Editor’s note: This commentary is by Michelle O’Donnell, of Burlington, a universal health care advocate and a member of the Vermont Workers Center.

Last July, I packed into a room in Montpelier City Hall for the Green Mountain Care Board hearing, where they would decide whether to approve a requested rate increase from Blue Cross Blue Shield and MVP. After listening to hours of moving testimony of people directly affected by high health insurance costs, board Chair Kevin Mullin said, “We acknowledge these rates are unaffordable, but at the same time we can’t put a company out of business.” 

It was a moment of shocking and rare honesty. In saying that, he admitted the true motive of our current health care system: profit. It’s this motive that led the GMCB to approve an almost 50% increase over six years in BCBS insurance rates despite stagnant wages. It’s this motive that leads the GMCB to continue to support the failing OneCare. It’s this motive that lands us with an all-payer system, where the incentive to provide care is still profit. 

Last week, Vermont’s State Auditor Doug Hoffer came out with a scathing report on OneCare. They have been around for almost five years, and the Green Mountain Care Board “doesn’t have enough data currently to know whether Vermont’s health care experiment is working well,” according to Hoffer. We have known well before this audit that the all-payer experiment is failing, just by looking around at our families and neighbors who are still dying because they aren’t getting the care they need.

We need a health care system that’s motive is not securing profit but securing human rights and dignity for all. To create an affordable and accessible health care system, half measures and reform will not work. Health care should be treated as a public good, not an opportunity for private businesses and the heads of nonprofits to make millions. We need the universal, public health care system laid out in Act 48, which was passed by the Legislature in 2011 after years of pressure from grassroots organizers. 

The truth is that in order to implement Act 48, it will mean shifting the burden of paying for health care from poor and working class people onto wealthy Vermonters. If the Covid-19 crisis has taught us anything, it’s that health insurance should not be tied to employment or income, and unequal access to health care harms all of us, but most deeply those affected by racism, transphobia, and other forms of oppression and state violence.

The lawmakers in Vermont, by not enacting Act 48, have shown that they value their wealthy donors and for some of them, their personal wealth, over the health and human rights of the rest of us. They have a moral obligation to fight for a better system, because health care is a human right.