Despite election, health pros stay the course

November 23, 2014

Rutland Herald

By Patrick McArdle
STAFF WRITER | November 23,2014

A close gubernatorial election raised questions about support for Gov. Peter Shumlin’s proposed single-payer system and the future of health care in Vermont — but those working in the industry say their goals haven’t changed.

Bea Grause, president of the Vermont Association of Hospitals and Health Systems, said her members have priorities other than just how to pay for health care.

“I think single payer is a strategy to try to achieve the triple aim, what we call our principles, which is to lower costs, make sure we work toward universal coverage and that patients have a choice of their doctor and hospital,” Grause said. “… Single payer could be a strategy to try to reach those goals but it’s not the goal in and of itself.”

Thomas Huebner, president of Rutland Regional Medical Center, said he didn’t think the election results would blunt the efforts to change health care in Vermont. He said it would be riskier to try to maintain the status quo than to try to improve the health care system in the state.

“It is an uncertain moment, there’s no doubt about it,” Huebner said. “But frankly, we’ve been faced with an uncertain moment for the last two or three years because although there’s been a broad direction, the details end up being, of course, enormously important.”

Thomas Dee, president of Southwestern Vermont Health Care, said the health care system in Vermont is “still moving down the river toward change” which will involve, at least, basing compensation on healthier patients and better outcomes.

“Even though there’s a major question at this point about moving toward this model of single payer, what is not in question, I believe, is that the current fee-for-service system that we’re operating under is going to be changing over the next few years,” he said.

Kevin Robinson, a spokesman for Southwestern Vermont Medical Center in Bennington, said it would probably be a mistake to believe single payer was a “done deal” anyway since the details of the proposal have not yet been presented.

Uncertainty about the future of health care makes planning difficult, said Claudio Fort, president of North Country Hospital in Newport.

“The tenet of health care that doctors go by is, ‘First, do no harm,’” Fort said. “We’ve got a pretty good health care system as far as all these things — cost, access and quality — already in place. We can do better. We need to do better. But whatever system we go to, what do we put in place in the interim to help physicians and doctors transition to a different way of organizing care and a different way of getting paid in care?”

Al Gobeille, chairman of the Green Mountain Care Board, which oversees health care in Vermont, said the results of the election will not change the board’s goal of making health care more affordable.

But he said he was sympathetic to those in the industry who don’t know what’s coming next.

“This has kind of been the issue for four years,” Gobeille said. “The governor said he’s going to bring a financing plan (for single payer) in January. I would think that would be the big moment where the Legislature has to decide what we’re doing. … Certainty, to me, is needed at this point and I hope that we’ll have that in the first few months of the coming year.”

Grause, of the hospitals, group said she hopes the Nov. 4 vote won’t cause political leaders to walk away from the challenge.

“Frankly, if fixing health care was easy, we would have done it already,” she said. “Part of the stress around it is that some people think we’re going too fast, other people think it’s going too slow or that maybe we should wait five or 10 years and let the market take care of what they perceive to be the problem. In my opinion, we need to continue to stay focused on the goals and stay focused on payment reform and keep moving forward. I think that’s imperative.”

Fort at North Country Hospital said many in health care are trying to keep their focus where it belongs.

“I’m trying to be engaged in the debate and what’s going on and make sure we have a voice,” he said, “but at the end of the day, I’m just trying to keep a small, rural hospital going and keep these services in place for our community.”