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Vermont health reform panel recommends analyst

By Nancy Remsen
Burlington  (Vt.) Free Press, June 29, 2010

MONTPELIER — The Health Care Reform Commission recommended Monday that the Legislature hire the Harvard economist who helped Taiwan revamp its health-care system for a six-month, $300,000 health research project for Vermont.

The consultant’s task: Give lawmakers three roadmaps the state could follow to achieve a more efficient and accessible but less-expensive health-care system. One must be a government-financed system, and another must include a public option for health coverage along with private insurance.

The commission received proposals from three consultants, interviewed representatives of two Monday morning and made a unanimous choice after lunch.

Today the Legislature’s Joint Fiscal Committee is to decide whether it agrees with the commission’s choice of William S. Hsiao, professor of economics at the Harvard School of Public Health and his associates, Jonathan Gruber, an economics professor at Massachusetts Institute of Technology, and Steven Kappel, a health policy analyst who previously worked for the state and for the Legislature.

Details of the Hsiao, Gruber, Kappel proposal — and the rival bids from Lewin Group of Falls Church, Va., and Mathmatica Policy Research Inc. of Washington, D.C. — remain confidential until an agreement is signed.

“All three proposals were good on the analytical front,” said Commission Co-Chairman Rep. Steve Maier, D-Middlebury. Still, he and others agreed Hsiao’s proposal stood out, and his presentation clinched his selection.

“Dr. Hsiao’s proposal offers us the greatest value,” said Rep. Mark Larson, D-Burlington.

“His group has a track record all over the work designing health-care systems,” said Rep. Francis “Topper” McFaun, R-Barre. “He knows what works.”

The research project was described in a health-care bill enacted during this past session. With an economic downturn and a budget crisis, lawmakers concluded this wasn’t the year to take another giant step in reforming health care. Still, a majority wanted to keep up the momentum — especially given what they saw as shortcomings of the final package passed by the U.S. Congress.

The designs the winning consultant must deliver by next winter are intended to guide the Legislature’s next steps.

Hsiao had spoken to the Legislature’s health-care committees last winter about the potential savings and shortcomings of a single-payer system. Many lawmakers came away impressed.

Sen. Kevin Mullin, R-Rutland, noted some people might suggest the “fix” was in to select Hsiao to do the study. Mullin said he tried hard to find reasons to pick one of the other consultants. In the end, he agreed with the rest of the commission: “This one is the best for Vermont.”

“I’m absolutely ecstatic,” said Dr. Deb Richter, an advocate of moving to a government-financed health-care system. “This gives me hope we really will come to some solution for Vermont, that this will advance us to some meaningful solution beyond where the national bill would have brought us.”

Richter recounted an image Hsiao had offered of health care in Vermont today: “He likened it to having pieces of a quilt. You have to sew them all together. That is what he can do.”

In a brief telephone interview, Hsiao said he and his colleagues were excited about the prospect of developing designs to guide the state: “Vermont could be in the vanguard for the nation.”

Contact Nancy Remsen at 651-4888 or nremsen@burlingtonfreepress.com. To have Free Press headlines delivered free to your e-mail, sign up at www.burlingtonfreepress.com/newsletters.