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Yahoo
2 days ago
- Health
- Yahoo
Sanders says Vermont's 'broken and wildly expensive' health care system must be fixed
Sen. Bernie Sanders, I-Vermont, held an airport press conference on Monday morning, May 19, to intensify the focus on Vermont's health care crisis, driven by high costs and long wait times for appointments. "Everyone knows that our health care system nationally and in the state of Vermont is broken, it is dysfunctional and it is wildly expensive," Sanders said. "Nationally, the cost of health care per person, unbelievably, is $14,500 per person. In Vermont, it's even higher than that. This outrageously expensive health care is economically unsustainable, and by the way, twice as much per capita as other major countries spend, which guarantee health care to all their people." Sanders was joined at the press conference by Sen. Virginia "Ginny" Lyons, chair of the Vermont Senate Health and Welfare Committee; Rep. Alyssa Black, chair of the Vermont House Health Care Committee; Owen Foster, chair of the Green Mountain Care Board; Lisa Ventriss, co-chair of Vermont Health Care 911 and former president of the Vermont Business Roundtable; Mike Fisher, Chief Health Care Advocate at Vermont Legal Aid, and Jacob Berkowitz, president of UVM Support Staff United. Conspicuously absent from the press conference were any health care executives from the University of Vermont Health Network, or any other hospital in Vermont. UVM Health Network spokeswoman Annie Mackin attended the press conference as an observer only. Sanders said that despite the huge expenditures on health care in Vermont, "many of our people are either uninsured or under-insured with high deductibles and copayments." "Further, we don't have enough doctors, we don't have enough nurses, we don't have enough dentists, we don't have enough mental health care providers or pharmacists," Sanders continued. Turning to BlueCross BlueShield of Vermont, Sanders pointed out the state's largest health insurer has lost more than $150 million in the last four years and is "now on the brink of financial collapse, despite requesting premium increases of over 20% year after year just to stay afloat." "The bottom line is the status quo is unacceptable," Sanders said. "We cannot continue to ignore this crisis. In Washington, under Trump and the Republican leadership, we're moving in the wrong way. Here in Vermont, there are important initiatives beginning to address this crisis." Sanders especially decried the $715 billion in cuts being proposed for Medicaid, which he said would cause 8 million to 13 million people throughout the country to lose their health insurance, and would impact nursing homes, community health centers and hospitals as well. Lyons stood behind the lectern next, saying Vermont is "now finally recognizing we're in a health care crisis," and referring to a "black box" of agreements between hospitals and insurers regarding costs that no one is privy to in its entirety. "The Senate and House are passing legislation that will open the black box for health care transformation," Lyons said. "And believe me, it's not difficult to understand our health care system and it's time we educate our public and our constituents about the costs that are embedded in the black box of health care." Owen Foster, chair of the Green Mountain Care Board, which regulates hospitals and other aspects of the health care system in Vermont, gave a glimpse into that black box when he said Vermont hospitals have the highest upcharge in the United States on outpatient drugs. Foster gave the example of a cancer drug called Neulasta, which is critical to chemotherapy and has an average cost of about $1,300 per year, but costs about $95,000 for a year's supply at UVM Medical Center, of which Blue Cross Blue Shield of Vermont reimburses about $85,000. "Vermonters with debilitating conditions such as Crohn's Disease, arthritis or even cancer not only suffer physically, but then financially," Foster said. "At the same time, our primary care providers can barely financially survive. It's backward and it's wrong and it needs to change." Mackin issued a statement before the press conference began, saying the UVM Health Network "shares the deep concern expressed by Senator Sanders about potential Medicaid cuts." "Any cuts to Medicaid will hurt millions of people nationwide who rely on it for their health, and will impact the safety net providers who care for them," the statement said. "As a safety net provider for patients with Medicaid, as well as patients with Medicare, patients struggling to afford commercial insurance, and those who are uninsured, UVM Health Network agrees that the status quo isn't working for Vermonters. Change that makes health care work better for our patients, our people and communities will require tough decisions from all stakeholders. As a leading provider of care in our region, we recognize the urgency of this moment and are taking action, beginning with a series of cuts and commitments aimed at improving sustainability and affordability for Vermonters totaling $158 million so far, and we are committed to the fight to protect Medicaid for the hundreds of thousands of people in our region whose lives depend on it." After the press conference, Lyons