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Several years ago Vermont declined to pursue a single payer model for health care because it was too expensive.

 

Since then, the price of an individual plan on the exchange doubled.

 

More people are underinsured.

 

Despite year after year double digit increases in premiums, Blue Cross Blue Shield has lost money in five of the last six years.

 

VT hospital costs are increasing faster than inflation, and faster than hospital costs nationally.

 

These high costs are squeezing out primary care, including the preventative care needed to keep people out of higher costs hospitals in the first place.

 

These higher costs are baked into every budget, from the state to your kitchen table. 

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At this point, the high costs are not keeping people healthier nor reducing wait times, especially in rural areas.

 

We also can’t afford them.

 

Increases in health care and mental health costs in the education fund account for about 10 cents of the increase in this year’s average tax rate.

 

Despite high spending, our current system doesn’t work for hospitals either.

 

In FY23, 9 of our 14 hospitals operated in the red. 

 

We did some very good work last session, work that sets us up for action in the coming biennium. 

 

This includes the hospital sustainability planning work in Act 167.

 

In addition:  

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Just as we need to rethink what we can afford in our public education system, we need to look at the structure of our hospital system, to ensure all communities- including rural areas-  have access to essential care, but just as importantly, to make sure that we are not paying for too much infrastructure and capacity in a way that drives higher cost and worse care.

 

We need to address documented overuse and  “avoidable cost” in health care.

 

By some estimates, 10-30% of hospital care for which we pay is unnecessary or avoidable.  By avoiding those costs, we free resources for community-based care, primary care and mental health– all investments that bring down overall cost.

 

These systems reduce demand on more expensive hospital services. 

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We need insist on health care reform, to ensure access to a public option, use reference pricing to return some accountability to hospital pricing, 

 

We can strengthen our primary care system and expand and connect our local community care coordinators, to ensure people have access to the care they need to stay healthy and avoid more expensive care.

 

Making these changes sets the table for conversations on how to move off our failed experience with the all payer model.