Newsletter for Meeting of October 23, 2013
October 23, 2013 Newsletter
By John Hammer
Charlotte Shelburne Rotary
Wednesday, October 23, 2013, 7:15 a.m.
Trinity Episcopal Church Community Room
Welcome
President Dave Jonah opened the meeting with the Pledge. Kris Engstrom gave the invocation.
Guests: Norm Silcox from Shelburne
Clinton Reichard, PDG District 7850
David Gladstone, Member of the Burlington Rotary Club
Terry Patron, Guest of Roz Graham
Al Gobeille, Speaker
Quote of the Day: “This is the domestic problem of our time!” Spoken by Al Gobeille when outlining the growth in health care costs over the next five years.
Upcoming:
October 27 – Shelburne Halloween Parade
October 30 – Peter Deng – Graduate from Champlain College who started an entrepreneurial project in Africa.
November 1 – Car Raffle – Shelburne Farms Coach Barn
November 6 - Doris Sage, Stigma Foundation
November 13 – Club Assembly
April 25-27 – 7850 District Conference, Hilton Hotel, Burlington
District 7850 Calendar: Hot Link http://www.clubrunner.ca/Portal/Events/EventsCalendar.aspx?accountid=50051
Announcements
Volunteer Activities
Michael Clapp reported that his construction crew of Rotary volunteers will be needed in the near future to finish the compost building at the Charlotte Central School
Car Raffle
Ric Flood was literally speechless (with laryngitis) so Robert Maynes took over. Two past regular ticket holders have dropped out. That will make it all the harder to get all the tickets sold. All members are encouraged to sell more pumpkin tickets and full tickets, if possible. This year’s tickets will be $275. Those who have solicited door prizes are urged to get them turned in as soon as possible so that the prize lists can be printed. Turn the prizes in to Colleen Haag at the Shelburne Town Offices. Sam Feitelberg has accounted for over $1,500 in door prizes already. Way to go! A Pumpkin Raffle ticket was drawn for Terrill Titus.
Shelburne Halloween Parade
Thanks to the fine work of DG Steve Dates, when he ran the Shelburne Halloween Parade, there is a marvelous guide booklet and volunteer matrix. Dave Rice has it all filled out and the parade is ready to go. The assignment sheet is at the end of this Newsletter. The Shelburne Cub Scout Pack has asked to be able to help after the parade. It was decided to assign them as the projects become obvious.
Thanksgiving Turkeys
George Schiavonne offered to take over the outstanding job that Jim Spad has done these many years coordinating the Thanksgiving and Christmas Turkey distribution.
Sergeant at Arms
Robert Maynes – Sympathy for Ric Flood’s laryngitis and in solidarity with the other gentlemen wearing suits today.
Sam Feitelberg – For such a quiet table today (referring to the nearby case of laryngitis).
Terrill Titus – For some of the very best conversations she has had with Ric ever
Linda Gilbert – Husband Al visited the Tela Rotary meeting and gave a full speech in Spanish. He expects that we will have a visitor next year from a member of the Tela Club.
Carol Obuchowski – For the great weather and the fact that she ahs not been frozen yet at three football games in the last month.
Joan Lennes – For Al Gilbert doing a wonderful job in Honduras.
George Schiavonne – First time that he has had breakfast together with Joan Lennes at the same table (They are political opposites in the same district, having run against each other.)
Kris Engstrom – For the lunar eclipse last Friday. She was finally able to see one. The weather was just right.
Roz Graham – Good to have Terry Patron here and she forgot something else.
Terry Patrone – Happy to be here at Roz’s invitation.
Steve Dates – Glad to have his good friends Clint and Norm here today.
Linda Schiavonne – Glad to have Clinton Reichard, Norm Silcox and Al Gobeille here with us.
Al Gobeille – Happy to be here and he felt he owed a dollar for being in a suit.
Chris Davis – Jets beat the Patriots
Fritz Horton – Once again asked that everyone who is soliciting door prizes do it this coming week. Reported that Sam Feitelberg had solicited $1500 in door prizes. Thank you Sam.
Denny Bowen – Will miss the parade because he has been summoned by his eldest daughter to Charlotte, North Carolina for further improvement.
Mark Joczik – Steelers are on a two-game winning streak and also congratulations for the fabulous job the Fletcher Allen Health Center (FAHC) staff has done in winning the award for being the seventh best hospital in the country.
