by John Brumsted, MD, UVMHN DuringBill Clinton’s 1992campaignfor president, a sign in thecampaign headquartersfamouslyread:"Change vs. more of the same. The economy, stupid. Don't forget health care.”Thiswas the central themeof the campaignand the sign wasmeant tokeep everyone focusedon the issues and themes that mattered most to Americans.
The mantrarings as true todayas it did 26 years ago -- but to make it even more relevant, I’d replace“the economy”with“affordability”because high costcontinues to be a significant barrier to health care. Thissituation isunacceptable.
With the passage of the Affordable Care Actmany more Americans have access to health insurance coverage. Thisis a good thing,but as the cost of health care has grown faster than the rate of inflation,more of the financial responsibility has been passed to individuals in the form of plans withhigh premiums anddeductibles andexpensiveco-pays.These costshave strainedhousehold budgets to the breaking point. As a practicing physician for more than 30 years in rural New York and in Vermont, I saw many patients who went without treatment because theysimply could not afford care.That has to change.
While thereasons for the growth in health care costs are varied and complex, it is our responsibility as providers of health care services to do everything we can to make care affordable and accessible.UVM Medical Centerhas taken important steps toward greater affordability bylimitingthe growthofits commercial rate requeststo less than the rate of inflation. In 2017,for example,that rate wasless than 1 percent and in 2018,we arecommitted to a similarly low commercial request because we know Vermonters need relief.It is critical that people begin to see these low increases reflected in the pricesthat the insurance companies pass on to them.
An essential component in achieving affordability is the work we are doing across Vermont and Northern New York to better coordinate care among all providers and makegreater investments in primary care,preventionand wellness.Already in 2018, we have taken a major step forward in accepting responsibility for health care costsbybeing paid a set amount for each individual who receives care.The amountwillnot vary -- even if more services areused.This approach requires us all to work more closely together to provide the right care at the right time and in the right setting, regardless of whether this is in a hospital, a medical office or in the home. Our motivation is to keep our patients as well as they can be.
We have come a long way in health care since the Clinton campaign, but we still have a long way to go to realize the change we need, to reject the notion that “more of the same” will get us there and to make health care more affordable forall. We are on the right path, and together, I know we can get there.
by Dr John Brumsted, MD, president and chief executive officer of the University of Vermont Health Network, and chief executive officer of the UVM Medical Center.