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By Michael Bielawski
The State of Vermont and two other states are entering into a federally-funded healthcare collaboration promoting “equity” in healthcare.
The language implies that participating states may allow some citizens priority to healthcare resources because they belong to ‘underserved communities.’
A news release by the Centers for Medicare & Medicaid Services states, “On July 2, 2024, CMS announced that Connecticut, Maryland, and Vermont will be the first state participants in the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model. Hawaii will also participate, pending satisfaction of certain requirements.”
AHEAD has three main goals: “Improve overall population health of a specific state or region,” and ”advance health equity by reducing disparities in health outcome,” and “Curb the growth of health care costs.”
More specifically, the statement says “AHEAD [All-Payer Health Equity Approaches and Development] encourages a state level, multi-sector approach to care, advancing health equity and thereby improving population health outcomes, and coordinating resources to address underlying factors that contribute to disparities in health outcomes in underserved communities.”
It’s not yet clear how these disparities will be directly addressed. In the past, the State of Vermont set a precedent to allow prioritized healthcare by race. For example, in 2021 the Green Mountain State prioritized vaccine distribution based on race.
Financial incentives
The presser continues to explain that states entering into this program will receive extra federal funding, but only if certain conditions are met. The language specifically says that states “will be held accountable” for “equity targets” to get their money.
CMS states, “The AHEAD Model is scheduled to operate for a total of 11 years, from 2024 through 2034. CMS will provide cooperative agreement funding to selected states for up to 6 years to support their participation in this Model. A maximum of 12 million dollars may be awarded to each participating state.”
Another section further specifies, “As part of the model, participating states will be held accountable for statewide or sub-state targets that align with model goals for Medicare FFS and across all payers. States will also be responsible for ensuring that statewide quality and equity targets for all residents are being met.”
It somewhat clarifies the equity targets: “States will be required to establish a model governance structure to guide implementation of the model. Through this structure, states will convene individuals and organizations with a wide range of perspectives to inform model activities and build partnerships between the state, providers, payers, and the community to support model goals.”
Participants who go further with their state health equity plans might have access to additional “bonus” money. It states, “The Health Equity Improvement Bonus will provide an upward adjustment to a participating hospital’s global budget based on performance on select equity-related measures.”
It continues that a “Statewide Health Equity Plan” must be developed by each participating state and other details.
Economy of scale
As with other multi-state collaborations on public services in the past, part of the logic for its implementation is that having a larger multi-state population means a greater economy of scale. That means proponents hope to bring down costs.
“AHEAD is a state total cost of care (TCOC) model that seeks to drive state and regional health care transformation and multi-payer alignment, with the goal of improving the total health of a state population and lowering costs,” it states.
It continues, “Under a TCOC approach, a participating state uses its authority to assume responsibility for managing health care quality and costs across all payers, including Medicare, Medicaid, and private coverage.”
Return of the failed “All-Payer” model?
Vermont’s lawmakers in the past have already thoroughly examined the economic viability of what was dubbed the “All-Payer” model. After much debate, it was ultimately determined not viable fpr the economy.
Meg Hansen, the former executive director of Vermonters for Health Care Freedom, was an adamant critic of the proposal.
“Vermont tried to do the single-payer model [also the ‘all-payer’ model] … under Democrat Gov. Peter Shumlin,” Hansen was quoted by the Heartland Institute in 2019. “He made it the hallmark of his administration. In 2011, the Green Mountain Care Board—five bureaucrats that now determine all regulations for Vermont—was created to oversee and regulate the entire process. But the whole thing collapsed. It failed. They ran the numbers: There was a 150 percent increase in income tax on Vermonters and it still wasn’t enough [money].”
This policy in its FAQ section features the phrase “all-payer” hinting that this policy could push Vermont back toward a large healthcare system potentially similar to the one previously determined unfit for Vermont.
It states, “The AHEAD Model requires participating states to collect and report statewide quality, health equity, and all-payer TCOC [total cost of care] and primary care investment performance data.”
The author is a writer for the Vermont Daily Chronicle
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Categories: Health Care, Race and Division, State Government
Image, trying to equalize all health outcomes across the state. How is this even possible? It’s not. All the taxpayer money in the world will not change this fact.
