We recently learned that the federal government has notified the state of Vermont that the enrollment targets for all-payer model (and thus the Accountable Care Organization, OneCare) are both “unattainable” and “unnecessary.”

This is an entirely new way to set standards. Imagine if a professor or teacher tells her students they need to write three papers, then decides it is unattainable after they fail to turn in the work, and then gives everyone an “A” anyway! We could also tell prospective lawyers they have to pass the bar exam, and then decide passing the bar is unattainable and certify them to practice the legal profession despite this. Should we apply this framework as well to pilots, surgeons, accountants, electricians? We could just keep changing the goalposts when people don’t meet them and declare them competent. Why should we stop with the all-payer model and OneCare?

Or maybe instead, we might conclude that this entire all-payer model, hinging on OneCare and an endlessly changing set of evaluative standards should be disbanded before we waste more time and money. There is no reason that we needed another middleman in our health care system, when we could have pooled our funds on health care for all instead.

Ellen Oxfeld

Middlebury