This commentary is by Ellen Oxfeld of Middlebury, a board member of Vermont Health Care for All.

In the past few weeks, the mess of Vermont’s health care situation has been abundantly documented by numerous commentators to this publication. Even members of the Green Mountain Care Board recently questioned executives from OneCare, asking them to show results to justify their high administrative costs, much of it funded by public dollars.

Commentators agree that Vermonters cannot get the care they need. One reason is high out-of-pocket costs, which now leave 44% of Vermonters under age 65 underinsured.

There is also agreement that high prices, and not patient overuse, ail our system. How could people overuse a system they cannot even access?

Indeed, many commentators also note that the only place in our current system that is overused is the emergency room — because people either do not have a primary care physician or because costs caused them to delay care until their condition became more critical.

But what is the solution to this problem? continue reading