Dear Editor,
Those seeking fundamental changes to our hospitals and healthcare systems—including us—were not surprised last month when the state’s hospital trade group pushed back against a legislatively mandated report that concluded serious work needs to be done before our entire healthcare system collapses. In fact, the hospitals were so threatened by change that they demanded that the report be retracted and that regulators essentially should just leave them alone.
For the good of Vermonters, our healthcare, and the hospitals themselves, regulators held tight. They defended the report, which was the product of thousands of comments from Vermonters, testimony from hospital leaders, doctors, and other healthcare workers, and careful deliberation from healthcare regulators. In less than a week, when the hospitals were called on their false assertion that the report was based on “faulty data,” they even retracted their demand for a retraction.
And that’s good news, as the report offers an encouraging roadmap for the state to follow in its quest to make healthcare more accessible, affordable, accountable, and equitable.
The report—presented to the Green Mountain Care Board by Dr. Bruce Hamory—paints a bleak picture of the current state of affairs. But it portends a much better healthcare future if we truly want it. As Dr. Hamory puts it, “The platform for healthcare in Vermont has burned and requires rebuilding in a modern form with more sustainable governance and funding methods.” It would be foolish and irresponsible to ignore the existential urgency of his message.
As the leaders of unions representing educators and healthcare workers, we would be foolish and irresponsible not to join the fight for healthcare reform.
In fact, both of our unions—Vermont-NEA and the Vermont Federation of Nurses and Health Professionals/AFT-Vermont—have been leaders in this state’s decades-long fight for systemic healthcare reform. Our combined membership confronts the realities of our broken system daily.
We also know we aren’t the only ones who care about improving the cost and delivery of healthcare to every single Vermonter. More than 3,000 folks from across the state participated in the report’s extensive engagement process, which the Legislature set in motion in 2022. Many spoke about their medical hardships and the financial burdens they lead to and offered ideas on correcting our healthcare system’s deficiencies. Their contributions were solicited and received respectfully.
This report is focused broadly on improving the sustainability and affordability of our healthcare system and strengthening the financial health of our hospitals. This effort entails reducing inefficiencies, lowering costs, improving the health of our population, reducing health inequities, and increasing access to essential medical and care services.
Its key findings suggest that if we—lawmakers, Gov. Phil Scott, healthcare providers, hospitals, and regulators—act now, we can unleash more than $400 million of savings over the next five years, money that can be better used toward healthy outcomes for all of us.
Among the report’s significant findings: “All Vermont communities are facing significant challenges with health care access, equity and affordability.”
There is not a single hospital that is not facing financial jeopardy.
We must transform how our hospital system integrates, coordinates, and delivers care. Doing nothing or tinkering at the edges will only drive commercial premium increases to even higher levels and further compromise the health of Vermonters.
Savings from hospital transformation initiatives are estimated at more than $400 million over the next five years. Imagine what we could achieve if we reinvested a generous portion of these savings to rebuild our primary care, nursing, mental health counseling, therapeutic, and home health capacities and to recruit and retain qualified personnel in these fields.
We must move as much healthcare as possible out of hospitals. Good medical care generally begins near or at home, and it should be provided to the greatest extent by doctors and other clinicians whose treatment protocols are anchored to prevention, care coordination, community access, and trusted, compassionate relationships with patients.
The Green Mountain Care Board should no longer permit further increases in commercial insurance premiums for working Vermonters and their employers to subsidize hospital financial shortfalls.
Additionally, regulators should begin implementing reference-based pricing (RBP) at certain hospitals at 200% of Medicare rates or less starting in 2025.
We pledge to support the Green Mountain Care Board and the Legislature in crafting legislation and regulatory policies inspired by and informed by the report and the current needs of Vermonters and their employers.
We will also rally the backing of other unions to this critical effort and urge Governor Scott and his administration to declare healthcare reform a fundamental cornerstone of their affordability agenda.
Deb Snell is president of the Vermont Federation of Nurses and Health Professionals/AFT-Vermont, and Don Tinney is president of Vermont-NEA.
