October 31, 2014

Understanding health care reform

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By Todd Gregory, MD

The discussion on whether to publicly fund Vermont’s health care system is a major crossroad with potential advantages, disadvantages and unknowns that will impact you and your family.

By January, if not earlier, Governor Shumlin will release a plan for how to publicly finance health insurance for most, if not all residents, using taxes to create a public program known as Green Mountain Care (GMC). State legislators will then evaluate, amend and ultimately accept or reject this plan.
While Vermont’s hospitals, physicians and other caregivers will evaluate health care reform proposals to ensure that they cover all Vermonters, reduce costs and enhance quality; the voice that matters most is yours. Please join this important dialogue, learn the facts and make your voice heard.

Ask questions
How Vermonters pay for health care is a critically important aspect of reform. As we make our way through the process of reforming how we finance health care, it’s important that we discuss all of the options.
To help you understand these important questions, we encourage you to ask a lot of questions of your legislators, governor, local hospitals and your health care providers.
Here are some that might be particularly helpful to help you understand how any proposed changes will affect you or your loved ones:
Will Green Mountain Care lower your costs?
How would the GMC benefits compare with the benefits you have today?
Can I plan to receive the same quality health care that I receive today?
Who will serve you when you have a question about care and coverage?
Who will decide which doctors you see and which hospitals you use?
Will you be able to access care outside of Vermont, especially in an emergency—and will you have to pay more if you do?
Will you pay more for your coverage if health care costs increase more than expected?
Who will be covered by the GMC plan? Will anyone not be covered, and if not, why?
How will GMC keep up with the latest health care innovations?
Asking questions—and getting them answered—is the only way to understand the benefits, risks and the trade-offs to you and your family, your community and to our state.

Understand costs
All Vermonters need to know how the GMC plan will affect them financially. Add up what you’re paying for health care. Include out-of-pocket costs, premiums and expenses associated with eye care, dental care and other health costs. Then, add up your state income and property taxes. This exercise will itemize what you’re paying now for health care and taxes. When January arrives, you’ll be better prepared to evaluate the proposed changes tied to the GMC plan and how much it will cost you personally.

Talk to experts
In Vermont, lawmakers, administration officials and others working on health care reform are just an email or phone call away. Talk to your legislators, call the governor to get your questions answered and be heard.
Finally, talk to doctors and nurses and other health care professionals. We all have thoughts on how to build a health care system that is more affordable, protects your rights, and are absolutely committed to providing you the very best care available. We may not have all the answers, but we are always happy to share what we know and like you, we’re going to keep asking questions.

Todd Gregory is the medical director of Rutland Regional Medical Center’s Emergency Department.

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