You’re right. When you consider what 250% of the federal poverty amounts to, it means taking even from the those who are just barely making it, but not poor enough for assistance. And this taking goes on until they’re poor enough to depend on the state or too poor to exist.
If there is any health outcome disparity between those with darker vs lighter skin it is most likely due to differences in serum vitamin D. The solution is simple: supplement with vitamin D. However, Big Pharma and its govt lapdogs can’t have an effective, inexpensively simple solution when complex, expensive and ineffective ones serve to divide us along racial lines while keeping us sick and lining the pockets of drug makers☠️
Hmmmm…the most ridiculous idea ever. If the only measure is equitable outcomes, it’s impossible to predict. Just as participants in clinical trials are not guaranteed equitable outcomes. If it’s about equitable access, that is also impossible to govern. Within the limited healthcare resources available to Vermonters, giving someone access and preferential treatment based on race and ethnicity always means making a choice to also intentionally withhold healthcare from someone who is in critical need but in the wrong “underserved population.” My vote is to walk across state lines to a saner healthcare facility.
And if you suffer discrimination, sue. This is probably unconstitutional.
Please understand this is not about healthcare, it is about power and money. Climate change is not about climate, it is about power and money. Equity is not about equalizing anything it is about power and money. Are you sensing a theme here…
Power and money equals control.
Whatever else this program does or does not do, one thing is for sure, it will result in many more high paid state employees. And after the federal funding runs out in six years, guess who gets to foot the on-going expense. Because you know it won’t get shut down when the Feds funny money stops rolling in.
you will all be equal when you are dead//// sounds like the plan is working for population control/////
Do what the protester imbeciles do. Protest by doing what the law says will give you maximum return: Always mark off that you are an African American and LGBT.
Problem solved by way of screwing over the politicians’ idiotic plans. Bankrupt them with their own BS. Stop being the nice mice in the lab for once, okay?? Break their toys by way of over-participation… or you will be run out of town and state. WTF is wrong with you silly people and your humble crap? Get wise or be eaten for dinner.
AHEAD, or the ‘Advancing All-Payer Health Equity Approaches and Development’ Model,
will soon be discovered to be better described as…
BEHIND, or the ‘Be-ever hindered in nightmarish demagoguery’ Model.
No one group gets to buck the line, priority as to the threat. I also think that if we had people smart enough to spend our taxes wisely on Americans instead of foreigners, health care would be free. But just look how wasteful our bleeding heart liberal lawmakers are doing. They are actually making us go backwards spending on ideas that do not work. Sounds good but doesn’t work.
I can see all kinds of law suits arising out of this initiative particularly when to “allow some citizens priority to healthcare resources because they belong to ‘underserved communities”.
This was already done in Vermont during Covid19! Where are all the lawsuits? Of COURSE this is again completely unconstitutional, but where exactly are the causes of action & the attorneys bringing them?
correction needed….
underserved communists……there fixed it for you. 🙂
“”AHEAD has three main goals: “Improve overall population health of a specific state or region,” and ”advance health equity by reducing disparities in health outcome,” and “Curb the growth of health care costs.””
To improve overall health, stop eating processed foods, stop getting vaccines and stop going to the doctor. (Point One)
The equity thing is gibberish, so I can offer no comment on that.
Curbing the growth of health care costs, see point one above.
Meanwhile……back in the state of Reality as opposed to Vermont: The State of Vermont was consistently rated as one of the healthiest states in the union, with some of the longest-lived residents, its health care system was highly rated and VT was determined to be a state which possessed the highest number of insured persons.
But NOT GOOD ENOUGH for the leftists in the legislature who are DEMANDING socialized medicine here & the single payer model implemented and to heck with the successes of what the state once achieved. Criminals, illegals, and minorities MUST come first!
Seems like some white liberals in Vermont may suffer healthcare discrimination in the future because they have the wrong skin color. But hey – they voted for this.
