Editor’s note: This commentary is by Patrick Flood, the former commissioner of the Department of Mental Health and the Department of Disabilities, Aging and Independent Living, and former deputy secretary of the Agency of Human Services. He is now retired and lives in Woodbury.

The health care reform debacle continues and is only getting worse. Recently OneCare Vermont presented its 2021 budget to the Green Mountain Care Board. Unbelievably, OneCare is proposing 2% “cost of living” increases for its staff, plus other administrative increases totaling over $1.4 million. When unemployment in Vermont is over 7%, and many Vermonters have lost their health insurance and the whole economy is reeling, what can justify such an increase? What bubble are the leaders of OneCare living in?

Could it be because OneCare has done such a great job and saved Vermonters so much money? Just the opposite. Recently, OneCare did a presentation on their finances for 2019. (Let’s overlook the shocking fact that Vermonters didn’t know for 11 months what the initiative cost in 2019.) OneCare reported losing (being over budget) in the Medicaid program by $13.5 million. They reported being over budget for the Blue Cross/Blue Shield part of their budget by $6.5 million. They reported saving $11 million in the Medicare program, but in reality, the actual savings are no more than $4.8 million because the balance was spent on OneCare programs and thus cannot be considered savings. Add up the losses, subtract the savings, and add in the administrative cost of $15.4 million for 2019 and the stark reality is that OneCare cost Vermonters a net $30.6 million. At the same time, OneCare is cutting community programs designed to improve care by $6 million. This performance is worthy of raises? What happened to “value-based payments”? Supposedly hospitals and other providers are “at risk” and if they perform poorly, they face a fiscal penalty. Why does this not apply to OneCare?

This initiative is failing badly. It is time for a whole new approach, which I address at the end of this commentary. Continue at site