By: Samantha Watson; Vermont Public

Sen. Bernie Sanders, on Friday, hosted a roundtable discussion with representatives from Vermont’s health insurance companies, the CEO of the state’s largest health care provider and others to discuss the rising costs of health care in Vermont.

The meeting comes just weeks after Blue Cross Blue Shield of Vermont and MVP Health Care — the only two insurers that offer plans through Vermont’s state health exchange —proposed rate increases that would raise premiums anywhere from 9-19% in 2025, if approved.

The proposal is up for review by the Green Mountain Care Board, a group created by the Vermont Legislature to regulate health insurance rates.

“It’s a broken, corrupt system,” Sanders told the room, adding that he was looking for concrete solutions. “What can we do here in Vermont?”

Sanders pressed Don George, CEO and president of Blue Cross Blue Shield of Vermont, on why the company was proposing such large premium increases.

He cited a number of factors, including the rising cost of prescription drugs and the decline of the average health of Vermonters — tied to the state’s rapidly aging population.

“The alarming trend that I want to address, for all of us, is a trend in the deterioration of the health status among the 200,000 Blue Cross Blue Shield of Vermont members, which is causing an increase in the proliferation and use of prescription drugs and increase in use of medical services and certainly an increase in use in the more intensive healthcare services,” George said.

Dr. Stephen Leffler, president and COO of the University of Vermont Medical Center, agreed.

“We need more younger Vermonters who need less health care, not on meds, don’t have chronic illnesses,” he said.

Leffler said UVMMC is busier than ever. It performed a record number of surgeries last month and is dealing with a hefty backlog, exacerbated by a shortage of health care workers.

“We have a shortage of nurses, respiratory therapists, radiology technicians, [I] could go on and on and on,” Leffler said. “They are able to draw high wages, and we have to compete and pay that.”

Sanders asked Leffler what UVMMC is planning to do about the state’s shortage of nurses. Vermont currently relies on traveling nurses to address the gap, which costs hospitals two to three times more than it would to hire in-state nurses.

“We have a shortage of nurses, respiratory therapists, radiology technicians, [I] could go on and on and on. They are able to draw high wages, and we have to compete and pay that.”

Dr. Stephen Leffler, University of Vermont Medical Center

Leffler said part of the solution is expanding the hospital’s teaching and resident capacity.

“We need to make sure that we have clinical space for every single student who wants to go to one of our colleges and become a nurse,” he said. “We don’t have enough clinical applications right now.”

Sanders said that is something he’s also working on in Washington D.C.

“We are quadruple funding for teaching health centers, which means that Rutland, and Southwestern [hospitals] and others will now be able to have residents,” he said.

The roundtable discussion also touched on the impact of rising insurance premiums on small business owners.

Gina Akley, president of Trow & Holden, a masonry business based in Barre, said she pays her employees a “tremendous amount of money to not take my health care.”

She said it’s cheaper for her business to pay employees a percentage of the premium as an additional salary, which they can use to find their own health insurance policy, than to join her company’s plan. And costs are slated to go up.

“With a 19% increase next year, if all of my employees took it, my health care costs would be half a million dollars,” Akley said. “I’m a $3 million a year company.”

Owen Foster, chair of the Green Mountain Care Board, said health care in Vermont faces a “systems problem.” He said the state’s insurance companies are not on solid financial footing and neither are the hospitals.

“There’s no more money to bail out these problems,” he said. “We can’t take it. We have to allocate our resources better.”

Small business owner Gina Akley questioned whether that was true.

“I looked up how much all of you make before I got here,” she said. “ I’ll tell you what I make: I pay myself $86,000 a year. … Everybody deserves to make money. And I don’t mean to denigrate that, but it’s very hard for me to look at some of those numbers and look at some of those profit numbers and say, ‘There’s not enough money in the system.’”

In 2018, Seven Days reported that 60 employees of 16 non-profits were paid a salary of half a million dollars. Nine of the top 10 highest earners worked in the health care field.

According to federal tax data, in 2016, the president of the Vermont Association of Hospitals and Health Systems made $348,662. Don George of Blue Cross Blue Shield of Vermont made a salary of $614,000.

A Vermont hospital salaries report released by the state reported that Stephen Leffler of UVMMC made a total salary — with benefits — of $724,286 in the 2020-2021 fiscal year.

Sanders closed the roundtable by urging participants to “go forward with a sense of urgency” while keeping in mind that Vermont is a small state.

“And all I can say, I think speaking for the vast majority of the people in our state, the status quo is not working,” he said. “But we’ve got to change it. We’ve got to be bold. We have to be prepared to take on some powerful special interests.”