The Essential Next Step:
Health Care Reform Needs a Plan

This past fall, I made a commitment to Vermonters to move the discussion on health care reform forward in a way that gets us to universal access to affordable care for all Vermonters, so that when our new governor is inaugurated, Vermont is ready to implement a new health care system that guarantees every Vermonter access to affordable, high quality health care. Beginning with a well-attended public hearing in January, I have been leading a process in the Vermont Senate to determine the best way to fulfill my commitment.

I am convinced that health care reform is not only necessary for the well being of Vermonters, it is necessary if Vermont is to pull out of the economic crisis that we are facing. The escalating cost of our current system is crippling our state, our families and our businesses. Every single Vermonter has already been touched in some way—or will be—by the broken health care system and its ramifications. Vermonters should expect a health care system that first prevents disease and then treats those who become ill. We must work together to find the best way to a new system.

To date, the discussion has largely been philosophical. Do you believe that people, regardless of income, deserve health care or not? What is government’s proper role? Do you believe that single payer is the only answer or not?

Vermont has, in fact, set a goal of universal access to health care for all Vermonters. Vermont has already picked all of the low-hanging fruit on the health care tree. We have tweaked our current system this way and that way in order to provide more people with more access to health care services.

We must admit, now, that in order to achieve our goal of universal access to affordable health care, more of the same is not enough. We must change the equation in order to achieve our goals. What must be done now is the difficult work of building an entirely new system that will actually deliver quality health care to all Vermonters at a reasonable cost.

What Vermont needs is a plan for how to move from our current broken system to a new system that expects health care for all with a fair payment system.

What is needed is true systemic reform, and we cannot have real reform without a real plan to create a whole new system—a not-for-profit system that strives to promote health and prevent disease, while at the same time provides care to those who need it. We must move away from simply “managing disease” and create an expectation that all people deserve good health and good health care. More primary care from more family practice physicians is the key.

In our current broken system, we ask people at the most vulnerable times in their lives to navigate an utterly incomprehensible and failed system. Some people are literally fighting for their lives. This situation is unconscionable. The only way to fairness and dignity is to develop a system that provides access to high quality care at a reasonable price.

That is why I am introducing a revised version of S.88—so that we can design the system that will actually deliver real health care to Vermonters, and answer all of the questions that need to be answered to implement this new system. My bill calls for the state to hire independent advisors, who will be overseen by a panel of Vermonters, to provide the state with a “menu of options.” These advisors will design three different health care systems—fully design them, not just study them—and deliver back to the legislature a full implementation plan for each of the three possible systems. After full public debate, the legislature will decide.

This is the essential next step in health care reform.

The bill requires not only a design for each option, but a list for each plan of the total cost and how it will be paid for, the pros and cons, how it will ensure that every Vermonter has access to health care, and what the unintended consequences might be—in terms of the economy, jobs, and health care delivery systems.

Each of the options will meet several design criteria:

• Universal access to health care for all Vermonters
• Affordability for all Vermonters
• Cost containment within the system
• Access to health care regardless of employment status
• Accountability for providers and payers
• Equity in care

This will not be easy. Change comes with uncertainty and risks. But the option of doing nothing is simply not acceptable. We are now paying the price of a broken system, and that price will only go up. The time to move forward is now.

With this bill, I will fulfill my commitment to Vermonters to lead the legislature in moving the discussion on health care reform forward, so that our next governor will be able to begin implementing the new Healthy Vermont system—whichever option is chosen—and we will be well on our way to true health care reform. Vermont will once again show a better way.

Read the draft text of the bill »