferred $1.5 million out of the Higher Education Trust Fund to the Next Generation Fund, making money available to be split among the Vermont State Colleges, UVM and Vermont Student Assistance Corporation.  Fourth, Administration’s concerns about the nearly bankrupt Unemployment Insurance fund resulted in limitations for the near term and creation of a 12-person study committee to work toward a permanent solution for the future.  These and others measures were built into the Companion Bill which currently awaits the Governor’s signature.

Although an official compromise was not reached, the outcome last week included remedies for those oversights identified by the Governor while keeping the Education Fund transfer and Vermont Housing Conservation Board off the table. I believe it is not good practice for either a governor or a legislature to go it alone.  It is the hope of many of us more moderate Democrats, that sections of the Companion Bill will provide an opening for more collaborative efforts for FY 2011.

I will be around most of the summer and value your input.  I am keeping data on calls and emails I receive.  Do share your concerns with me.  When possible, include your reasons why it is important to you or your suggestions for solution.  KLWebb22@mac.com