Vermont’s pursuit of a more affordable health care care system must include cuts from the top, two state lawmakers say. Sen. Tanya Vyhovsky (P/D-Chittenden-Central) and Rep. Esme Cole (D-Hartford) will introduce bills in the coming days proposing to mandate that all "executives and clinical leadership" at Vermont hospitals earn no more than 10 times what they pay their lowest-earning, patient-facing workers. The bills would also direct state regulators to review administrative-to-clinical staff ratios to ensure they are aligned with national averages. The proposal comes as Vermont is scrambling to slow the growth of hospital budgets in response to rapidly-increasing health insurance costs. Average health care premiums in the state rank among the highest in the nation, and local businesses and taxpayers are bracing for another year of increases. “The people who have the least ability to pay more are being asked to do just that to prop up a system that prioritizes profits over people,” Vyhovsky said at a press conference on Thursday. She was joined by leaders of unions representing employees of the University of Vermont Health Network and a representative from the office of Sen. Bernie Sanders (I-Vt.). The bill would apply to all of Vermont’s 14 nonprofit hospitals. But it would have the biggest impact on the UVM Health Network, where a number of senior executives earn far more than $400,000, a rough estimate of where salaries would be capped under the proposal. That includes CEO Sunny Eappen, whose $1.8 million compensation package in 2023 — the most recent year for which data is available — represents almost 50 times what a new licensed nursing assistant makes. “Vermont hospital executives work really hard in the context of our nation's privatized, broken health care system,” Cole said. “However, it would be difficult to convince me that they are working up to 50 times harder than the LNA on the overnight shift during the COVID pandemic.” [content-3] It is unlikely that the measure would move the needle much on health care spending. The network says compensation for senior leaders makes up only about 1 percent of its payroll. Vyhovsky acknowledged the limitations but said the bill could still be an important tool to address health care costs. “There is no one policy change that will slow the sinking of our current system,” she said. “We will have to pick away at the problem from many angles." It is unclear…