Health Care Predictions False

March 24, 2012

Rutland Herald

Over the last several months Wendy Wilton has garnered a lot of attention with her “Model of Green Mountain Care.” She often shares the table with prominent Republican leaders including Randy Brock. I think it is time we look at her numbers closely and share her errors with the public.

Reviewing Wendy Wilton’s projections shows that a number of her facts and assumptions are inappropriate, misleading and sometimes simply wrong. It seems she entered her project with a preconceived conclusion and conjured up the numbers to support her premise.

The major premise of her manifesto is to build a cost model of Green Mountain Care.

A prudent person would choose a model that represents the structure and key aspects of the selected subject.

Ms. Wilton gives the financial details of her “model” on page 3 of her paper. Under the heading “Expenses of the Green Mountain Care Fund” you can see that she chooses “Rate basis: 2011 Catamount-MVP”. Let us be clear, this is an MVP traditional insurance policy. MVP is an out-of-state insurance company. Its cost and structure is not representative, let alone a model, of Act 48, Green Mountain Care.

Green Mountain Care is Vermont self-insuring its people, eliminating the traditional insurance company costs and waste, replicating the savings that many large companies enjoy when they self-insure. Example IBM, GE and the like. In addition Green Mountain Care is striving to be a single-payer, again to let the health care providers, both hospitals and doctors, streamline their administrative costs by eliminating the unnecessary paperwork dealing with multiple insurance companies and the divergent rules and processes that must be complied with to get paid.

The fact that Ms. Wilton’s does not model to costs of a self-insurance program or one of the many true single-payer systems but chooses the added expenses of an out-of-state insurance company, makes her claim that she is modeling Green Mountain Care false.

Beyond this gross misrepresentation, Ms. Wilton chooses the MVP insurance cost over the less expensive, but identical, Vermont Blue Cross Catamount policy found on the same web page. The MVP costs are 12 percent higher than the Vermont Blue Cross policy, another “error.”

There are several more similar “errors” in most of the remaining elements of her “model,” all adding costs, making her prediction of Green Mountain Care seem more and more expensive. A thoughtful person would conclude Ms. Wilton model a fiction, a horror story, to scare most of us who do not have the time to really understand the complexities of health insurance reform.

Most Vermonters want to improve our health care system in both cost and quality. We want Green Mountain Care to get it right. It is important that responsible people give Vermonters the facts, the best information so we can make the best-informed decisions.