Improving Vermont Health Care

INTRO: A good manager routinely sets a goal and then analyzes which alternative best meets that goal. Commentator Rick Hubbard thinks our Vermont political leaders should use this approach to improve delivery of our health care.


Most of us would agree that the overall goal of health policy in Vermont should be to deliver quality health care to all Vermonters at the least cost.

Although little discussed to date, there are now at least two ways to reach that goal.

Currently, Vermont spends two point two billion dollars a year on health care. Our present competitive health insurance approach leaves over fifty thousand Vermonters without any insurance, ninety thousand more without adequate insurance, and leaves our government paying when low income Vermonters cannot afford insurance. Moreover, current administrative costs are astronomical. Over the last 30 years, the number of health administrators have increased nationally by almost 2,500 percent, the bulk of this over just the last decade of managed care.   By comparison, the number of doctors and nurses increased by only 160 percent.

Recently, our legislature commissioned a major study of health care in Vermont by the Lewin Group, a nationally respected consulting company. It concluded that channeling the same two point two billion dollars through a single money collecting and bill paying system is much more efficient. With this approach, every one of us would receive quality health care, privately provided by doctors, while still saving over $100 million dollars. In addition to dramatically increasing health care, these annual savings are the equivalent of almost five hundred dollars for every family in Vermont, a benefit for everyone, whether moderate, liberal or conservative.

This study provides us with a wonderful opportunity to debate whether our present competitive insurance approach or the more efficient alternative recommended by the Lewin Group, or still some other alternative, best meets the goal of delivering quality health care to all Vermonters at the least cost.

Most of us can’t, or won’t, decide which approach is best until we’ve had the opportunity to learn about and thoroughly debate alternatives, question underlying assumptions, and become familiar with the pros and cons of different approaches.

This coming Saturday at noon, busloads of Vermonters from all over the state are joining Dr. Deb Richter and a coalition of Vermont health professionals at a large rally on the statehouse lawn in Montpelier. Its purpose is to discuss health care and encourage our political leaders to begin an open, extensive debate about which alternative will best improve health care in Vermont. Information about the Lewin Report will be available.

For my part, I say: “let the debate begin.” I’m for the alternative that provides quality health care to all Vermonters at the least cost. Bring your best arguments to the table. We all stand to benefit.

This is Rick Hubbard from South Burlington, Vermont.