Douglas: How Far We’ve Come

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Vital Signs: Vermont Charts A New Course For Health Care

(HOST) This week VPR is presenting Vital Signs, a series of programs on what health care overhaul means for providers and patients. As he watches the debate unfold, former governor Jim Douglas says his successor and lawmakers have a great deal to build on as they go forward.

(DOUGLAS)  There’s a big debate about health care these days. We’ll see where it goes, but it’s interesting to see how far we’ve come.
Eight years ago I recognized that health care spending was on an unsustainable track, driven largely by chronic disease. Vermont is the 2nd oldest state, and since older folks are most likely to have chronic illnesses, we can expect these costs to rise. Vermont needed to act, and so we launched the Blueprint for Health, focusing on prevention, wellness, screening, early detection and management of chronic disease.  It’s a lot cheaper to keep someone healthy than to treat the problem later. A key component of this is the medical home, where everyone has a primary care practice team to help you stay well. All our insurance companies pay through this model. So does Medicaid and, recently, Medicare, based on the Vermont example.
In 2003 we joined Michigan to form the first multi-state purchasing pool to lower drug costs in Medicaid. We received Federal permission in 2005 to use Medicaid funds for preventive care and we’ve saved more than a quarter billion dollars since. We launched Choices for Care, to keep older and disabled Vermonters at home if they wish; that has saved millions.
We’ve led on health information technology, creating the VITL program, a fund for health IT acquisitions and a claims reporting & evaluation system. Two years ago Vermont was named the most improved state for the percentage of prescriptions issued electronically.
In 2006 we passed sweeping legislation creating Catamount Health to extend coverage to those with incomes too great for Medicaid, but still struggling to get by. It reduced the number of Vermonters without insurance to among the lowest in America, only 7 percent, and half of those are eligible for public programs. Throughout the recent recession, the percentage of uninsured stayed constant. AARP called it ‘the most progressive health care law in the country.’
We launched a healthy aging initiative, a Fit and Healthy Kids program, No Child Left Inside, community health grants, the DETER substance abuse initiative and workplace wellness and safety awards.
I wanted to be sure the rest of the country learned of our efforts, so I was honored when the President asked me to host a White House Forum on Health Reform in 2009. I made health care the centerpiece of my year as chairman of the National Governors Association. I was pleased to accept awards from the eHealth Alliance, the National Committee on Quality Assurance and AARP. Cost has always been the key, not quick fixes. Reform that’s unsustainable is bound to fail.
The best evidence of our success is that Vermont has been declared the healthiest state in the nation for 4 consecutive years. There’s always more to do: we need to focus on prevention, control obesity, encourage advance directives, assign everyone to a medical home and offer more choice in insurance; but the steps we’ve taken on access, cost and quality are a model for the rest of the country. Once again we Vermonters can be proud of what we’ve accomplished.

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