(January, 2002) In his state of the state address last January (2001), Governor Dean announced the formation of a Governor’s Bi-Partisan Commission on Health Care Availability and Affordability to be chaired by Con Hogan, his former Agency of Human Services Secretary. I was selected by the Speaker to be one of two House members on the Commission.

Since February, the Commission met every two weeks, received about 200 written comments and held meetings with various interested parties. I was impressed with the knowledge, skills and dedication each member of the Commission brought to this critical assignment. A final report was prepared for the Governor in November.

There were several sections of the report I endorsed. The recommendations designed to reduce wasteful administrative costs, improve consumer education, and establish best treatment protocols are all worthy goals to pursue. However, in my minority report to the Commission, I pointed out their failure to acknowledge some of the underlying reasons for the problems facing Vermont’s health care system, and their lack of real solutions to our problems.

In my opinion, there are two major problems facing Vermont’s health care system today:

1. The insurance market is increasingly unaffordable for Vermont businesses and individuals. This is now the third year in a row where policyholders have faced double-digit premium increases.

2. Vermont cannot afford its Medicaid program which offers state coverage to low income Vermonters. The Medicaid financial deficit will be $34.8 million in FY’03 and will grow to $306 million in FY08 unless substantial changes are made.

Our health care affordability crisis is the direct results of public policies that have: (1) imposed regulatory burdens on the health insurance market without adequate consideration for their effect on the affordability of premiums; and (2) expanded the Medicaid program to over 20% of Vermonters without the application of appropriate cost containment strategies.

We need aggressive and effective responses to correct these mistakes and I hope bills that I’ve introduced on these issues will frame the discussion focus this session.

I also served on the Commission on Tobacco, Alcohol and Substance Abuse Addiction. “The commission’s purpose was to make recommendations for the development of a coordinated, effective, and adequately funded system for preventing tobacco, alcohol and substance abuse addiction, and treating such addictions, when they occur, in a humane, caring and effective manner.”

We met seven times and heard from many people who represented various sectors of society. The most compelling testimony was from our youth as they described their experiences with substance abuse. The problem is getting worst and no school is immune. It was a reality check because the major school infractions when I went to school were gum chewing and not wearing a tie. Today, 4% of our 8th to 12th graders have used heroin. I also spoke privately with parents and listened to there trying experiences.

An undercover policeman described how widespread drug problems are in our state and what he faces daily combating them. A judge also shared his experiences about the number of young repeat offenders he faces. Treatment is the answer and many of our youth are crying for help but succumb to continued addiction because facilities and after care support are lacking.

I think the final report of the Commission on Tobacco, Alcohol and Substance Abuse Addiction addressed the system’s weaknesses and focused on improving efficiency, coordination, cost saving and achieve the maximum return on dollars spent. However, I do not agree that the tobacco prevention money, awarded to the state from the class action suit against the tobacco companies, should be preserved for tobacco prevention and not shared for substance abuse, prevention, and cessation and rehabilitation initiatives.

I believe it’s vital that we have an effective prevention and intervention program. It’s also clear to me that addiction includes tobacco since testimony to the commission indicated it’s the gateway to drug usage with our youth. Though tobacco has terrible health consequences, alcohol and substance abuse are far more devastating to Vermonters whose rehabilitation is vital because many are young and in crisis.

I will work to implement the recommendations of the report but I will also want to use the tobacco settlement money as a funding source to meet the substance abuse crisis needs of our youth. I will also work to assure that these programs are cost efficient, coordinated with other addiction programs and have measurable goals to determine effectiveness.

Thanksgiving week I shared a meal with residents at a wilderness camp for youth in Bensen. Most of the teenagers are under SRS auspices and classified as “troubled or unmanageable youth”. The program at the school is intense and lasts at least a year. The teenagers live outside in tents (even in the winter), are self-sustaining and counselors are present 24/7 to address their needs. The kids put on some skits after dinner and then spoke from the heart on what the camp meant to them. A few were going to go home for Thanksgiving Day and were fearful of what to expect. It was heartening to hear their new goals and I was told the rehabilitation success rate of the camp is over 90%.

Thank you for your calls and notes. I can be reached at 658-3975 (home), 228-2228 (State House) and via e-mail at:
Rep. Frank Mazur
South Burlington