There goes Vermont’s quality healthcare system. SVMC in Bennington saved my husband’s life not once, but twice. I myself have been catered to (in good, kind ways) & consoled & been cared for by engaged & respected medical professionals all over VT – top class.
It’s ALL going away thanks to “equity”. Hospitals are hemorrhaging, so to speak, good doctors, nurses & specialists at a rapid rate. The leftists are bound & determined to DESTROY Vermont’s once excellent-rated health care system in the name of social justice.
People will die. Communism will prevail & the accompanying socialized medicine & institutionalized medicine will downgrade this state further.
What a shame. The people who are experimenting with this beautiful little state as though a sick social experiment should find themselves on the receiving end of this phony B.S. one day when THEY are in need.
It upsets me when I see BLM flags still flying here in Vermont where we were the first to abolish slavery back in the 1777. When BLM first hit this state, we had a 1.3% black population that had a higher educational attainment rate than the whites. And the median income was in the same $50K range according to demographics long kept on 24/7WallStreet.com It is sad to see that so many Vermonters are gullible to enough to think that we should be the same as the rest of the country.
VERMONTERS stand up you are not a product of this national norm and you shouldn’t believe it. Sure there’s trace amounts of racial divides, but they are being made much worse by segregated groups in our schools – both among students and staff. Remove the stench that says we, too, must bow to the communist BLM organizers’ agenda to upend values that are globally esteemed. VERMONTERS celebrate your strength – teach the rest of the country – we don’t need the BLM communist indoctrination dividing us. Vermont – heal the nation with united efforts to teach acceptance and celebration of diverse cultural influences in our midst.
BLM really stands for: female dogs, Little, Marxists…….
You’ll have to use your decoder ring about the dogs, censors across the internet don’t allow a more accurate concise word usage.
Easy solution, suddenly 97% of Vermonters identify as BIpoc, transgenders……..
Then we’ll all be rich!!! We’ll all be healthy!!! All our problems in the world will be solved,
I’m not sure why everyone isn’t doing it? It solves all of lifes problems,….
After almost 500,000 Union troops, including black American Soldiers, died to end slavery in the US; and after nearly a century of the civil rights movement, constitutional amendments, Supreme Court rulings and Federal and State laws to end discrimination – it rears its ugly head again.
Through-out my life whether in the military, business or private life, I have believed in treating all people fairly. And have walked the talk.
But it’s not the ordinary American citizen discriminating, it the State and Federal government using some unsubstantiated idea that due to some form of discrimination there is an underserved population – hence they jump to the head of the medical line.
Who may I ask, are the underserved? People on welfare? Illegal aliens who are by many factual information form medical services are costing Americans $ Billions. We know from congressional reports the VA is diverting resources from American GI’s who need help, to pander to illegal aliens.
We know that lower and middle class Americans are underserved medically because they can’t afford insurance under Obama care and the Vermont’s medical insurance. We know there are sections of the US that are medically underserved like Appalachia. Are they covered by this new political policy? Nope!
So, who are the medically underserved in Vermont? Basically, anyone in Vermont paying for their overpriced health insurance under the wackadoodle Obamacare and Vermont cares. Just try and get an appointment to see a cardiologist, hematologist, orthopod etc. They’re months out.
So, while the rest of use paying the way for ourselves and others, and want to see a doc, it appears some racial groups will get to the head of the line.
The problem with this whole concept of underserved is just willy-nilly political pandering. And the question that is never asked or answered is who are these underserved why are they underserved?
There is not definition of who underserved person is – and race can’t be a decider because we know that their a is a comparable black middle and upper class, such as entertainers, municipal employees, athletes, doctors, lawyers and business owners.
So when we hear underserved we need to think another failure of our educations systems. How can people not know about good health, insurances, going to see a doctor etc. Although today, anyone trying to see a doctor is faced with issues.
The big question is how is going to be administered? when someone calls for an appointment are the going to ask if they’re an underseverd black person or whoever they want to include in their political game? Or is it any black person can get an appointment before you or I. Or are they going to triage to see who needs medical attention 1st.
It’s unconstitutional and against Federal Civil rights laws. So, what this is all about is the pandering by democrat and lib pandering for votes.
