I agree with much, but not all, of Emerson Lynn’s June 8 column “Gov to lead on health care? Deal with GMCB first.” I disagree with this. The Green Mountain Care Board (GMCB) is only carrying out its assigned mission handed down by the legislature and our governor. For the record, I am on the advisory committee of the Green Mountain Care Board (GMCB). I have watched them juggle so many competing interests, none of them easy and always painful to some, while grappling with this ACO and its so-called “value-based” care.
Without the GMCB our health care predicament would be far worse.
I have also been an activist for single-payer healthcare for many years. I was involved with the creation of the GMCB and in passing Vermont’s historic Act 48. I have also worked on this issue in other states. The prime lesson I have learned here is how our government, federal and state, functions with top down leadership. Like in an army or a corporation, ideas leadership doesn’t like go nowhere, even though the rank and file sup- port them. So I agree with Mr. Lynn’s assertion that the Governor needs to lead on health care.
Unfortunately, leadership’s current commitment to the ACO concept merely avoids the real, and politically painful, work that needs to be done to fix our mess of a health care debacle.
The leadership we need is away from the ACO. After all these years and millions fed to it the ACO has done nothing for a single Vermonter. It has not lowered our scandalous costs by a single dime. Vermonters paid $6.5 billion a year in 2019, before COVID, which is about $10,000 per person. BCBS and MVP are again requesting rate increases that exceed any pay raises Vermonters will ever get to cover these costs and I’m sure that hospitals will want fee increases too.
At bottom, the problem is that we run our health care as a business. Patients are the source of revenue and profit. OneCare’s value-based care won’t change this and wasn’t meant to. This business model that pumps patients for profits must become history.
During COVID Governor Scott showed great moral and political courage in bucking the general Republican trend of seeing who could inflict the most cruelty on vulnerable citizens. This seems to have made Governor Scott a pariah in a demented Republican party. But the only way to fix our costly and deadly health- care nightmare is for Governor Scott to bring that same courage to the health care debate.