Editor’s note: This is the third in a five-part series profiling members of Gov. Peter Shumlin’s Green Mountain Care Board, a panel tasked with designing a universal health care plan for Vermont.
Con Hogan is an ideas man.
He sees the big picture and knows how things fit together.
Perhaps that’s why so many nonprofit organizations and foundations have sought his insight over the years. And it’s likely why several Vermont governors appointed him to high-profile positions like the chair of the Commission on the Accessibility and Affordability of Health Care and Gov.-Elect Richard Snelling’s Transition Team. It might just be why Gov. Peter Shumlin appointed him to the Green Mountain Care Board.
Con (Cornelius) Hogan, 70, has an extensive history in Vermont politics, that’s too lengthy to summarize here. Most notably, he served as the Vermont secretary of human services from 1991 to 1999 and as commissioner for the Department of Corrections from 1977 to 1979. This year, he is beginning his six-year term as a member of the Green Mountain Care Board.
There is something about Hogan that transcends experience. The former gubernatorial candidate can seem awe-inspiring, especially at first, but as he reminisces about Vermont politics, he takes on a more avuncular air.
Hogan says he’s had three careers. In the 1960s and 1970s, he worked in corrections. Then he took a large company through a Chapter 11 bankruptcy. Health care issues and system reform did not come into his work until the 1990s when Gov. Snelling appointed him secretary of human services.
“I knew nothing of this work for my first two careers,” Hogan said.
He learned one important thing as executive vice president and then president and director of Montpelier-based International Coins & Currency.
“I learned how to count,” Hogan said.
The high cost of chasing money
Sifting through balance sheets and business records, Hogan took to the numbers game. As a member of the Green Mountain Care Board, tasked with the monumental goal of laying the foundation for a universal health care system in the state, Hogan will bring his expertise in financing, human services and research.
Hogan says one of his primary goals is to change the system to reduce the costs of chasing money for doctors.
We spend so much money chasing the money, and that then adds fundamental complexity to a system that does not need to be this complex, this dense.”
– Con Hogan
“A lot of doctors are sick of the paperwork,” Hogan said. By streamlining the payment system to create a “single-pipe” system where all providers are paid through a single entity, Hogan said the state can reduce administrative costs. Limiting the amount of time doctors spend on insurance claims, for example, would reduce costs for the health care system overall and give doctors more time with their patients.
Hogan immersed himself in health care issues in the 1990s as secretary of human services.
Later, he became a consultant, working for nearly a decade in Europe on children’s health issues.
“It gave me a chance to really see and feel health care systems in other parts of the world,” Hogan said.
His experience in countries like the Netherlands, United Kingdom and Northern Ireland inspired him to write three professional books primarily about health care reform.
There is a story Hogan likes to tell about his experience in Northern Ireland, which was part of the United Kingdom health care system. Hogan became ill with a blood infection early on a Sunday morning. He called the emergency number, and they sent him to a clinic 35 minutes away. After three or four days in another hospital, he was discharged. Wanting to settle up financially before leaving, Hogan trolled the hospital looking for a billing office. Finally, he found someone with a title of “director.” He was director of supplies.
Fazed, Hogan asked where he could go to pay his bill.
“Mr. Hogan, you don’t understand,” the man said. “It is not worth it for us to have a billing system for you.”
That was the point, Hogan thought. Every health care system has problems. Ours is wasting time on things like billing and insurance when we should be focusing on providing health care.
“We spend so much money chasing the money, and that then adds fundamental complexity to a system that does not need to be this complex, this dense,” Hogan said.
Evidence and data: top priorities
Hogan is focused on evidence-based decisions. He said when he worked on a book with Dr. Deb Richter in 2005 about the future of health care in Vermont, they vowed to cite every declarative sentence they wrote with some respectable authority.
Hogan says concentrating on evidence and data helps to draw the conversation away from ideological debate and closer to a more pragmatic discussion of how to get things done.
Rick Davis, president and co-founder of the Permanent Fund for the Well-Being of Vermont Children, said when he was starting the foundation, he had heard a lot about Hogan’s work.
“He’s passionate about the work, but he also has the big picture in mind,” Davis said.
That’s why Davis recruited Hogan for his foundation’s board, and that may be why the governor appointed him to the Green Mountain Care Board.
“He focuses on how it all fits together,” Davis said.
Hogan’s experience and ideas led him to run for governor of Vermont in 2002 as an independent. Hogan lost to Republican Jim Douglas.
Davis said a lot of people liked Hogan because he had a lot of great ideas, but “campaigning was not his forté.”
Helping frame the Hsiao report
While he may have lost the gubernatorial race, Hogan’s progressive ideas remained popular, and he continued to write about health care reform. He was also instrumental in setting the framework for the Hsiao report—a study led by Harvard Professor of Economics William Hsiao that compared three options for health care reform.
Like other members of the Green Mountain Care Board, Hogan has worked on health care reform efforts in the past. He worked on the health care reform effort in the early 1990s in Vermont that paralleled the national campaign.
“We crashed just as badly as they did,” Hogan said.
One thing Hogan learned from that experience, he said, is just how powerful politics are in the world of health care. If there is a state that has a chance to get this done, however, Hogan thinks it is Vermont. He said if the Legislature can relax long enough to let it happen, and if the conversation can be about the actual costs, savings and services instead of an ideological debate, there’s a chance.
He said that government programs in Vermont have covered enough of its residents that the state has a strong foundation.
Also, Hogan says, “we’re small enough to have this conversation.”
Hogan will tackle hospital budget issues as his first task on the board.
Editor’s note: Con Hogan is a former board member of the Vermont Journalism Trust, the parent organization for VTDigger.org.