Dave á JusThere's an interesting and often frustrating dynamic in #Vermont over the state's authority for #healthcare financing, delegated by the governor & legislature to a panel called the Green Mountain Care Board in 2011 after passage of the groundbreaking Universal Healthcare law. The #GMCB was chartered to ensure broad equitable access to affordable medical services. It was assumed at the time that both Medicaid & private insurance options for everyone would pretty much always be around; that regulators wouldn't sign on to approve 22-25% rate hikes even for healthy people; that the tax credit/subsidy from the lifesaving federal Affordable Care Act (flawed, but almost entirely by the lack of the critical component mandating public involvement - in what was once an entirely public-sector realm and in every modern industrialized country, still is. Its only other substantive flaws lie in the way that Mike Johnson, former Senate Majority Leader Mitch McConnell & others were able to sabotage and dismantle its key provisions.) would still provide a marketplace for those particularly of limited means to choose from among multiple insurance plans; that Universal Healthcare would in fact be implemented with funding by the state — which never came. And in the view of observers, some of those basic, now flawed assumptions have caused the Board's mission to creep to ensuring sustainability mostly of the so-called private insurance industry. And delivery of services by our hospitals which rely on Medicaid reimbursements for upward of 40% of their operating costs came under threat. Our area's essential Birthing Center closed. Nearest OB/GYN and neonatal services are for many over a hundred miles away and there isn't transportation. Dialysis, ED, PC, MRI at regional rural facilities were all threatened with consolidation if not elimination.
The Board requested and was granted greater authority over private facilities' budgets. The largest hospital's CEO resigned rather than face a cut to his $32M compensation package. And now maybe the GMCB is going to use some of its enhanced authority more forthrightly to protect both hospitals and the public:
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Parents and providers fear Rutland Regional Medical Center’s planned pediatric closure would jeopardize patient health and drive up costs
> The Green Mountain Care Board is weighing whether to prevent the service reduction, in a first-ever instance of its new authority.
