By Deb Richter

Co-chair of Vermont Health Care for All

Jan. 20, 2011

William Hsiao’s report Wednesday, Jan. 19, was an historic moment. It’s historic because it proposes, as it was asked to do, to create a health care system. If the Vermont Legislature acts on this report as it should, Vermont will be the first state in the nation to have a genuine health care system. No other state has a coordinated system. Without the kind of coordinated system Dr. Hsiao proposes in Options 1 and 3 of his report, there is no hope for control of our health care costs.

Every country that delivers health care at far less cost than we do depends on a coordinated system. They depend on a system to see that everyone gets needed health care, to provide management of overall costs, to see to it that health care is adequately but fairly financed, and above all to solve ongoing problems. Problems are bound to arise. Health care is a dynamic area. Populations grow older or younger, new technologies are introduced, new patterns of treatment evolve – all which impact and stress areas of health care.

Some of the best health care systems, such as France’s, Sweden’s, Germany’s, Canada’s, Switzerland’s, are not today the same as they were 20 or 30 years ago. And that’s because as systems they have had to adapt and change to new dynamics, new demands and stresses as time passes.

Dr. Hsiao’s report is a pioneering effort. Comments will flood in calling attention to this or that weakness in the report’s proposals. Some will be valid criticisms. We have some of our own that we will post after careful study. Some will be disguised attempts to block reform. But the thing to keep in mind is this: The first step is to create a system and that is the foundation of  Dr. Hsiao’s report. Without a system, none of the pros and cons, no matter how trivial or how ambitious, will work to the Vermont public’s benefit.