Yes. Postponing a planned transition to a publicly funded health care system does not mean this Legislative session is not discussing significant health related priorities. These include continuing to move forward with health care reform, reducing the Medicaid cost shift in an appropriate manner, preserving the collaborative role of the Green Mountain Care Board, re-establishing loan-repayment to help recruit providers, strengthening Vermont’s obesity prevention efforts, and strengthening Vermont’s tobacco prevention efforts.
Vermont needs to continue to implement effective health care reform. Demand is predicted to increase for medical care, mental health care, and substance abuse services and the fee for service model is unsustainable. We need meaningful reform that improves access, fosters improved quality, reduces complexity, and increases coordination of care. NMC and Vermont’s hospitals are collaborating with each other, the Green Mountain Care Board, State officials, and other stakeholders on reform efforts. For us, this includes participating in the Accountable Care Organizations (ACOs) and leading the Regional Clinical Performance Council; working with the Blueprint for Health, NOTCH, private practice Primary Care, etc, to better align care; reducing avoidable Emergency Department visits; implementing LEAN strategies to remove duplication and waste; and pursuing integrated collaboration with funders for sustainable Lifestyle Medicine clinic to strengthen prevention efforts. We have asked our Legislators to make sure any legislated reform efforts align with and do not distract or detract from the ongoing efforts.
The Medicaid cost shift must be addressed in an appropriate manner. The underfunding of Medicaid interferes with access, risks destabilizing practices and providers, and is a burden to employers and the individuals on their workforce. It is crucial that funds raised in the name of reducing the cost shift actually make it through the system to reduce premiums for employers and individuals. Otherwise, we risk the likelihood of just swapping one problem for another and achieving no true improvement for Vermonters. We have asked our Legislators to ensure efforts to reduce the cost shift are effective and do not create larger problems.
We need to strengthen our obesity prevention efforts. I am amazed that consumption of sugary drinks is now the single largest source of calories in children! Sadly, 58% of Vermont adults and nearly 27% of our youth are overweight or obese and Vermont spends an estimated $163 million annually on obesity related conditions. This has to change. Studies suggest a 10% price increase for sugary drinks through taxation would decrease consumption by 8-10%. This is an instance where raising taxes can help. It can reduce consumption, particularly among children, and create funding for important prevention efforts like the Healthy Roots program which has been so successful in our area. We have asked our Legislators to support the 2-cent per ounce excise tax on sugary drinks and endorse using the funding for obesity prevention and greater access to care.
We need to maintain momentum on preventing tobacco use. Did you know that Vermont currently spends $348 million a year in tobacco-attributable health care expenses? The good news is, Vermont has successfully cut the youth smoking rate in half and adult smoking has dropped steadily. Franklin County’s adult smoking rate (17%) is now lower than the State’s rate (18%). However, tobacco use remains high among our vulnerable populations. A study shows that $5 were saved in reduced hospitalizations for every $1 spent in tobacco prevention/control in Washington State. We need those savings! Still, while the Centers for Disease Control (CDC) recommends Vermont invest $8.4 million annually in tobacco prevention, Vermont has invested $3.9 million a year recently (out of the $109 million in tobacco funds/taxes). We have asked our Legislators to continue to invest in tobacco control and prevention efforts (as they reduce larger costs) and please support an increase in the tobacco tax and extend it to “e-cigarettes.”
We have discussed these priorities with our Legislators in various settings. We hope you will do the same. Please reach out to members of the Legislature and reinforce what you think is important as we work to create an even healthier Vermont.
— Jill Berry Bowen, NMC’s Chief Executive Officer