Ways to control health care costs

April 17, 2012

Brattleboro Reformer

I am proud to support Vermont’s health care reform movement.

Even former Governor Douglas said he was in favor of universal access; and he also introduced Vermont’s Blue Print for Health and Medical Home model for chronic care. These models of care have already improved health care and reduced hospitalizations and costs.

The Shumlin administration is determined that Vermont’s health care (an eventual single payer plan) will succeed. He asserted in a March 26 VPR interview with Bob Kinzel that the plan will still be viable if the US Supreme Court overturns the 2010 Federal Affordable Care Act, because Vermont is already paying the entire bill for a "broken’ system." He said, "Our system of reform is not dependent on federal subsidies."

Also interviewed was Anya Rader Wallack, chair of the Green Mountain Care Board. She said that if the court overturns only the Federal mandate to buy health insurance but not the entire bill, Vermonters and businesses will still be eligible to receive several hundred million dollars in tax credits, which would make it easier for Vermont to slow the projected rate of increase in health care costs and fund its insurance program. (The GMCB is also studying several payment reform plans.)

Governor Shumlin and governors in other states recognize that the unsustainable growth of health care costs threatens not only their states but the entire national economy. They know that 2010 Affordable Care Act is not expected to significantly slow the cost growth curve in health care costs.
Here are some additional ways to control costs that are under consideration:
-- Payment reform: instead of fee-for service, using bundled payments, etc.
-- Increase in number of primary care physicians and fewer specialists, so the ratio approaches 50:50, used in most SP countries. This can lower costs and improve health outcomes.
-- Organize medical care into Accountable Care Organizations and Medical Homes to improve efficiency of resources and quality.
-- Avoid unnecessary tests, procedures and hospitalizations.
-- Reforms in postgraduate medical education.
-- Administrative cost reduction through single payer model.
-- Use of budgets rather than entitlements so that basic care is assured and extravagance during economic austerity is denied.

National reform remains needlessly costly and incomplete. Millions of our neediest will fall through the cracks. I believe that if Vermont succeeds, it will be an important role model for the nation. We are being closely watched.

Margaret Newton,
Brattleboro, April 13