Healthcare

 

Healthcare is a human right for all, not a privilege for some.

We have seen some progress toward universal healthcare for all Vermonters over the last six years, but there is much more to do. Healthcare is a human right, and we cannot rest until every one of our citizens has coverage. To do any less fails our progressive principles as a state. 

Vermont Health Connect has failed Vermonters, resulting in a loss of trust that has set the state back on achieving universal healthcare. We must start by fixing the costly and poorly implemented website by building an expert team and holding them accountable. With my background in IT and project management, and eleven years of service as a lawmaker in Montpelier, I am the only candidate for governor with both the tech and legislative experience to make this happen. As Governor, I will move quickly to ensure both the right people and the right technology are in place and that core operating standards — and Vermonters’ expectations — are being met. 

We can advance the transition to single payer care by first implementing universal primary care, in which every Vermonter will have a primary care doctor. Without primary care in place, people often have no choice but to seek care in emergency rooms. This is expensive and inefficient; our emergency rooms are not the place for routine and preventative medical care. Further, in the case of a real emergency, primary care providers are vital to help families navigate visits to specialists, making sure care is coordinated. Additionally, we must change the way hospitals and caregivers are paid. Rather than being paid for volume, resulting in overbooked waiting rooms and costly procedures, hospitals and providers should be accountable for the health of a set number of patients, and receive a pre-determined budget from which to provide care. Finally, we must reform our Medicaid system, which covers a third of all Vermonters. As Governor, I know we can do this.

Job number one: fix the website.

We have work to do. We know that Vermont Health Connect was poorly conceived and implemented, at great cost to taxpayers. Vermonters deserve better – and they will get in under a Dunne Administration. I spent eleven years in the State House and eight years at Google, the biggest tech company in the world: I have the IT, legislative, and management experience to fix Vermont Health Connect once and for all. My approach to fixing Vermont Health Connect and delivering quality and value to Vermonters includes the following:
 
Provide a fresh healthcare leadership approach: As Governor, I will introduce a new leadership team with backgrounds in health, human services and information technology to not only lead Vermont Health Connect but also to provide oversight and accountability. I will also require accountability from staff and contractors, instituting rigorous performance management standards. 

Correct basic functions: I will get the bugs out of Vermont Health Connect, so an individual's ability to easily change their address or marital status is finally resolved. I will also push for a fully automated system, as required by the Affordable Care Act, and allow health insurance companies to reconcile their databases with Vermont Health Connect’s on a monthly basis. This comes back to accountability.

Move Vermont to universal healthcare and control the soaring costs. 

As we continue on the road to universal care for all Vermonters, we must shift our treatment plans to emphasize primary and preventative care, and our hospital and physician payment models to reward providers for a healthy populace rather than a high volume of visits and procedures. This system doesn’t work.

As Governor I will:

Pass legislation to provide primary care for all:  I will work to support and pass legislation to provide primary care for every Vermonter, to create a framework of preventative care. I will also collaborate with federally qualified health centers (FQHC) to improve access for all Vermonters. A strong, statewide primary care model will move routine and preventative care out of our emergency rooms, where it doesn’t belong, and back into providers’ offices where conditions can be caught early and treatment can be executed. Just as important, primary care doctors act as essential guides and coordinators for care in the event a patient needs to see specialists. That is why I firmly believe we need to get back to community health and supporting Vermonters’ health and wellbeing in their local communities, not just in emergency rooms.

Coordinate the care of chronic conditions: We can and must do a better job of coordinating the care of chronic conditions such as heart disease and diabetes among hospitals, providers and public health organizations. It’s better for the patient, and it’s better for Vermont’s healthcare costs. Chronic conditions that are left untreated can lead to expensive visits to the emergency room. We need to get back to basics, managing chronic conditions with community public health programs that are proven to help lower healthcare costs. 

Encourage more use of Accountable Care Organizations: We should be urging our  community health centers, hospitals and care providers to collaborate via accountable care organizations (ACO) to improve outcomes for patients and reduce costs. We are already seeing the benefits of ACOs across Vermont using technology and coordination among providers such as the partnership between the University of Vermont Medical Center in Burlington and Dartmouth-Hitchcock Medical Center in Hanover to support the Medicare population. Investing in this approach can help save money, improve outcomes, improve communication among providers and patients, and empower Vermonters to take control of their own personal health.

Change how we pay for healthcare: Vermont is among several states evaluating innovative ways to reform the way healthcare is paid for, how hospitals finance the cost of care, and how physicians and other medical professionals charge for medical services. As governor, I will focus on reducing the cost of care in the following ways:

  • Invest in health information technology to reduce paperwork, improve communication, and increase efficiency.
  • Shift Vermont to global budgeting, which encourages doctors to prioritize wellness and prevention.
  • Appoint members to the Green Mountain Care Board who will continue to advocate for consumers during insurance company premium reviews and hospital budget negotiations.
  • Transition Vermont to a healthcare finance system based on a set amount of resources to deliver the best possible health outcomes for a community of people, which will reward hospitals and physicians for making Vermonters healthier, not for the number of procedures they perform.

Medicaid Reform: Medicaid provides health coverage to 1/3 of all Vermonters -- about 200,000 residents, including children.  We need to identify and manage the primary issues driving up costs to protect the state budget and also to ensure Medicaid’s long-term solvency. As governor, I will tackle this head-on by doing the following:

  • Overhaul our Medicaid technology system. This will require an investment in information technology to upgrade a platform that is costing the state millions of dollars and adding uncertainty to our state budget.
  • Conduct a comprehensive review. We need to analyze our Medicaid system according to the type of care provided by physicians, the number of Vermonters covered, and the percentage of the Medicaid budget used.

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