SHOULD SOUTH CAROLINA AND OTHER STATES LOOK TO GREEN MOUNTAIN STATE FOR GUIDANCE?

When I think of Vermont, I think these two things: maple syrup and uber-Liberal neo-hippies.

But now there’s a third thing that Vermont has given to America, a test case in health care reform.

In a guest editorial Thursday, Ken Thorpe, Ph.D., the Executive Director of the Partnership to Fight Chronic Disease, noted “Vermont’s primary focus was to make health care more affordable and at the same time expand coverage.”

While it is still too early to know if it worked, Thorpe said there are three core elements that have Vermont showing early signs of promise, and which could be replicated elsewhere.

Health care legislation must be bipartisan and have something “in it” for everyone. Vermont’s health reform program was solidly bipartisan — enacted by a Republican governor and a Democratic legislature. Key to the reform’s political success was the recognition by both sides that the debate would need to be refocused on broader systemic ills, like cost and quality, rather than solely on the contentious and politically-charged issues, like coverage and payment. At the time reform was being debated, the vast majority of Vermonters — and almost all voters in the state — had health insurance, so policymakers had to communicate what these people would get out of reform, other than a higher tax bill, and the answer was lower health care costs.

Health care legislation must be comprehensive. Vermont passed comprehensive legislation to modernize chronic care delivery models, create a statewide health IT platform, implement effective efforts to prevent disease and build a new insurance program for the uninsured (Catamount Health). By 2010, an estimated 96 percent of Vermont residents will have health insurance coverage.

Health care legislation must address cost, which means getting a handle on the root cause of spending. For years now, many of the health reform proposals that have been introduced in this country have failed to control the root of increases in spending. More than anything, that root cause is that Americans are in poor health — and many of their chronic health problems are preventable. Recognition of these “unhealthy truths” helped to shape the types of policy solutions proposed in Vermont during the 2006 debate. Controlling chronic conditions through prevention and disease management featured prominently in Vermont’s plan to make health care more affordable.

I absolutely agree that the primary focus of a reformed health care package should focus on making health care more affordable while expanding coverage. But at the end of that statement, I would add the addendum “in the private sector.”

What Thorpe is saying is dead on. But I think this plan needs to be attempted in the free market before we implement a predominantly government solution.

The government’s role should be more of a moderator than a provider. I think the government would be best fit to help implement and encourage private companies to enact all three of the objectives achieved in Vermont.

And by offering more information and choice to the insured, we can significantly cut the taxpayer’s bill and maintain the quality of care offered in the private sector.

The Vermont plan is a good start. We just need a free market test case as well.