By Peter Hirschfeld
Vermont Public Radio, Jan. 21, 2014
Vermont lawmakers are at a critical juncture in their quest for a publicly financed health care system. And they’re bringing aboard a $10,000-a-month consultant to help them get it right.
The Legislature already has a small staff of fiscal analysts to call on. But as lawmakers undertake the most ambitious health care reform agenda in state history, they’re spending some money on outside experts.
“When you’re talking about doing a $1.6 billion or $2 billion project or program, I think it’s appropriate to spend a couple hundred thousand dollars to look at whether we’re moving in the right direction,” said House Speaker Shap Smith.
Smith said the Legislature has some serious questions to answer before it can move ahead with single-payer.
The Shumlin Administration will use its considerable executive branch resources to design the governor’s single-payer proposal. But Smith said the Legislature has to do its own due diligence when it comes to figuring out how much the system will cost, and how taxpayers should pay for it.
So they’ve brought in a health care economist from Emory University to help them out. Ken Thorpe is no stranger to the Vermont Statehouse. Seven years ago, he helped the Legislature put together an insurance subsidy that would later become known as Catamount Health.
Thorpe is a national expert on health care policy, and he visited several legislative committees Tuesday to introduce himself and offer some initial thoughts on the work ahead. Thorpe said that if Vermont can’t reduce the chronic diseases responsible for skyrocketing health care costs, then financing reforms like single-payer aren’t going to solve the problem.
“So at the end of the day, no matter where you want to go in terms of cost containment, if we don’t have a statewide capacity to really prevent the growth in chronic disease and more effectively engage and manage chronically ill patients, the only other option you have for controlling costs is just by slashing payment rates,” Thorpe said.
With programs like the Blueprint for Health, Thorpe said that Vermont is already beginning to lower the enormous health care bills racked up by people suffering from conditions such as diabetes and high blood pressure.
Smith said he’ll be looking to Thorpe to determine whether Vermont’s current reform programs are reducing the rate of growth in health care spending fast enough. And if they aren’t, then Smith said lawmakers need to reassess whether single-payer is such a good idea.
“Everybody agrees that we want to make sure that we have quality health care, we’re doing things to bring down the rate of growth for costs,” Smith said. “And if we don’t have those two things, we don’t want to move forward with the single payer.”
Thorpe’s four-month contract will keep him in Montpelier through most of the 2014 legislative session.