What’s Next For Health Care Reform in Vermont

Governor Shumlin’s recent decision to shelve plans to move forward with Universal Health Care surprised many in the Health Care Policy world.

In light of this, here at VPIRG we are still determined and dedicated to bringing health care reform to Vermonters. Click here to read a recent VTDigger Op-Ed written by VPIRG’s own Falko Schilling unpacking our thoughts and analyzing the administration’s decision.

But there is much we can still do this Legislative session. Here are Falko Schilling’s thoughts on the important work ahead:

After the Governor’s announcement that this is not the time to move forward with Green Mountain Care, those of us fighting for universal coverage had to take some time to step back, look at the landscape and reassess how we can continue to improve our broken health care system.

Publicly financed, universal health care is a big, audacious and necessary goal, and there is a lot of work we can do now to get us there. Moving forward there are at least three areas where our work can lay the groundwork for bolder reforms in the future.  We need to increase consumer voices in during reform, reduce out of control health care costs, and make Vermont’s health care system more transparent. If we can address these issues we will make big strides towards a system that works better for all of us.

To create a system that best represents the needs of everyday Vermonters we must ensure consumers have a meaningful voice in the reform process. Having spent the last three years working on health care reform I can say that the voices of everyday Vermonters can have a meaningful impact on the reform. Our decision makers want and need to hear from consumers because the more we talk about health care in theory, the further we get from the personal experiences of Vermonters who need to get care every single day. Over the coming months and years there are a number of areas where we will need to help bring consumer voices to the reform process. From pushing back on rising insurance rates, to sharing stories about affordability and access, we will need to voices of consumers to ensure health care reform is successful at addressing the needs of all Vermonters.

One thing that is clear to everyone paying attention is that our system costs too much, and those costs are only going up. If we want to slow the alarming growth in health care costs we need to ensure our system starts paying for quality not quantity. For far too long our health care system has been based on financial incentives that reward providers for the volume of the services that they provide, not the value to patients. Vermont has been on the leading edge of changing that paradigm.  As we develop innovative payment models, such as global budgets and accountable care organizations, we have an amazing opportunity to provide lessons for the rest of the nation.

Another way that we can help make our health care system more affordable is by reducing the cost shift that makes coverage more expensive for Vermonters that purchase insurance. Public programs like Medicare and Medicaid provide essential coverage for thousands of Vermonters, yet what these programs pay providers has not kept pace with actual costs. What this means is that Vermonters who purchase commercial insurance end up paying more to make up for the shortfall from public programs, this is often called “the cost shift”. By increasing the state’s investment in these programs we will be able to significantly reduce this cost shift, and drive down the cost of premiums for all Vermonters buying coverage.

Finally, for reform to be successful we need to make our health care system more transparent. Our current system is complex, confusing, and too often keeps Vermonters in the dark about the true costs of care. Different from almost every other consumer transaction, consumers have no idea what their health care services will cost them until they get the bill.  The state has the tools to make this information available, and we need to make sure that consumers have the information they need to make informed decisions about their health care.

Consumers are also largely keep in the dark about the many reform efforts that are being undertaken on their behalf. This is not intentional, and all these efforts are aimed at improving costs, quality and overall experience. It will be the job of advocates and decision makers to pull back the curtain on the many initiatives to improve our health care system. The better Vermonters understand our current system they more they will be able to engage and shape a system that will better serve all of us.