Terrill Titus – Very happy to be with Clinton Reichard and is happy to see all the well-dressed women in this club.
Roz Graham – Roz remembered she won’t be at the Halloween Parade. This is the beginning of a new weekly TV series, “Roz Remembers!”
Trafton Crandall – Slaughtered his three little pigs yesterday. Aurrrgghhh! “Who ate sausages this morning for breakfast?” He will be absent for several weeks because he will be attending his granddaughter’s second birthday next week, followed by a two-week trip to Kenya.
Russ Blodgett – Reminded everyone that tonight the Red Sox play in the first game of the World Series in Boston.
Roz Graham’s number was called and she drew the Ace of Hearts. Roll over the pot of $218.00.
Speaker – Al Gobeille – restaurateur, Shelburne Selectboard member but most importantly today he is the Chair of the Board of the Vermont Green Mountain Care
He was shocked to hear that his old conservative friend, George Schiavonne, revealed today at the breakfast table that he ate hemp hearts on his muesli, overspread with almond milk. Hemp Hearts?
Vermont Green Mountain Care has about 20 employees and they are involved in regulation and innovation in the provision of Vermont health care.
What has happened in America in health care.
· In 1964 healthcare was 5.65% of our GDP. In 2008 dollars it cost about $500 per person
· In 1992 it was 13.1% of GDP at $1,200 per person
· In 2008 it was 16.3% of GDP at $7,000 per person
· In 2018 it is expected to consume 18.6% of GDP for who knows how much. “This is the domestic problem of our time!”
Teddy Roosevelt tried to establish national health insurance and so also did Nixon (with Ted Kennedy) who came out with a program much like the current Affordable Care Act. Both were Republicans.
“This is something that could literally bring our country to its knees. This is a phenomenal problem.”
An average American family makes about $60,000 a year which adds up to about $30 per hour of work by both of the parents. A cost of “platinum” health care is $10.75 per hour ($5.78 lower level). That comes out to more than 28% of a family’s income which is taken with health care. He pointed out that back when he was buying his first home, the banks would not give you a mortgage if you were paying more than 28% for housing. Over that you were considered too risky.
We don’t have the best outcomes by far when we are compared with the rest of the developed world. But we pay significantly more. In Switzerland you pay 8% of your salary, no matter how much you make. In the U.S., your contribution towards health care stops after you reach $90,000 of salary. He says that the Affordable Care Act is a good idea.
Al got involved because of this problem. The biggest problem in Vermont’s health care is confusion in who does what, who is responsible for what, and who’s to blame for what. Act 48 governs. The Green Mountain Care Board (GMCB) regulates and innovates. They are not VermontHealthConnect.gov.
The GMCB picks the benefits for the web site. They cost them out with the insurance companies to make them as affordable as possible. They regulate FAHC. The award FAHC just received is magnificent! The GMCB works on insurance rates, hospital budgets and certificates of need. They evaluate the need for capital improvements. It prevents an “arms race” within the state between health care facilities.
They set standards to innovate the provision of the most efficient service. GMCB has energized all the 14 health care facilities that serve the state such that they are all working hard to innovate. The GMCB sets clear standards and the hospitals are allowed innovate to reach those standards on their own in their own way.
We need a clear standard of what we are willing to accept in terms of efficiency. How do we measure efficiency? “You have to measure the results through money, but with health care it isn’t just about money, it’s about care.” We need to know that the cost is fair and that it is efficient in what care it brings to the patient.
‘One Care’ is an entity begun by Dartmouth and FAHC and joined by all the other hospitals in the state to participate in an accountable health care organization with Medicare. They control health care based on quality scores for any volume reductions that they see and share in the savings.
The GMCB receive the projected costs of the health insurance premiums from the MVC and Blue Cross. The GMCB then study them and make recommendations and corrections. By doing so and working with the insurance companies, they have cut the premium costs for next year by $24.7 M out of a projected total of $ 400 M book of business. That’s sound regulation. What happened last year when the hospitals had been told that they could only grow at 3% patient revenue they came up with innovations such that the projected growth rate for 2014 is projected to be 2.7%, the lowest growth rate in cost per patient since the statistics were begun. The hospitals did it themselves. They came in proud of what they had done.
We, as a society, must reduce the growth not the provision of health care. The prognosis is that by 2045 at the present rate every dollar that we earn will have to go to health care.