told the Burlington Free Press there are currently bills moving through the House and Senate that would address Vermont's health care crisis. The Senate bill would begin to regulate and control hospital costs through reference-based pricing − bringing prices in line with national averages − and global budgeting for hospitals, so their budgets don't escalate every year. The Senate bill would also provide financial sustainability for up to half a dozen hospitals "desperately in the red across the state," by shifting money from the state's larger hospitals to its smaller, rural hospitals. "The third part of the bill is to increase interoperability, so patients, payers and providers all have access to clinical data when they need it," Lyons said. The House bill focuses on saving Blue Cross Blue Shield of Vermont, by reducing reimbursements to hospitals when their costs are too high. "What we are trying to do is open up that black box," Lyons said. Contact Dan D'Ambrosio at 660-1841 or ddambrosio@ Follow him on Twitter @DanDambrosioVT. This article originally appeared on Burlington Free Press: Press conference focuses attention on Vermont's 'broken' health care
Yahoo
10-05-2025
- Business
- Yahoo
Blue Cross VT CEO: Progress has been made, but health care costs 'simply unsustainable'
Blue Cross Blue Shield of Vermont CEO Don George has been ringing the alarm on the finances of the largest health insurance provider since last July, when he sent an open letter via email describing Blue Cross VT's "fragile financial situation." George said the insurer was being battered by escalating prices for hospital services and extraordinary markups in prescription medications, depleting its member reserves, driving up premiums and making health insurance all but unaffordable. He said Blue Cross VT found itself in the "unprecedented position" of being forced to file an amended request to the Green Mountain Care Board for an additional 4% increase in contributions to its reserve fund, which comes from premiums paid by policy holders. The reserve fund is used to cover unexpected levels of claims, which Blue Cross VT was experiencing. In case you missed it: Health companies return $2.6 trillion to shareholders over time amid rising medical costs This week, George sent another open letter via email, thanking "stakeholders" for the overwhelming response to his raising the alarm. "We want to express our appreciation to our regulators, legislators, government and health care partners across the state for their willingness to advance difficult but meaningful changes for our health system," George wrote. George outlined the steps that have been taken to stabilize Blue Cross VT and avert a crisis: Establishing, in coordination with the Vermont Department of Financial Regulation (DFR), a comprehensive capital recovery plan to ensure our long-term stability. Expanding the value of our Blue Cross Blue Shield of Michigan affiliation, a key enabler of our mission to make health care work better for all Vermonters. Reducing our financial risk in Vermont Blue Advantage, our Medicare Advantage plan. Limiting our already lean administrative expenses. Actively supporting legislation to protect our members and safeguard our position within the marketplace. Continuing to offer the highest quality health plans and customer service to our members. Proposing and supporting systemic changes in our health care system, including urging the Green Mountain Care Board to implement hospital/payer-specific revenue caps − an important step toward affordability. Blue Cross VT's financial challenges were a long time coming, according to George, who said high hospital prices, increased utilization, sicker patients and premiums insufficient to cover escalating claims, all spelled trouble. "Additionally, we've seen an increase in members with complex care needs and catastrophic conditions," George continued. "In 2024, 15% of our members met these criteria and accounted for 54% of total claims cost. We're incredibly proud to support Vermonters who are most in need of care. The high costs of these claims, however, requires a significant and steady draw on our finances." In 2024, George said that Blue Cross VT's member reserves fell to $58.4 million, with the inclusion of a $30 million loan, "triggering regulatory solvency oversight by the DFR." As a result, the portion of member premiums placed into the reserve fund rose to 7%. "The DFR will determine when we can return to normal funding levels," George said. While there were some "positive developments" in the first quarter of 2025, George said the cost of care remains "alarmingly high." "We currently pay $35 million per week in claims for our members, an amount fueled by hospital and drug costs that show no sign of slowing," he said. "The cost of health care is putting tremendous pressure on Vermonters − our people, our businesses and organizations that fund benefits, and our economy. It's simply unsustainable." George called out a recent settlement between the UVM Health Network and the Green Mountain Care Board as a "chance to reset," but not a solution to the rising trajectory of health care spending. "The $12 million promised to Blue Cross VT to resolve 2022 and 2023 overcharges is an important step, however, these funds are not nearly enough to offset our $62.1 million loss in 2024 or the cumulative millions over the past three years," George said. "More deliberate, long-term actions are required to limit pricing, curb unnecessary utilization and ensure long-term stability of our organization and our health system." Contact Dan D'Ambrosio at 660-1841 or ddambrosio@ Follow him on Twitter @DanDambrosioVT. This article originally appeared on Burlington Free Press: Blue Cross VT CEO says some progress made on health care affordability Sign in to access your portfolio
