Matt Dunne, Burlington Free Press
A year ago we had great hopes for serious health care reform on the national level. However, it’s becoming more clear, especially after the election in Massachusetts, that we cannot count on Washington to do the job we need to do ourselves here in Vermont — transform our health care system.
Let’s face it. Health care costs are driving most of the financial problems in our state.
Over the last two decades, Vermont has tried a variety of small changes here and there to solve the looming health care crisis. It is now clear that they have failed, and in some cases have made things worse, as we have subsidized more people’s care without effectively addressing the core cost drivers.
The Vermont Legislature is now facing a horrible decision: Will we stop serving our citizens or will we cause even more cost shifting for hospitals by cutting reimbursements below what it costs to perform a procedure? If we raise taxes today to cover the deficit caused by health care costs and do nothing to change our system, we will find ourselves in exactly the same situation next year.
Instead, we can do what large businesses do and self-insure Vermonters under one system to increase our buying power, reduce administrative costs, and guarantee that everyone pays and everyone is covered. The fact is that some large companies employ and cover nearly as many people as we have living in Vermont.
When I was the head of AmeriCorps*VISTA, I self-insured all 6,000 people working for me, not because it was the right thing to do … but because it saved money. We then used those resources to achieve our core mission.
With one large pool, the state will then have the buying power to change the way we reimburse for medical care — rewarding doctors, hospitals and citizens for prioritizing health care activities that lead to good health outcomes, rather than paying per procedure. Hospitals like the Cleveland Clinic and the Mayo Clinic have demonstrated that better care can come at dramatically lower cost. We can bring these demonstration projects to scale.
When I was in the Senate, I proposed adopting an electronic health care record system similar to what VA hospitals have been using for years. We successfully created VITL organization, but unfortunately, four years later and despite financial support from Sen. Patrick Leahy, the administration has not finished the job. This system would allow hospitals to share information with each other. This will allow us to measure the effectiveness of our health care providers, reduce medical errors, and help prevent expensive and unnecessary mistakes.
If mechanisms are not found to cut the ever-spiraling costs of medical procedures, prescriptions drugs and hospital visits, our towns will continue to run deficits to devastating effect. Vermonters will continue to go bankrupt. Our business growth will be stifled, prolonging the recession. Taxpayers will be saddled with huge tax increases. Our hospitals and doctors will be focused on uncertain revenues and paperwork, not making people well. And our ailing friends, neighbors and relatives will continue to suffer because they cannot afford, nor will they seek out, even the most basic health care.
Now is the time for Vermont to use its scale, sense of community and our in-state expertise to lead the nation in health care reform. As urgent as it is, such a change will not happen overnight. The Legislature must take steps now, like initiating a statewide hospital budget, so we can start to achieve real cost-containment in the near future. Vermonters must let our elected officials know that change must start this year and demand real leadership on this issue for the future. We cannot wait any longer.
Matt Dunne of Hartland is a Democratic candidate for governor.