Health care protesters take aim at all-payer system at events Friday, this weekend

Advocates for making Medicaid more accessible and ditching the all-payer system held a picket Friday.
Advocates for making Medicaid more accessible and ditching the all-payer system held a picket Friday.(WCAX)
Published: Oct. 2, 2020 at 7:48 AM EDT
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BURLINGTON, Vt. (WCAX) - Advocates for making Medicaid more accessible for low-income Vermonters plan to march in towns across Vermont urging state leaders to ditch the state’s experimental all-payer model. But state leaders say they’re not abandoning the reform effort just yet.

The Vermont Workers' Center, the organizer of the planned actions on Friday and this weekend, say the all-payer model is riddled with problems and isn’t meeting its goals. They’re pushing for universal, government-funded health care for all.

“No one should have to question how much it should cost when they are deciding to get treatment, whether it’s for COVID or anything else,” said the center’s Jessica Morrison.

Vermont abandoned attempts to create a single-payer system back in 2015 and is now in year three of a five-year experiment with the all-payer system. It still relies on private insurance but changes how doctors are paid and focuses on preventative care.

Protestors say the state’s reform efforts and the company overseeing the reform, OneCare Vermont, have failed to bring down costs and has led to lower wages for health care workers.

“The money is there if we decide it’s a priority. We shifted a lot of priorities for the pandemic,” Morrison said.

But state officials are doubling down on the reform effort with a planned reboot of the all-payer model. Agency of Human Services Secretary Mike Smith says it’ll take changes at the state and federal level as well as within OneCare Vermont. “Take the theoretical and make it better operationally,” Smith said.

Smith also points to the all-payer model’s fixed monthly payments that kept providers alive when the state shut down elective procedures in the thick of the pandemic. “To avoid any collapse of health care during the time of the pandemic,” Smith said.

But for reform to work, every provider serving every Vermonter has to be a part of OneCare. The Scott administration is working to try to bring the 7,500 member Vermont State Employees Association and the 12,000 member teachers' union into OneCare.

Scott says despite the challenges, Vermonters need to give the all-payer model time since the gave five years to single-payer reform before Governor Shumlin ditched the effort.

“I think we owe it to everyone to keep moving forward in the all-payer model for the full five years. I believe it can be improved. It can work but we have to prove ourselves,” Scott said.

Supporters of the all-payer model also stress that it will take time to see if reform efforts are actually working, because improving population health doesn’t happen overnight. But for those picketing Friday and this weekend, it’s not fast enough.

Related Stories:

Green Mountain Care Board changes course on hospital budget cuts

Scott administration to release plan to reboot all-payer health care efforts

Group of Vt. doctors push for single-payer health care reform

Audit questions whether OneCare saves money

Pandemic tests Vermont health care reform efforts

‘Rally for Medicaid’ takes aim at OneCare Vermont

Experts say Vermont health care reform efforts on track

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