After two years of preparing to tackle health care reform, the Shumlin administration is losing its most important player, Anya Rader Wallack, the
chair of Green Mountain Care Board. Her departure will change the effort, but won’t derail it.
The Green Mountain Care Board has
established budget targets for Vermont’s
14 hospitals that will add as much as $85 million to the $2.1 billion that is
budgeted for the current fiscal year. The actual amount of new money will
depend on a series of board decisions on individual hospital budgets before the
new fiscal year begins on Oct. 1. The minimum new money would be $64 million.
The Green Mountain Care Board is
moving steadily toward establishment of a modestly credible budget inflation
limit for the Vermont’s 14
hospitals for the coming fiscal year, a performance that would keep Gov. Peter
Shumlin’s health reform initiative on track. But some troubling portents have
showed up in the process so far.
The Green Mountain Care Board has set forth a tentative target inflation
rate of 4 percent for Vermont’s
14 hospitals for the coming fiscal year, a target that would add about $85
million to the current statewide spending level of $2.136 billion. The final
system increase will depend on the board’s decisions on the individual
The odor of scorched
tires, faint but unmistakable, figuratively hung over last week’s meeting
between the Green Mountain Care Board and representatives of Vermont’s hospitals. For the first time, the rubber began
hitting the road on health care cost containment in the state, the linchpin of
Governor Peter Shumlin’s single payer reform initiative.
wins the gubernatorial race in Vermont, the campaign has pretty much failed to
illuminate the issue of health care reform, one of the most momentous the state
has ever faced. Health care now eats up 20 percent of the state’s economic
output and there is a broad consensus that the current trend is unsustainable.
On March 4, 1981, Burlington residents awoke to a political shock. Bernie
Sanders, a 39-year-old, tousle-haired radical from New York City had defeated the incumbent Democrat Gordie
Paquette for mayor of the city. And he started a political revolution.
The Green Mountain Care Board has now completed its approval process for
the coming year’s budgets for Vermont’s
14 hospitals. It was the board’s first effort and marked the third iteration in
the state’s effort to regulate health care costs. The first was the Hospital
Data Council that ran through the 1980s and early 1990s; that morphed into
BISHCA, which first got the power to set budgets in the mid-1990s; and now the
Green Mountain Care Board, which has the same powers as BISHCA, but should have
far greater weight than its predecessor.
Fletcher Allen Health Care of Burlington
and the Dartmouth-Hitchcock Medical Center of Lebanon, N.H., which have
competed for decades to treat Vermont’s
sickest patients, last week sought federal approval to jointly manage Medicare
patients in Vermont.