This commentary is by Jason Williams of Winooski. He is the chief external relations officer for the University of Vermont Health Network.
We have all had the experience of being overwhelmed with gratitude for a caregiver who was present during a very personal health care story: a life-changing moment. For some, telling the story brings relief, while for others it ends in the pain of loss. Like you, I have both types of stories. Medical care is related to life and quality of life.
As you read this, think about the health care you want for yourself and your loved ones when you need it. And we encourage you to continue working together to reach that goal, despite recent alarming actions by the state’s Green Mountain Care Commission, including budget orders leading to health care rationing. Also, Consultant report prepared for GMCB recommended closing local community hospitals and reducing services by nonprofit academic health systems.
Clinicians across the state provide excellent care to people in need within a disparate system of services that is often inefficient and fragmented. It’s hard for patients to languish in the hospital — sometimes for more than a year — for no medical reason, simply because they can’t be discharged due to lack of housing, transportation, mental health care, or long-term care options. That’s true.
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You can change this. I am encouraged by the role state human services departments can play in leading health policy and planning. If the state worked with health care providers to ensure all Vermonters have access to the right care, when they need it, in the right setting, we could save untold millions of dollars. This is the fastest path to affordability short of expanding Vermont’s workforce and tax base.
Significant community challenges complicate our work. Vermont needs thousands of housing units — Up to 36,000 units by 2029 — and a statewide emergency medical services system to safely transport patients. We must invest in community-based mental health, substance use, and disease prevention programs like never before. These programs help patients avoid the need for more expensive hospital or nursing home care.
The good news is that a significant part of this work is already in place. If we invest in them like our lives depended on it, which they do, imagine the progress we can achieve together.
Instead, recent GMCB budget decisions will penalize the University of Vermont Medical Center for providing more life-saving treatment to patients than it was authorized for last year, even though the net financial results of that treatment resulted in a loss. I did. If faithfully implemented, these budget orders would reduce the budget by more than $120 million. This is the equivalent of shutting down the three UVM Health Network hospitals in Vermont for 17 days and keeping everyone away.
Until now, we’ve absorbed most of the budget cuts, but patients have felt the impact through new equipment, service delays, and longer wait times. The cuts mandated by the GMCB are so significant that, despite further cuts to government services this year, an impact on patient care is inevitable.
So far, we have paused construction of our ambulatory surgery center, a state-recognized necessary project, eliminated more than 130 positions and improved system efficiency. We have also launched legal efforts to seek redress against these orders. Tough decisions await compliance.
A recent consultant’s report recommended that instead of encouraging Vermonters to make smart investments, they should essentially close four community hospitals and consolidate their services elsewhere across Vermont. It also recommended that more hospitals send care to UVM Medical Center, even though it is already full and facing budget cuts from the Green Mountain Care Commission. The result is increased costs and suffering as people are unable to access local care, have delayed care, or are forced to seek care out of state.
I believe the Green Mountain Care Commission has an opportunity to join other areas of state government and the health care provider community to create positive change. I am confident that if they unite us, build trust, and choose to work together, we can achieve the goals we all desire.
As Vermonters, we have important decisions to make. Will the path forward be determined by the rapid erosion of safety-net health systems, or will it require actions that foster the stability needed to build stronger, more sustainable health systems?
Every day, when I think about the care my family and friends receive from clinicians across the state, I am determined to do better for all Vermonters. Please rest assured. We continue to meet these challenges with integrity, diligence, and consideration for our neighbors and friends, striving to provide the highest quality and most accessible care despite these circumstances. I’m coming. Everything we do comes from knowledge, experience and understanding to do one thing: serve our patients and our communities.
