Editor’s note: This commentary is by Barb Wilson, of Shoreham, who ran for the Addison-Rutland 1 House Representative seat in 2018, the first time anyone ran as a Democrat in many years. She garnered 42% of the vote.
[A]t the March 18 Addison County Legislative Breakfast in Middlebury, I had the opportunity to ask Gov. Phil Scott how he was going to address the health care access crisis underway in Vermont. This question arose after I listened to the governor respond to a question the previous Friday evening (March 15) on the “Vermont This Week” special question and answer edition. In response to a question from Allen Quittner asking why he wasn’t pushing for universal primary health care, the governor responded that “We are doing a pretty good job in Vermont. Ninety-seven percent of Vermonters are covered by some sort of health care at this point in time.” And then he proceed to say: “We are moving forward with the all payer model,” which he stated is just a “different payment model.”
While addressing the governor, I quoted the 2018 Vermont Health Insurance Survey results, which were recently published by the Vermont Department of Health, stating that the number of Vermonters who are underinsured has gone up yet again. According to the report, 36% of Vermonters under age 65 are underinsured; their “medical expenses are more than what their income could bear” and they “delay care at higher rates than those with adequate insurance (2018 Vermont Household Health Insurance Survey: p. 23 and p. 30).
I also reported that this was the exact same message that I heard running for Addison-Rutland 1 representative as I knocked on hundreds of doors. The cost of health care was by far the number one concern. For those with insurance, they were unable to afford to use it due to the high premiums, deductibles and co-pays. For others, they were faced with making the risky decision of whether or not to purchase insurance or instead using what they would have paid on premiums to cover their family’s annual health care expenses.
At the governor’s breakfast, I stated that the all payer model does nothing to address this critical health care access problem, which continues to worsen. The governor’s response was that the he disagreed and that the all payer model focused on a different payment model and that a high percentage of the effort was on prevention.
I was very disappointed with Scott’s response to my question. Implementing a different method for how physicians are paid does nothing to help a family afford to go to the doctor in the first place. As a state, we attempt to address affordability at the lowest income levels, however, for a family whose income is above the subsidy assistance level, they continue to see their premiums, deductibles and copays increase. It becomes more difficult with each passing year to seek out medical treatment as a result of the ever increasing premiums, deductibles and co-pays.
An alternate way of paying physicians has nothing to do with making it possible for Vermonters to actually afford to go to the doctor in the first place. Unfortunately, for many, they are forced to delay getting treatment until the situation worsens and they have no choice. This drives up the costs even more. When 36% of our state’s population delays seeking out health care due to affordability, this by no means addresses prevention.
I believe it is time that we start focusing on the root causes of our health care crisis instead of placing layer after layer of expensive Band-Aids on the problem. By ensuring that all Vermonters have access to affordable primary care is a major first step that would actually address the “prevention” effort that the governor emphasized. But first we must structure a primary care solution that eliminates overhead, administrative costs, and enables primary care doctors to actually practice medicine instead of filling out forms and fighting with insurance companies to obtain permission to treat their patients.
