by John Brumsted, MD, UVMHN During Bill Clinton’s 1992 campaign for president, a sign in the campaign headquarters famously read: "Change vs. more of the same. The economy, stupid. Don't forget health care.” This was the central theme of the campaign and the sign was meant to keep everyone focused on the issues and themes that mattered most to Americans.
The mantra rings as true today as it did 26 years ago -- but to make it even more relevant, I’d replace “the economy” with “affordability” because high cost continues to be a significant barrier to health care. This situation is unacceptable.
With the passage of the Affordable Care Act many more Americans have access to health insurance coverage. This is 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 with high premiums and deductibles and expensive co-pays. These costs have strained household 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 they simply could not afford care. That has to change.
While the reasons 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 Center has taken important steps toward greater affordability by limiting the growth of its commercial rate requests to less than the rate of inflation. In 2017, for example, that rate was less than 1 percent and in 2018, we are committed 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 prices that 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 make greater investments in primary care, prevention and wellness. Already in 2018, we have taken a major step forward in accepting responsibility for health care costs by being paid a set amount for each individual who receives care. The amount will not vary -- even if more services are used. 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 for all. 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.