The Chamber of Commerce

Containing Health Care Costs

Various Groups Continue Health Care Initiatives Outside of State House

Although much of what we read and hear regarding health care revolves around the current Legislature, many initiatives are thriving outside of Montpelier such as health education, chronic care work, and hospital community reports and needs assessments. In 2003, the Vermont Legislature implemented Act 53, which outlined several goals to contain health care system costs and increase quality. In addition to Act 53, the Commissioner of Banking, Insurance, Securities, and Health Care Administration (BISHCA), the Vermont Department of Health, as well as various community leaders are working together to implement the following initiatives:

• The State is currently overseeing a four-year health resource allocation plan (HRAP), which will include a statement of principles, an inventory of existing health care resources, and recommendations for the allocation of resources pursuant to the principles. www.bischa.state.vt.us
• Hospitals are conducting a four-year community needs assessments and publishing community reports, which will include measures of quality, patient safety, financial health and costs, openness in process, a summary of the community needs assessment, and governance information. www.bishca.state.vt.us
• Fit and Healthy Kids is working as a comprehensive approach for addressing an important and complex issue. This initiative creates an environment where children - and adults - can make healthy food choices and become more physically active so that they can lead the healthiest lives possible. The Department of Health is working with the Department of Education to coordinate Fit and Healthy Kids. www.healthyvermonters.info
• The Vermont Blueprint for Health (Chronic Care Initiative) is a collaborative project begun in the fall of 2003 and led by a public-private partnership. The Blueprint is based on the chronic care model, which pursues patient self-management, provider practice change, community development and information system development. Pilot programs are being implemented at the Northeast Vermont Regional Hospital , Southwestern Vermont Health Care and Northern Counties Health Care. The programs include a diabetes collaborative, a self-management program, and several grants for physical activity and other health programs. www.healthyvermonters.info

In order to address systemic challenges, health care requires a culture change. The current system limits the ability of consumers to understand and gain some control over the cost and quality of their health care. Nor does the system presently do enough to encourage consumers to manage their health to optimal levels and then connect that health improvement to cost savings. That is precisely why the above efforts are so vital to improving health care in Vermont . If you are interested in becoming more involved in health care policy or any of the aforementioned initiatives, please contact Cathy Davis at ext. 206.

Be part of the Solution!

• Be involved in your family's health. By staying healthy (not smoking, eating right, exercising, reducing stress), your family will need less medical care.
• Act like a consumer. When health insurance pays for our care, we tend to think that "someone else" is paying for it. Actually, it's our money: premium payments, deductibles and co-payments. Question how much treatments cost and whether they are necessary. Ask the doctor if a generic will be as effective as the brand-name drug. Have a procedure done at another hospital if the cost is lower there.
• Don't encourage the state legislature to pass insurance mandates. When insurance companies are required to cover additional treatments and services, costs go up for everyone. Consider what level of care should be mandated by the state and whether we can afford it.
• Support competition to keep costs down and give consumers choice. During the past few years, several insurance companies have left Vermont because of our high costs and extensive regulations. The few remaining companies have fewer incentives to provide good service and keep costs down to win our business. State mandates have taken away the choice of buying less costly insurance coverage. Our elected officials, as they consider health care legislation, should concentrate on ways to make health care affordable and not reduce competition and innovation.