Evolving standards for all payers reveal their shortcomings


We recently learned that the federal government has notified the State of Vermont that the enrollment targets for the All Payers (and therefore OneCare) model are both “unachievable” and “unnecessary”.

This is a whole new way of setting standards. Imagine if a professor or teacher tells his students that they need to write three articles, then decides it’s impossible after they haven’t returned the assignment, then gives everyone an “A” ” in any event ! We could also tell potential lawyers that they have to pass the bar exam and then decide that it is not possible to get the bar and certify them to practice the legal profession despite that.

Should we apply this framework to pilots, surgeons, accountants, electricians? We could just keep changing the goalposts when people don’t meet them and declare them competent. Why should we stop with the all-pay model and OneCare?

Or maybe, instead, we could conclude that this whole all-payer model, relying on OneCare and an ever-evolving set of valuation standards, should be dissolved before we waste any more time and silver. There is no reason that we need another intermediary in our health care system when we could have instead pooled our funds for health care for all.

Ellen oxfeld

Middlebury

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