Paula Routly: Vermont's Unsustainable Cost of Health Care

For as long as Seven Days has offered health insurance to our employees, circa 1997, I’ve signed the monthly check that pays for it. In that time, I’ve seen the per-employee premium increase steadily from roughly a hundred bucks a month to just shy of $1,000. It took two decades for the monthly price to climb to $491. Then, in the past six years, that cost has doubled, to $980 per month. Our rapidly rising numbers track with what Colin Flanders reports in this week’s cover story, about the increasingly unsustainable cost of health care plans in Vermont.

I remember the shocking realization that it was the responsibility of our little company to provide this pricey benefit to our employees. Simply put, people wouldn’t work for us if health insurance wasn’t part of the offer. Of course, we want our coworkers to be well — never to neglect a medical issue for financial reasons. Still, I wondered: How did providing access to and paying for health care become part of our business and an essential recruitment tool? More recently, when I sign that $30,000 check each month, I’m thinking: Where are we going to get the money to pay for this? Medical insurance is now our third-biggest expenditure, after payroll and printing.

To be honest, it’s something of a relief to read that other Vermont employers are struggling to manage this out-of-control expense. Every autumn we get the bad news about next year’s rates and debate whether we should tinker with the plans we offer or switch to another insurer, whether we can absorb the increase or need to pass it along our employees. I always assumed bigger Vermont employers were getting a better deal; otherwise, they’d be showing up to complain at Green Mountain Care Board public hearings, right?

In fact, most private companies and public employers just ate these price hikes; offering a good health care plan makes you more competitive. Now, at last, some of them are speaking out. The University of Vermont recently announced a tuition hike and blamed it on the rising cost of employee health care. After years of quietly accepting the increases and passing them on to taxpayers, school districts and other large public entities are sounding the alarm, too.

Maybe it’s not a big deal if your company’s sales are growing steadily or you can raise prices without losing business. But for those of us serving customers who can’t pay more — childcare providers, restaurants, local news publishers, regular Vermonters — these annual, double-digit increases are unsustainable.

In “Urgent Scare,” Colin explains how we got here. Problems with Vermont’s health care system have been growing larger, and more tangled, for years, and Colin has covered some of them, including the shortage of first responders in rural areas and wait times to see specialists at the University of Vermont Medical Center. This particular story was prompted by a recent report — ordered by the legislature — that spells out what ails Vermont hospitals and what can be done about it. The author, Dr. Bruce Hamory, “spent a year in Vermont meeting with hospital leaders, state officials, health insurers and patients. He reviewed budget documents, data submissions and demographic trends,” Colin writes. Hamory’s diagnosis is dire. His recommendations, transformational — and controversial.

“There is no hospital in Vermont that is not in jeopardy,” Hamory said. I hope you’ll read Colin’s piece to better understand what the state is up against.

In five months, I’ll qualify for Medicare — one of the very few benefits of getting old. Meantime, my goal is to stay out of the hospital. Today, at least, that means taking a walk around the block before it gets dark — and before the vote counting begins to determine our next president — instead of stress-eating leftover Halloween candy.