Before critics pick apart the Shumlin administration’s health care proposal, Vermonters must step back a few paces and view the issue from afar.
We know the basics: Health care as it is practice today in this country consumes more of our gross national product than any other western country in the world, and our outcomes are often worse; health care costs are increasing by double-digits annually as a percentage — an unsustainable trend; administrative costs are much higher than other nations; and health care insurance companies often put profits ahead of customer service and add extra layers of cost not present in other systems throughout the world. To address those shortcomings, the Shumlin administration has proposed a modified single-payer system with cost containment initiatives — but the 80-page bill proposed on Tuesday obviously does not have all the answers. Rather, it suggests a three-stage process that phases in changes over the next four years.
Phase one is the appointment of a six-member independent board that will be given the task of setting cost containment targets, creating budgets within the health care system, making judgments on health insurance rates, and propose reforms for the way hospitals and the medical community are paid — based on outcomes not fee-for-service procedures. That’s a tall task for a six-member board (with the chairman being a full-time paid position), but getting more than six people to devise a viable system would likely be an even greater challenge — and certainly the full Legislature is better equipped to react to such a complicated proposal than it is to collectively write it.
The simple reality is that Tuesday’s proposal is the first step in arduous climb to surmount this state’s — and the nation’s — health care crisis. That Vermont is the first state in the nation to tackle the task is historic and heroic. Our success will depend on how well legislators and involved parties can keep their eyes focused on the big picture and work together to sort out the details along the way.