More Bureaucracy, Higher Taxes, Fewer Health Care Options

More Bureaucracy, Higher Taxes, Fewer Health Care Options

By Charlie Bucknam

In the closing days of this year’s session, the legislature passed 107 page long S.88, “An Act Relating to Health Care Financing and Universal Access to Health Care in Vermont”. (It is now referred to as Act 128.)See S 88 as passed by House and Senate
The bill authorizes the Commission of Health Care Reform to engage a consultant or consultants to design 3 options for “reforming” health care in Vermont. Each option must be in keeping with the 9 principles and 11 goals outlined in the bill. The 3 options must be presented to the General Assembly by February 1, 2011 in order for the next legislature to have time to enact one of them.

There are numerous troublesome components in this bill:


• We cannot afford it. The legislature allocated $300,000 to hire a consultant to develop the three options even though the state is facing substantial budget deficits over the next several fiscal years. (It was recently announced that a consultant from Harvard University has been selected.)


• It places limitations on hospital revenue growth that will leave Vermont hospitals at a competitive disadvantage to the New Hampshire hospitals that are under no such restrictions. It will cost jobs, reduce revenue for the state, and ultimately restrict Vermonters’ convenient access to health care.


• The timing is baffling. Undertaking this study at this time before anyone has a grasp of the impact of the 2,400 page Federal health care bill (Patient Protection and Affordable Care Act of 2010) recently rushed through Congress will amount to a waste of time and money.

• The 9 stated principles and 11 goals, if adhered to and achieved, will limit health care options for patients and will alter the relationship between patients, physicians, and other health care providers. While the bill’s Principle #5 states the importance of the “primacy of the patient-provider relationship”, other principles and goals within the bill contradict this principle. For example, Principle # 7 states that the “system” must “reduce costs that do not contribute to efficient, quality health services”; and reduce “care that does not improve health outcomes”, …for “the health of the Vermont economy”. Who will be deciding which costs don’t contribute to efficient, quality health services? Who will determine what types of care “do not improve health outcomes”? These decisions will no longer be made solely by the patient in consultation with his/her physician. Instead, decisions regarding types of treatment and care options will be made by bureaucrats for the health of the Vermont economy.

• The bill assures that any plan will raise taxes for Vermonters. Principle #8 states that “financing of health care in Vermont must be sufficient, fair, sustainable, and shared equitably”. Goal # 4 states that “the state is committed…to raising revenues that are sufficient to support the state’s financial obligations for health care on an ongoing basis”. Translation: higher taxes on working Vermonters.

• Incorporated in the Goals are provisions implying that the state will engage in price fixing to control costs. Goal (5)(D) states that “health care costs will be controlled or reduced by “reducing the cost of pharmaceuticals, medical devices, and other supplies through a variety of mechanisms”. Goal (5)(E) states that health care costs will be controlled or reduced by “aligning health care professional reimbursement with best practices and outcomes rather than utilization”. Again, Montpelier bureaucrats, funded by Vermont taxpayers, will be deciding the price of health care services and products Vermonters need.

Burdening Vermonters with higher taxes to fund more bureaucracy to control our health care choices is not the solution to lower costs or for better health care. Instead, we need to seek solutions that preserve and enhance Vermonters’ freedom to choose their health care options. Entrusting government to make the kind of life-altering decisions envisaged in this bill is a mistake.

Senators Kitchel and Choate supported this bill.  I welcome their comments on my post, and suggest they post their analysis of Act 128.