Exchange is not single payer

April 11, 2012

The Mountain Times

Dear Editor,

Many Vermonters have expressed concerns about the transitional "health care exchange" process. It is important to keep in mind that this is not part of the single-payer system being developed by the Green Mountain Care Board.

Under the benefits plan described by the GMC Board all Vermonters will have a simpler, more coordinated, incentive-driven healthcare system. Compensation for providers will be value-based- they get paid to improve patient outcomes at the most reasonable cost.

The benefits plan widens benefits beyond clinical care into a system-wide approach. This includes prevention and public education. It incorporates Community Wellness Teams to help support patients and families by coordinating care and services, managing cases, and helping people manage their own care.

Patients who have avoidable complications won't fall through the cracks of the system in the area between primary and specialized care. The issue of "generous" insurance policies for some Vermonters and not others will be meaningless. This rational approach will mean every Vermonter will receive the care and support we all need.

This will reduce waste in the system from things like poor access and coordination of care, over-treatment, excessive use of some medications (antibiotics), and even the unwanted use of intensive care in the last few days of life.

All of this should have been incorporated into the Affordable Care Act (Obamacare), but the lobbyists for those few who make huge profits from the current failed system prevented it from happening.

Vermonters are too smart to let that happen here.


David Schoales, Brattleboro, Vt.