Equity destroys everything it’s implemented in.
Perhaps this is the rebooting, repackaging, and rebranding of the Tuskegee experiments? The globalist eugenists are working overtime to get their agenda done – they know their time is running out. They will take out as many as they can – and not to lunch. Anyone notice the milky, wispy, white, strange vapor substance blanketing the sky this morning? I noticed a number of funky manuvers from jets spewing the smog from their engines. Don’t be surprised if the rain comes down in buckets later this week and all that “stuff” lands on gardens, trees, and water sources…eat, drink, and breathe in more aluminum – it’s safe and effective!
This is an 11 year experiment that is doomed to fail while pretending to control health care costs. I knew the All Payer Wavier would not work from the beginning, and said so multiple times. I have repeatedly called for the abolishment of the Green Mountain Care Board. I have called health insurance a worthless product. It seems government cannot solve the problem . I recently heard that there is a new program to eliminate all hospital bills for low income people. I am very anxious to learn more about this. Mike Fisher said this would not hurt hospitals to give this free care because low income people don’t pay their bills. We have always paid our hospital bills. I did refuse to pay more than what medicaid paid because it was unfair to make me pay more because the hospitals were willing to charge less for medicaid. I want a health care system that is fair to all. I hope Vermont does not participate in this proposed 11 year experiment.
With as many informed commenters as VDC has… its clear that there is something not right in our voting venues now…that actually reflects the voters’ choices… we can only blame ourselves so far, then we start believing the gaslight that says our elections are above board and one vote equals one vote.
Look up “DOMINION” and “salami tactics” and how they relate in algorithmns applied to voting results. Any reporter who tried during that last three elections to point out this tactic came under fire from OUR Sec of State (Condos) and his mini-me assistant sec of state.
Until we acknowledge the depth of corruption of our VOTING rights, we can beat ourselves with wet noodles and the outcome will still be predetermined.
Salami tactics people… and now Dominion voting machines have put that in algorithms… the veil is torn: do you see, or is cognitive dissonance still kicking in?
Don’t allow your own integrity to be gaslighted but corrupt politicians… KNOW you are looking at flying monkeys sent by the dark one to take away your freedom to choose… its as simple as that. That’s what its all about: corral, kettle, propagandize, gaslight, target, dox, and take away your ability to HAVE a choice… by removing them.
Welcome to the sterile world of fearful humans.
God is great. God is good. God is merciful.
We don’t need any other laws than His.
Health is directly related to exercise, fresh, uncontaminated food and water, and the food we feed our brain: our thoughts. Health is predetermined by the quality of those characteristics. Period.
God made our thoughts, what we see and believe about ourselves and others and the world around us, link directly to our endocrine system — and the ancients have known this for millenia.
The afflictions from our own sins against our light nature as children of God, everything that stands between us and fully knowing Him (guilt, shame), makes us ill, or dis-eased. Our guilt tells our body not to thrive, OR to fight fight fight… but we never address our thoughts.
Curations of exercise, fresh foods and water, and our thoughts and what we feed our brain (how many hours do you inculcate world views from paid propagandists?) will change everything.
Of course, if you’re poor, you really have to make some sacrifices to get yourself healthy on your own…but it can be done with courage, knowing you are doing what He wants, not what you want… to be closer to him. Our dis-ease puts us at odds with Him.
This world systems contaminates, pollutes, propagandizes our minds, and removes the choice of how to deal with that crapola… and we are on the verge of making it illegal to MAKE any other HEALTHY choice for ourselves.
Making the connection between the health propaganda (you just need to take a pill) and your own health (did you buy into it? qui bono?) does away with any dependence on western medicine.
I’m nearly 15 years free of allopathic medicine, using homeopathic, terrain theory, detoxing and cleansing to get my body back to where it was meant to be, and then curating everything that goes into any part of my body i.e. NO vaccines ever (except tetanus, measles and polio).
It can be done… disentanglement is refreshing, believe me. Especially knowing the choice of what master we serve… is ours and ours alone.
Be positive, and look forward to the fall elections when this whole Biden/democrat/marxist nightmare will hopefully be in the ash bin of history.