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Scott Calls On Shumlin Administration To Delay Approval Of All-Payer

Angela Evancie
VPR file
Lt. Gov. Phil Scott, shown here on Aug. 3, says he's concerned by the Shumlin administration's accelerated timetable for the approval of an "all-payer" system of health care payment reform.

Republican gubernatorial candidate Phil Scott is calling on the Shumlin administration to delay the approval of a health care payment reform plan until Vermonters have a much better idea of how the new proposal will work.

Scott says there should be no rush to judgment about this far-reaching change in Vermont's health care system.

The Shumlin administration announced this week that it's reached a preliminary agreement with the federal government on a plan known as “all-payer.”

The goal of the proposal is to move away from the current "fee-for-service" system, which pays for every specific procedure, to one that rewards quality and positive health care outcomes.

The Green Mountain Care Board plans to hold a series of public hearings about the proposal over the next three weeks.

Board chairman Al Gobeille says he hopes his panel can take a final vote on the plan in roughly a month.

GOP gubernatorial hopeful Phil Scott says he's very concerned by the accelerated timetable.

“Vermonters deserve to have a really detailed discussion about this before we move forward,” Scott says. “And if that takes a month, two months, six months or a year, I think it's worth having. So I think it's premature to lock us into an agreement, something that the next administration will have to deal with."

And Scott thinks it's going to take some time for providers and consumers to understand just how the new payment system will actually work.

“Nobody has a good handle on what the all-payer model is, and what it is going to do, and what's the ripple effect and the long term ramification and what it's going to cost,” Scott says. “There are some basic questions that need to be answered."

Gov. Peter Shumlin says all-payer is needed to bring health care costs under control, and he defends the timeframe for approval.

“We now have an opportunity to move to a system that can finally get costs under control while improving quality,” Shumlin says. “I think that's what this draft agreement does.”

Shumlin says it's an optional program, so any provider who has questions about it doesn't have to be part of it.

“This is optional for providers,” he says. “If they want to join up, I personally as governor believe it's going to be a much better system, but we've all got to make it work together." 

Shumlin also says the agreement with the federal government allows Vermont to get out of the plan as long as the state gives the feds six months notice.

“It has exits built into it, and I did that deliberately, so that if a future governor is talking to Vermonters and they say, 'Listen, this really isn't working for us,' with 180 days notice we can get out of this thing without penalties,” the governor says. “Now, that would be a huge change and a real shame, but we did build in exits."

Will the administration reconsider its timeframe if the testimony at the public hearings raises major concerns about all payer?

Shumlin says that question is premature.

“I expect confusion. This is an incredibly confusing topic, but I don't want to speculate on whether people will think it's a good idea or bad idea, because most people don't understand it yet,” he says. “So I'm not going to color that one or shade it."

The current public hearing schedule is as follows:

  • Monday, Oct. 3, 5:30-7:30 p.m. Montshire Museum of Science, One Montshire Road, Norwich (Nonprofit Community Room)
  • Thursday, Oct. 6, 4-6 p.m. University of Vermont Recital Hall, 384 South Prospect St., Burlington
  • Tuesday, Oct. 11, 4-6 p.m.  CVPS/Leahy Community Health Education Center, Rutland Regional Medical Center, 160 Allen Street, Rutland
Bob Kinzel has been covering the Vermont Statehouse since 1981 — longer than any continuously serving member of the Legislature. With his wealth of institutional knowledge, he answers your questions on our series, "Ask Bob."
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