Caledonian Record

To the Editor:

On Tuesday, July 24, I attended the MVP Rate Review Hearing with the Green Mountain Care Board in Montpelier. I must admit, it was my first hearing of this kind, and going in, I did not think I held any real expectations. It was to be mostly a first-person learning experience for me. Yet, after it was over, I found myself feeling a bit surprised, and fairly disappointed – indeed, like some expectation had not been met.

At the outset, there was an interesting, if not somewhat perplexing exchange between the MVP attorney and the GMCB to bar the report and direct testimony of former Vermont State Representative Michael Fisher, our Vermont Health Care Advocate (HCA). (For more on this, go to WCAX.com and search “Health Care Advocate” on July 24.) The Board agreed to exclude Mr. Fisher’s testimony on the basis of a legal technicality, reasoning that Mr. Fisher did not qualify as an “expert” in health care finance, nor was he a certified insurance actuary – ultimately ruling that Fisher’s report was more “opinion” than expert testimony. I wondered what kind of health care hearing would not want to “hear” from the HCA? Nevertheless, the Board did not permit his report to be heard, and limited his comments to that of a rebuttal witness – only able to respond to points that had been previously made, and not to introduce any new statements.

Following that rather bizarre exchange, I witnessed an elongated “dance” between the GMCB and MVP’s lawyer and actuary discussing largely technical reasons as their basis for yet another health insurance rate increase for Vermonters. Perhaps this was by design. Perhaps the arguments for a “reality check” had already been made. But, in my mind, I thought I would hear more universal and common-sense arguments. It seemed as though these proceedings were very far down-the-line of acceptance by the Board – to the point of going through the motions for the sake of formality. I thought, “I must be late to this process. The Board must have already approved the ‘sniff test’ and common-sense arguments. I guess this is the time for the bean counters.” At the end of the day, it appeared that everyone was satisfied, and it seemed evident that the Board would just lay down and accept yet another premium hike for Vermonters.

So, here’s my comment:

Our tough little state – indeed our entire country – continues to be afflicted with continuously rising health care costs at a rate that significantly exceeds cost of living increases. Everyone knows it; everyone agrees that it is unsustainable and unacceptable to the masses; most of us feel the high costs continuing to eat into our budgets; many of us simply cannot afford to insure ourselves and our families at these rates; and nobody seems to be doing anything about it. It’s like we’re all whining frogs in a pot of water being boiled by big money, big medical, and big pharma.

… and here are my questions:

Who’s going to throw a stake in the ground and say, “Enough!” Who’s job is it anyway? If not the GMCB, then who? What is it going to take for our elected officials in government to say, “NO! UVMMC does not need another building or an administration that costs $15 million annually. NO! Our payers (insurers) should not have to chase these outrageously inflated heath care costs. NO! Vermonters will not pay anymore for what should be a right to adequate health care. Time is up. Game is over. You get X amount of money for our health care – that’s it and there ain’t no more. Work it out!”??

It should be more clear now than perhaps ever before that our health care system is a self-interested, self-fulfilling industry, and it cannot nor will not regulate itself for the benefit of health care consumers (Vermont employers, families, and individuals). And, what of the treatment of our Health Care Advocate by the Board? Our “regulators” seemed content to choose to simply brush him aside. This is a very ominous sign.

Finally, our legislators and health care stakeholders like to bandy about the term, “Health Care Reform” – like it is something that is already underway. What I witnessed on Tuesday was a clear indication that we are not even close to any kind of reform. Under our current crushing circumstances, shouldn’t our state representatives be inspired to stand and deny additional rate hikes, never mind mandate reductions? Aren’t we all weary of being financially bullied by our existing health care system? Isn’t it time for real change and true reform – not just passive words and posture? If not now, when?

If you agree with these sentiments, I urge you to reach out to your state representative and/or the Green Mountain Care Board directly and passionately.

David Hills
Middlebury, Vermont
Mr Hills is the managing partner of Waypoint Management Services, LLC of Middlebury, Vermont.