Health care report ignores big questions

by Pat McDonald

As Gov. Shumlin and the Demo­cratic leadership of the Ver­mont Legislature continue their efforts to transform our state’s health care system into a centrally planned and government-managed sys­tem, it has become clear that they would like us to focus exclusively on the potential upsides of their new sys­tem while ignoring the downsides.

We all agree that health care costs are unsustainable and that something needs to be done to bend the cost curve. Bending that curve will require government to make smart and rational decisions, and be cognizant of the impacts those decisions will have on health care consumers and providers and Vermont’s employers.

In response to a 2011 legislative mandate, the Legislature’s joint fiscal office and the Department of Banking, Insurance, Securities and Health Care Administration recently issued a report that focused on the cost of Vermont’s health care system, and the potential savings that might accrue from the proposed system. The report estimates that under a single-payer system, Vermont could reduce health care expenditures by nearly $2 billion by 2020.

The most stunning aspect of the report, however, is what it ignores: There is no mention of how to fund such a system, and there is no discussion of how this system will affect Vermonters, Vermont businesses and Vermont’s network of health care providers.

Curiously, the report also includes savings that the state was already hoping to achieve from the Blueprint for Health Chronic Care Initiative. Those “Blueprint savings” should be in our health care spending baseline, and not counted as “single payer savings.

Furthermore, no information is provided regarding coverage: that is, what medical and pharmaceutical benefits will be covered under the system, and what benefits will not be covered. For example, will there be limits on the quantity of services Vermonters receive, such as an annual maximum number of visits to a physical therapist? What portion of the cost of care must be paid by the patient? How will Vermonters access care from providers whose services are not covered under the new system, and how will we access care at out-of-state health care facilities?

Pat McDonald is the Chairperson of the Vermont GOP