Yahoo
09-05-2025
- Business
- Yahoo
Blue Cross VT CEO: Progress has been made, but health care costs 'simply unsustainable'
Blue Cross Blue Shield of Vermont CEO Don George has been ringing the alarm on the finances of the largest health insurance provider since last July, when he sent an open letter via email describing Blue Cross VT's "fragile financial situation." George said the insurer was being battered by escalating prices for hospital services and extraordinary markups in prescription medications, depleting its member reserves, driving up premiums and making health insurance all but unaffordable. He said Blue Cross VT found itself in the "unprecedented position" of being forced to file an amended request to the Green Mountain Care Board for an additional 4% increase in contributions to its reserve fund, which comes from premiums paid by policy holders. The reserve fund is used to cover unexpected levels of claims, which Blue Cross VT was experiencing. In case you missed it: Health companies return $2.6 trillion to shareholders over time amid rising medical costs This week, George sent another open letter via email, thanking "stakeholders" for the overwhelming response to his raising the alarm. "We want to express our appreciation to our regulators, legislators, government and health care partners across the state for their willingness to advance difficult but meaningful changes for our health system," George wrote. George outlined the steps that have been taken to stabilize Blue Cross VT and avert a crisis: Establishing, in coordination with the Vermont Department of Financial Regulation (DFR), a comprehensive capital recovery plan to ensure our long-term stability. Expanding the value of our Blue Cross Blue Shield of Michigan affiliation, a key enabler of our mission to make health care work better for all Vermonters. Reducing our financial risk in Vermont Blue Advantage, our Medicare Advantage plan. Limiting our already lean administrative expenses. Actively supporting legislation to protect our members and safeguard our position within the marketplace. Continuing to offer the highest quality health plans and customer service to our members. Proposing and supporting systemic changes in our health care system, including urging the Green Mountain Care Board to implement hospital/payer-specific revenue caps − an important step toward affordability. Blue Cross VT's financial challenges were a long time coming, according to George, who said high hospital prices, increased utilization, sicker patients and premiums insufficient to cover escalating claims, all spelled trouble. "Additionally, we've seen an increase in members with complex care needs and catastrophic conditions," George continued. "In 2024, 15% of our members met these criteria and accounted for 54% of total claims cost. We're incredibly proud to support Vermonters who are most in need of care. The high costs of these claims, however, requires a significant and steady draw on our finances." In 2024, George said that Blue Cross VT's member reserves fell to $58.4 million, with the inclusion of a $30 million loan, "triggering regulatory solvency oversight by the DFR." As a result, the portion of member premiums placed into the reserve fund rose to 7%. "The DFR will determine when we can return to normal funding levels," George said. While there were some "positive developments" in the first quarter of 2025, George said the cost of care remains "alarmingly high." "We currently pay $35 million per week in claims for our members, an amount fueled by hospital and drug costs that show no sign of slowing," he said. "The cost of health care is putting tremendous pressure on Vermonters − our people, our businesses and organizations that fund benefits, and our economy. It's simply unsustainable." George called out a recent settlement between the UVM Health Network and the Green Mountain Care Board as a "chance to reset," but not a solution to the rising trajectory of health care spending. "The $12 million promised to Blue Cross VT to resolve 2022 and 2023 overcharges is an important step, however, these funds are not nearly enough to offset our $62.1 million loss in 2024 or the cumulative millions over the past three years," George said. "More deliberate, long-term actions are required to limit pricing, curb unnecessary utilization and ensure long-term stability of our organization and our health system." Contact Dan D'Ambrosio at 660-1841 or ddambrosio@ Follow him on Twitter @DanDambrosioVT. This article originally appeared on Burlington Free Press: Blue Cross VT CEO says some progress made on health care affordability Error while retrieving data Sign in to access your portfolio Error while retrieving data Error while retrieving data Error while retrieving data Error while retrieving data
