Consultant: Health Care Reform Won’t Be Quick Or Cheap

12/15/10 7:34AM By John Dillon
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Photo/Terry J. Allen
Dr. William Hsiao
(Host) The consultant in charge of designing an overhaul of Vermont's health care system says complete reform won't be quick - and it may not be cheap.

Dr. William Hsiao of the Harvard School of Public Health is due to present his findings in mid-January.

As VPR's John Dillon reports, Hsiao gave a status report on his work this week. And he outlined the challenges ahead.

(Dillon) Hsiao is an economics professor at the Harvard School of Public Health, and has helped guide health reform efforts around the world.

The Legislature gave Hsiao orders to come back with three alternatives: a single payer health plan, a public option, and a reform plan based on his own design.

With a month to go before he delivers the report,

Hsiao gave an oversight committee an update on some of his findings so far. He said that Vermont's current system is not working. About 7.5 percent of the population remains without health insurance, and costs are rising at unacceptable rates.

(Hsiao) "You really have, I call it a broken system. Actually it will continue to erode unless you take some major steps."

(Dillon) Hsiao said savings could only be achieved by changing how health care is paid for.

(Hsiao) "The only strategy that has proven to be effective around the world - other than revolution - is you change the payment system."

(Dillon) A single payer system, he says, would cut administrative costs and could pay health care providers for performance, instead of the fee for service system that exists now.

But Hsiao said he's concerned that making what he called the "dream" of health care reform into reality will cost more than some people expect.

(Hsiao) "In that process, that's when rubber meets the road. What you have to do and what you have to pay to make that dream come true. So I'm quite confident our report is not going to please everyone."

(Dillon) And the public eager for complete health care reform better be patient. Hsiao said the plan he's designing could take more than a decade to fully implement.

(Hsiao) "If you're talking about a whole system change, particularly the delivery change - we predict that it will take at least 12 years, and that is optimistic."

(Dillon) Political obstacles also remain. To enact single payer in Vermont, the state would need a federal waiver.

And Governor elect Peter Shumlin said this week that for a complete single payer system to take effect here, Congress would also need to change a federal law that regulates employer self-insurance plans. Those plans cover about 20 percent of Vermont workers.

For VPR News, I'm John Dillon in Montpelier.

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