This comment is by Patrick Flood of Woodbury. He is a former commissioner of the Vermont Department of Mental Health and the Department of Handicaps, Aging and Independent Life, and former Deputy Secretary of the Social Services Agency.
Due to failed leadership and the erroneous waste of Vermonters money, our health care system is about to collapse. It didn’t need to happen.
Once again, Blue Cross Blue Shield of Vermont requests unaffordable rate increases. This is largely due to the fact that the high cost of care has drained the carrier’s reserves to the point that the organization is on the verge of bankruptcy. If BCBSVT goes bankrupt, our health care system will collapse, because its customers will not be able to obtain care and providers will not be able to receive payments.
We know why it happens and how it could have been avoided. People in charge of the Vermont health system and many public defenders who have special attention, have known for years what is the problem: most of our dollars in health care have gone to hospitals to pay unnecessarily high administrative costs and avoidable care. (Two studies commanded by the Green Mountain Care Board and research by The Vermont Healthcare 911 Coalition have shown this in a conclusive manner.
Meanwhile, primary care, mental health, home health and other care providers have been hungry for funding. The result is that the costs have soaked while access to care has worsened and many doctors’ practices have closed or are faced with the closure.
It is shameful that our leaders have let this train wreck develop in the last decade when we all knew what was the real solution:
- Strengthen primary care so that each vermont has access to a doctor;
- Strengthen mental health services to keep people with stable and emergency mental health problems;
- Strengthen services and health at home to keep people away from the hospital and bring them home earlier when they go; And
- Make sure that there is a long-term care network, including quality nursing homes, to meet the needs of an aging population.
If we had taken these measures, the Vermonters would be healthy and the overall costs would have been lower, in particular hospital expenditure resulting in a lower increase in premiums.
Instead, over the past decade, we have had terribly erroneous initiatives like OneCare Vermont and the “All Payer model”, which has brought to a miserable cost and wasted huge sums of money. Administrative costs for only were About $ 100 million.
Until recently, hospitals have roughly obtained what they asked for by increasing the budget. The only light point was recently monitoring the current Green Mountain Care Board to limit the hospital budgets. Unfortunately, without other daring actions, the efforts of the board of directors can be too late.
So what can we do now? The half-pasts will not cut it. The solution, as I see, has three parts integrated.
First, the GMCB must considerably reduce what hospitals can charge. The Board of Directors may approve different rates for each hospital so that the most responsible for the crisis, mainly UVMMC, can be awarded the biggest reductions.
Such reductions can stabilize the BCBSVT while wider reforms are set up. UVMHN has huge reserves that will allow it to resist such a change for a year or two. A crisis like the current one is the reason why reserves exist; It’s now time to use them.
Second, lower the prices that the Medicaid program pays to UVMMC and use savings to increase the rates that Medicaid pays to primary care, mental health, health at home and nursing homes. This is possible because the state of the Vermont establishes the prices in our Medicaid program. The increase in rates for community service providers would allow these providers to immediately start hiring more staff and provide more prevention services, preventing hospitals and reducing hospital spending.
A study commissioned by the GMCB have shown that up to 30% of hospital spending is “avoidable”, which means that it could have been prevented if alternative services were in place. Even 10% of our total hospital expenses would amount to more than $ 300 million, enough to fully cover the costs of what should be done for primary care and other key services.
Third, start working immediately on a complete health plan on the scale of the state to determine the services we need in each part of the state to have the most efficient and effective health care system. This plan should be in our hands no later than January 1, 2026.
Yes, this means that our hospitals will have to make major changes. But it is much better for Vermonters to adopt a systemic approach to light -eye planning, data focused on, than taking each hospital in their own financial interest.
Rest assured that there is more than enough money in our health care system to provide basic health services to each vermont at an affordable cost. But we waste it preventable in hospitals, mainly at UVMMC. This can be changed quickly to record our system.
Or we can wait and let go of bankruptcy and watch more and more Vermonters abandon their insurance coverage because they can no longer afford it.