‘Health Care Board’ At Center Of Overhaul Prompts Debate

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(Host) A "health care board" is central to the new proposal to overhaul Vermont’s health care system.

But some of the state senators who are reviewing the bill have a lot of questions about the role and the authority the board would have.

VPR’s Bob Kinzel is following the legislative debate over this sweeping health care proposal.

(Kinzel) The heart of the bill passed by the House is the creation of a new five-person Health Care Board, which would oversee virtually every aspect of Vermont’s health care system.

The board would set a global, or total, health care budget for the state, and it would review all hospital budgets and private health insurance premiums.  It would also be responsible for implementing new cost containment strategies and designing a new payment system to replace the current "fee for service" system.

Addison Senator Claire Ayer is the chairwoman of the Senate Health committee. She thinks the board needs a lot of authority to deal with many difficult issues:

(Ayer) "I want them to be independent so that they can make the hard decisions: ‘Yes, we’re paying for this. No, we’re not paying for that.’ There are a lot of check points in the budget, a lot of check points in reporting appropriations. They’re not going to be doing it in a vacuum, but what we need is for them to be independent of political pressure."

(Kinzel) The Shumlin administration says the work of the Public Service Board is a good model for the new Health Care Board. But that analogy doesn’t sit well with Chittenden Senator Hinda Miller.

Miller notes that while the PSB is a regulatory body, it’s the Public Service Department that does utility planning for the state.  Her problem with the proposed Health Care Board is that it performs both duties.

(Miller) "I think it’s very valuable to have that separation of planning and regulation. … So the House did it one way. We’re the Senate. We’re bound to drill down one more level. And we have the benefit of the work of the House. But we also have the responsibility to go down deeper one more time."

(Kinzel) Rutland Senator Kevin Mullin is the vice chairman of the committee. He’s concerned that lawmakers are giving the board too much authority on decisions that he feels should be made by the Legislature.

(Mullin) "It’s pretty hard for me to explain to constituents anything about what’s happening in health care because all the bill does is defer all decisions to a new board."

(Kinzel) And Mullin thinks that some Democratic leaders in the Senate are trying to rush this bill through the chamber.

(Mullin) "I was just told today that the pressure is now on the Senate to deliver a bill in two weeks. You know, I’m not going to basically say that just because I’m told that it has to be done in two weeks that it’s going to be done. It makes no sense to me."

(Kinzel) The legislation does not include a specific funding source to pay for a single payer system in Vermont. That decision will come during the 2013 session.

For VPR News, I’m Bob Kinzel in Montpelier

(Host) The Senate Health and Welfare Committee will hold a public hearing on the bill Thursday at the Statehouse beginning at 6. You can listen live by visiting vpr-dot-net, and clicking on the House stream.

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