I agree with Mr. Emerson Lynn’s commentary of March 23, “GMCB needs to be the answer, not the problem.” It was formed to be the answer or at least part of the answer, and I was one of the many who formed it. I have been on its advisory board since GMCB’s formation in 2011. Unfortunately, our legislature has not provided the GMCB the latitude it needs in order to be that answer.

Given our system of industrialized health care, the GMCB does have to balance our system’s relentless desire for ever higher fees and rates with the people’s abilities to pay these fees. It is the people who pay for and subsidize this system, with its fantastically exorbitant executive salaries (UVMMC’s CEO, for example, gets about $2.5 million a year) and various other expenses not related to our health care like lobbying. In that light its stance on the average 3.2% growth rate is laudable.  

But do not look to OneCare and so-called payment reform for “the answer.” Whatever pennies OneCare might save us after years of trying to implement it will evaporate in the enormous administrative costs of maintaining yet another private entity, with the usual administrative costs and outlandish CEO salaries.

The real answer is to stop treating our hospitals (and healthcare generally) as though they were manufacturing plants or car dealerships. They are not and should not be run as such. There is something grotesque about the health of a hospital being expressed in terms of a percentage growth rate. As a patient fourteen years ago, fighting for my life against a system that depends on such things as “payer-mixes,” in order to come out ahead, I felt more like a dollar sign than a human being.

When talking about Act 48’s goals, Mr. Lynn omitted its very first goal: “It is the intent of the general assembly to create Green Mountain Care to contain costs and to provide as a public good, comprehensive, affordable, high-quality, publicly financed health care coverage for all…” That is the real answer to our health care nightmare. It was abandoned by Governor Shumlin back in 2014 for political reasons dressed up in the usual excuse that it was “too expensive.” It is not “too expensive” compared to the system we have now.

Walter Carpenter


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