This commentary is by Liz Hunt of Charlotte. She is a pediatric nephrologist (children’s kidney doctor) at UVM Children’s Hospital.Since the Oliver Wyman Act 167 report was published and the Green Mountain Care Board announced its budget decision for the UVM Health Network, there has been a sense of worry and sadness at UVM Medical Center. As a pediatric nephrologist, I am concerned about the planned cuts at UVMMC, which will significantly impact people with end-stage kidney diseaseI grew up in rural Vermont and care for children who travel far distances to see me. I rely on partnering with strong local care, so the idea of reducing services at smaller hospitals like North Country Hospital and Gifford hospital is worrisome. This is a critical time for Vermonters to consider what they want for the future of health care. There is an abundance of data that adults and children who live in rural areas have poorer health outcomes. What impact will the recommendations in the Wyman Report and the decisions the GMCB is making have on health care outcomes for Vermonters in rural areas? How many people will decide not to get health care if they must drive to Burlington for care?We all want to see equity in high-quality care for the patients we serve, but the current health care climate in Vermont seems to be going against this trend. The people disproportionately impacted by the GMCB recommendations are people who live in rural areas without easy access to transportation and people whose jobs aren’t flexible. I do not think that this is equitable health care. READ MORE UVM Health Network cuts elicit dismay, frustration by Peter D'Auria November 21, 2024, 6:00 pmNovember 21, 2024, 6:01 pm What are our options if services are shut down in Vermont? I spent my early childhood in rural Vermont and attended the UVM Larner College of Medicine. I left Vermont for Boston for residency and fellowship training. While in Boston, I trained in top academic hospitals and appreciated the specialized services they can provide.I returned to Vermont because I believe in providing excellent care that is local and personalized, something that can be lacking in large urban hospital settings. I’m thankful that I know my patients as people and that I see them in the community and at my kids’ sporting events.  I am proud of the UVM Children’s Hospital and the care we provide. The GMCB-mandated cuts threaten that high-quality care for patients young and old.If we lose services in Vermont, patients and families will have to travel further for care. This is extremely burdensome to patients and likely will not lead to improvements in the cost of care.  A few years ago, my son became unexpectedly critically ill. He was cared for at the UVM Children’s Hospital pediatric ICU, but eventually had to be transferred to Boston for specialized care.The care he received at UVM Children’s Hospital was excellent and at least equal to the care he received in Boston. He made an amazing recovery, thanks to the care UVMCH provided. Being in Boston with him was difficult. It meant driving back and forth, splitting time with my husband, not working and not seeing our other kids. Our family’s experience made me realize how expensive, isolating and intimidating it is to be getting care in a big city far from home. Is this what we want for health care in Vermont?I encourage my fellow Vermonters to think about their values and their health care priorities.  This experience has made me curious about the Green Mountain Care Board. What is their mission and their expertise? They are making decisions that will shape Vermonter’s access to health care. What are the checks and balances for non-elected government agencies? I worry that if we lose services, medical staff and hospitals, that we won’t be able to resurrect them later.  How do we balance the need to make health care affordable and to ensure that everyone, including people in rural areas with life-threatening medical problems, has access to good health care? I think that everyone can agree that health care is too expensive and complicated. Complex problems benefit from groups of experienced people from varied backgrounds to solve them. Clinicians, patients, legislators and GMCB members need to work together to understand the complex nature of this problem and ensure equitable access to healthcare throughout Vermont. Read the story on VTDigger here: Dr. Liz Hunt: How do we balance health care affordability and access?.