Commentary: Health care in Vermont – Choosing a path together

November 12, 2024  |  By Jason Williams

We all have a deeply personal healthcare story, an experience that overwhelmed us with gratitude for the caregiver who was there in that life-altering moment. Some we are relieved to recount, and others end in the agony of loss. 

Like you, I have both kinds of stories. Health care is about life and our quality of life.

As you read this, I ask you to think about the health care you want for yourself and your loved ones in their time of need. And I encourage us to keep working together to get to that place despite recent alarming actions by the state’s Green Mountain Care Board, including budget orders that will lead to healthcare rationing, and recommendations calling for rural community hospital closures and the curtailing of services by our not-for-profit academic health system.

Clinicians across our state provide excellent care to those who need it in a system of disparate services that is too often inefficient and disconnected. It is distressing when patients languish in hospitals – sometimes for more than a year – without a medical reason, simply because they cannot be discharged for lack of housing, transportation, mental health care or long-term care options.

We can change this. I’m encouraged by the role the state Agency of Human Services can play to lead on health care policy and planning. If the state works with health care providers to ensure every Vermonter gets the right care, when they need it, in the right setting, we can save untold millions of dollars. This is the quickest path to affordability, aside from growing our population of working Vermonters and tax base.

Significant community challenges are complicating our work. Vermont needs thousands of units of housing – up to 36,000 units by 2029 – and a statewide EMS system to transport patients safely. We must invest in community-based mental health, substance use and disease prevention programs like never before. These programs keep patients from needing more costly hospital or nursing home care.

The good news is the key pieces of this work are already in place. If we invest in them like our lives depend on it – because they do – imagine the progress we can achieve together.

Instead, recent Green Mountain Care Board budget decisions penalized the University of Vermont Medical Center for providing more lifesaving care to our patients last year than allowed, even though the net financial result of that care caused us to lose money. Enforcing those budget orders to the letter will reduce our budgets by more than $120 million, which would be equivalent to closing our three UVM Health Network Hospitals in Vermont for 17 days and turning everyone away.

In the past, we largely absorbed budget cuts, though patients felt the effects through delays in new equipment and services and longer wait times. The Green Mountain Care Board’s mandated reductions are so significant that, despite more cuts this year to administrative services, we can’t avoid impacting patient care.  

So far, we’ve paused construction on the outpatient surgery center – a project the state agreed was needed, eliminated over 130 positions, and improved system efficiencies. We’ve also begun legal efforts to seek relief against these orders. Tougher decisions lie ahead to comply.

Instead of driving smart investment, the Green Mountain Care Board recently recommended Vermonters essentially close four community hospitals and consolidate services to one place or another all across Vermont. They also recommended more hospitals send their care to UVM Medical Center, even though we’re already full and facing budget cuts by the the board. The result will be increased cost and suffering as people lose access to local care, delay treatments or seek care out of state.

I believe the Green Mountain Care Board has the opportunity to join other areas of state government and our provider community to create positive change. If they choose to bring us together, build trust and collaborate, I’m certain we can achieve the goals we all want to see.

As Vermonters, we face an important decision: will the path forward be defined by the rapid erosion of our safety net health care system, or will we demand actions that foster the stability necessary to build a stronger, more sustainable system of care?

Every day when I think about the care my family and friends receive from clinicians across our state, I’m resolved to do better for all Vermonters. Rest assured, we will continue to bring honesty, hard work and care for our neighbors and friends to tackle these challenges and, despite all of this, strive to provide you with the highest quality, most accessible care. All of our actions come from a place of knowledge, experience and understanding to do one thing: serve our patients and our community.

Jason Williams is the Chief External Relations Officer for the University of Vermont Health Network. A multi-generational Vermonter, Williams is a UVM graduate and Winooski resident.