Editorial: The harm caused by excess

News last week that the Vermont Department of Health Care Access (DVHA) has incurred excesses in its $2.8 million media campaign promoting Vermont Health Care Connect should prompt the Shumlin administration to scrutinize the media firm’s accounting and make appropriate adjustments.
In stories last week, the charges logged by Washington, D.C.-based public relations firm GMMB that seemed most outrageous were paying $18,235 for a brief analysis of media coverage of Vermont Health Connect, $8,600 for a contact list of about a dozen reporters from various media, and setting aside $12,600 to schedule meetings between editorial boards and Vermont Health Care Connect officials. Not included in that $12,600 fee were the talking points, supporting materials or managing the calendar for those meetings, which cost an additional $49,000. All told, about half million dollars was spent on the “earned media” part of a much larger allocation. In a small state where most statewide public relations firms know key media players first-hand, that part of the firm’s contract was not a good return on investment.
The harm done is that such excess creates a deeper public cynicism about the plan’s value and the state’s ability to run it efficiently. That’s why the administration should review the charges and offer a remedy if these particular line items — amounting to a chunk of the multi-million dollar media campaign allocated from the federal government — are found to be inappropriate.
So far the governor has sidestepped responsibility because, as he says, the contract was pursued and signed by the DVHA, independent of the governor’s office. But the buck stops with the governor, and it’s he and his team who should step into the fray and pressure GMMB for a better value for the money spent.
Meanwhile, what the public should acknowledge is that the effort does require a sizeable campaign to make all Vermonters informed of the new health care policy — and that’s no easy task. The state law mandates that 100,000 Vermonters buy health care insurance on the exchange over the next three months. As of last Tuesday, about 631 people had signed up, and according to one poll, of the 43 percent of Vermonters who had heard of Vermont Health Connect only half of them actually knew what it was.
Those numbers seem low. By now, the business community is supposed to have informed all of their employees of the impending changes in the health care law and started the process of determining how to proceed. What does seem plausible, is that while many Vermonters have heard of the impending changes, they may not recognize the name (Vermont Health Connect) and it is quite certain that most don’t know which plan they will choose and whether they will be insured through their business or individually through the exchange. We are all early in that process, and it’s not surprising that only a few have signed on.
It is precisely because the state is in the beginnings of its sign-up phase, that the public needs to have confidence in the state’s ability to run the program effectively and efficiently. Currently, such confidence is lacking.
Things did not go well in this first month. The online system has not preformed well, and many have been frustrated trying to buy insurance on their own. But anyone who works with computer systems understands that even the simplest of tasks can be hard to program effectively and can take months to get right or make adjustments. It is a frustrating part of modern life.
Trying to create an entirely new health care system online was bound to have some setbacks and kinks to work out.
That said, the state departments in charge and the Shumlin administration need to change their tone from being overly Pollyannish to leveling with the public about the challenges ahead. First, that the cost savings may not be as great as they had projected with what is a hybrid system, and secondly, that the signup might be more convoluted than imagined. It is not as simple as 1-2-3. Folks will need to focus on the process, get help from family, friends and navigators, and be prepared to spend several hours weighing the options and making the best choices for themselves and their family.
That’s OK. Change is needed, and no one — except those eager to proclaim failure — was expecting a flawless transition. But what the state needs now is frankness from its leadership and the assurance that excesses will be exposed and corrected along the way until the system serves the public as intended.
Angelo S. Lynn

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