Vermont’s health care costs continue to soar, and state regulators haven’t done enough to curb them, according to Auditor Doug Hoffer. 

The average Vermonter pays more than $9,000 a year for health care, an expense which skyrocketed 167% between 2000 and 2018, according to a report released by Hoffer’s office Tuesday. The state has the second highest per capita prices in New England, just behind Massachusetts. 

The report offered a critique — both implicit and explicit — of the state’s health care reform efforts and its inability to slow the growth in costs. “You got to say, ‘boy, who’s at the wheel?’” Hoffer said in an interview. “Does anybody have the political will to stand up and say ‘no, this is not right?’ We can do better.’”

Green Mountain Care Board executive director Susan Barrett contended that the board had done what it could to lower costs, given its limitation. The board oversees hospital budgets and insurance rates, but has no control over drug costs or workforce issues. 

“We agree health care is too expensive, here in Vermont and throughout the country. Period,“ Barrett said. “To say that we haven’t been using the levers we’ve been given just isn’t true.” 

In his analysis, Hoffer attributed the rising costs to hospital consolidation at the University of Vermont Health Network, and the rising cost of services at hospitals. 

Over the past decade, UVM Health Network has expanded, affiliating with Central Vermont Medical Center in Berlin, Porter Medical Center in Middlebury and three New York hospitals. That consolidation increases prices and limits competition, VTDigger reported in January. It also gives the network more leverage when negotiating with insurance companies, driving up costs for patients, Hoffer said.

The growth in spending over that period went to the institutions, Hoffer said; Between 2011 and 2017, 55 cents of every new dollar spent on health care went to hospitals and the practices they own. Independent practices lost money over that period and many affiliated with hospitals. The extra cash also didn’t go to workers; most health care providers in Vermont have lower wages on average than those in surrounding states. 

In 1997, Vermonters spent an average of 12% of their income on health care services. Two decades later, it had risen to nearly 17%. 

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Last week, the Green Mountain Care Board approved rate increases to insurance companies, in the face of pressure to keep costs flat during a pandemic. 

“Really the takeaway for me is that the Green Mountain Care Board should devote more energy and resources to answering these questions — that’s their job,” Hoffer told VTDigger. 

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