Next month, I’ll begin commuting to Albany to eventually take the helm of the Healthcare Association of New York State. As I pack up fourteen years of news clips, binders and legislative studies, I’m reflecting on the challenges and opportunities Vermont still faces on health care reform.
Precious little in this complicated industry is easy, cheap or quick. New policies, devices and innovations are continuously changing how we receive and pay for health care. As a result, securing lasting improvements are typically hard-won victories.
Achieving better access, quality and cost control are akin to checkpoints on this journey that has no end. And while it may not seem like it at times, Vermont has successfully passed more of these checkpoints than any other state in the nation – thanks to a longstanding shared commitment among policymakers and providers alike. Our shared work has spurred tremendous improvements in the delivery of primary care, in connecting providers electronically and more recently through supporting local efforts to holistically address Vermonters’ medical and social issues together.
Not everything is perfect or finished, and I invite those in the chorus who are chanting, “It’s not enough,” or “It should be done another way,” or “Just stop already!” to come to the table. Tough questions and vigorous debate about the many steps along the way are vital to our success on this journey.
Payment reform is the next phase in our health care evolution. It sounds like simple common sense to pay doctors and hospitals for coordinating care and keeping Vermonters healthy, rather than paying them for every single service they provide. But in fact, this approach is groundbreaking.
For context, we must remember that our sluggish economy has sputtered over the last several years. Vermonters are grey and getting greyer, so we’ll soon need more care, which means more cost pressures. Medicaid covers one out of every three Vermonters – assistance that 's paid for in part by Vermonters who are commercially insured, and by tax revenue.
But these challenges are actually the very reasons to continue payment reform – not reasons for quitting. If we stop trying to better serve Vermonters, we’ll fail both them and ourselves. Mistakes and missteps are forgivable and fixable. Giving up is not – because our health and the health of our economy depend on it.
As I pack up my office and say goodbye to Vermont for now, I am so thankful to the thousands of optimistic, smart and dedicated people I’ve been honored to work with here. Their tireless leadership and willingness to be creative and collaborative are my top reasons why I am optimistic about Vermont’s ability to keep making progress on health care reform.
