Many Vermonters have expressed concerns about the transitional
"health care exchange" process. It is important to keep in
mind that this is not part of the single-payer system being
developed by the Green Mountain Care Board.
Under the benefits plan described by the GMC Board all Vermonters
will have a simpler, more coordinated, incentive-driven healthcare
system. Compensation for providers will be value-based- they
get paid to improve patient outcomes at the most reasonable
The benefits plan widens benefits beyond clinical care into a
system-wide approach. This includes prevention and public
education. It incorporates Community Wellness Teams to help
support patients and families by coordinating care and services,
managing cases, and helping people manage their own care.
Patients who have avoidable complications won't fall through the
cracks of the system in the area between primary and specialized
care. The issue of "generous" insurance policies for some
Vermonters and not others will be meaningless. This rational
approach will mean every Vermonter will receive the care and
support we all need.
This will reduce waste in the system from things like poor access
and coordination of care, over-treatment, excessive use of some
medications (antibiotics), and even the unwanted use of intensive
care in the last few days of life.
All of this should have been incorporated into the Affordable Care
Act (Obamacare), but the lobbyists for those few who make huge
profits from the current failed system prevented it from
Vermonters are too smart to let that happen here.
David Schoales, Brattleboro, Vt.