At the Addison County Legislative Breakfast in Middlebury on March 18, I had the opportunity to ask Gov. Scott how he was going to address the health care access crisis underway in Vermont. This question arose after I listened to the governor respond to a question the previous Friday evening (March 15) on the Vermont This Week Special question-and-answer edition.
In response to a question from Allen Quittner asking why he wasn’t pushing for universal primary health care, the governor responded that “We are doing a pretty good job in Vermont — 97 percent of Vermonters are covered by some sort of health care at this point in time.” And then he proceeded to say “we are moving forward with the all-payer model,” which he stated is just a “different payment model.”
While addressing the governor, I quoted the 2018 Vermont Health Insurance Survey results, which were recently published by the Vermont Department of Health, stating that the number of Vermonters who are underinsured has gone up yet again. According to the report, 36 percent of Vermonters under age 65 are underinsured; their “medical expenses are more than what their income could bear” and they “delay care at higher rates than those with adequate insurance.” (2018 Vermont Household Health Insurance Survey: p.23 and p.30)
I also reported that this was the exact same message that I heard running for Addison-Rutland 1 representative as I knocked on hundreds of doors. The cost of health care was, by far, the number one concern. For those with insurance, they were unable to afford to use it due to the high premiums, deductibles and co-pays. Others were faced with making the risky decision of whether or not to purchase insurance or, instead, using what they would have paid on premiums to cover their family’s annual health care expenses.
At the governor’s breakfast, I stated that the all-payer model does nothing to address this critical health care access problem, which continues to worsen. The governor’s response was that he disagreed and that the all-payer model focused on a different payment model and that a high percentage of the effort was on prevention.
I was very disappointed with Gov. Scott’s response to my question. Implementing a different method for how physicians are paid does nothing to help a family afford to go to the doctor in the first place. As a state, we attempt to address affordability at the lowest income levels; however, for a family whose income is above the subsidy assistance level, they continue to see their premiums, deductibles and co-pays increase. It becomes more difficult with each passing year to seek out medical treatment as a result of the ever-increasing premiums, deductibles and co-pays.
An alternate way of paying physicians has nothing to do with making it possible for Vermonters to actually afford to go to the doctor in the first place. Unfortunately, for many, they are forced to delay getting treatment until the situation worsens and they have no choice. This drives up the costs even more. When 36 percent of our state’s population delays seeking out health care due to affordability, this by no means addresses prevention.
I believe it is time that we start focusing on the root causes of our health care crisis instead of placing layer after layer of expensive Band-Aids on the problem. Ensuring that all Vermonters have access to affordable primary care is a major first step that would actually address the “prevention” effort that the governor emphasized. But first we must structure a primary care solution that eliminates overhead and administrative costs, and enables primary care doctors to actually practice medicine instead of filling out forms and fighting with insurance companies to obtain permission to treat their patients.
Barbara Wilson lives in Shoreham.