For 37 years, my dad served the communities of Lamoille County as an independent family physician in Johnson. I know how important it is to have health care options in our own communities. The high price of health care is at the crux of our affordability crisis in Vermont. I would like to specifically write legislation to address health care affordability and accessibility in Vermont.
SUPPORT COMMUNITY HEALTH CARE
We need health care IN OUR COMMUNITIES. Small, private health care practices have been shown to provide better care at a more affordable price. In fact, patients who attend small, private practices are 33% less likely to return to the hospital within 30 days of a hospital admission than are patients who attend hospital-owned practices. In addition, when a physician-owned practice is bought by a hospital, each patient ends up paying an average of $400 / year more out of pocket; there is a similar cost increase associated with increasing the size of a practice.
Small, community practices provide better care because the physicians know the patients personally and understand their health history. They are more economical because they escape the overhead costs of running a hospital, and are often operating at much lower profit margins.
Unfortunately, it is becoming less and less possible to run a small, community practice. When my dad retired from his practice in Johnson this past summer, there was no one who could afford to take over the practice. I worry that the same fate will eventually face the Cambridge Health Center if we are not conscious about supporting local health care. We need to ensure that independent physicians get compensated for the same procedures at the same rate as hospital-owned practices do. Currently, larger hospitals can contract separately with health insurance companies to receive greater compensation for the same amount of care, which raises everyone's health insurance costs and drives local doctors out of their practices.
COMPETITION IN HEALTH CARE LOWERS PRICES
Health care works best on a free market system. Currently, Vermont is moving toward enabling UVM Medical Center to have a complete monopoly on health services in this state, which is sure to drive up health insurance costs for all. We need to encourage many different health care providers to coexist in a competitive market. A large part of doing this includes prohibiting large hospital associations like UVMMC from setting secret health care compensation rates with insurance companies, which are presumably much higher than any other health care providers' compensation.
LOWER HEALTH INSURANCE COSTS
17% of our income, on average, goes to health care costs in Vermont. The answer to lowering health insurance costs is to make health care more economically efficient. This means emphasizing primary care, as regular visits to a primary care physician can keep us healthier and fix problems before they become unpleasant, costly emergencies.
The current health care system does not do enough to incentivize people to see their primary care physician instead of going to the emergency room whenever they have non-emergency issues. I would like to see us explore options such as Universal Primary Care, which could remove the burden of deductibles and copays for primary care needs and, therefore, incentivize people to utilize their primary care physician for routine matters.
In summary, shifting the health care system to emphasize primary care is the most economically wise option. It has potential to lower health insurance costs by making our health care system more efficient.