 This is the House Health Care Committee. It's Wednesday, May 5th. It's just about 3.30 in the afternoon, and we are convening following the floor. And this afternoon, we are going to be reviewing language again that is in the budget, but language that was on our agenda for the morning and had to be deferred until now. It's language that addresses setting up a healthcare task force. I think I'll leave it at that, but I've asked Jen Carby to walk us through the language and so that we have it in front of us and then we will be in a position to be thinking about it further over the next between now and when the Appropriations Committee asks for our input on languages in the budget. So with that, I'm going to turn it over to Jen and will you give it a more proper introduction? Sure. Good afternoon, Jennifer Carby, Legislative Council. I will put up the language. We're looking again at the Senate passed budget, so H439, and I'll show you what page we are on if you want to follow along. So it's the same document we looked at this morning. We're now on page 114 and it's section E126.2, Task Force on Affordable Accessible Healthcare. This creates first the Task Force on Affordable Accessible Healthcare to explore opportunities to make healthcare more affordable for Vermont residents and employers. The Task Force would be composed of six members, three current members of the House, not all from the same political party appointed by the speaker and three current members of the Senate, not all from the same political party appointed by the Committee on Committees. It gives the Task Force certain powers and duties. It directs them to explore opportunities to make healthcare, including prescription drugs more affordable for Vermont residents and employers, including identifying potential opportunities to leverage federal flexibility and financing and to expand existing public healthcare programs. Directs the Task Force to consider the following, keeping in mind the Principles for Healthcare Reform enacted in and this should be 2011, and astute reader or watcher pointed out to me this morning, should be 2011, acts and results number 48. That's the big Act 48 that people know. So keeping in mind the Principles for Healthcare Reform enacted in Act 48 and codified at 18 BSA, section 93, 71. And I think we've looked at those somewhat in here before as well. So Task Force is supposed to consider the long-term trends in out-of-pocket costs in Vermont in individual and small group health insurance plans and in large group health insurance plans. How Vermont's current healthcare system is impacting Vermont residents and businesses and their access to affordable healthcare. The extent to which Vermont's uninsured rate may have increased during the COVID-19 pandemic and the specific causes of any such increase. Opportunities to decrease healthcare disparities, especially those highlighted by the COVID-19 pandemic and those attributable to a lack of access to affordable healthcare services. The findings and recommendations from previous studies and analyses relating to the affordability of healthcare coverage in Vermont and opportunities made available by the Biden administration to expand access to affordable healthcare through existing public healthcare programs or through the creation of new or expanded public option programs, including the potential for expanding Medicare to cover individuals between 50 and 64 years of age and for expanding Vermont's Dr. Dinosaur Program to cover individuals up to 26 years of age to align with the young adult coverage under the Affordable Care Act. And that talks about public engagement in order to gain a fuller understanding of the impact of healthcare affordability issues on Vermont residents. The task force shall solicit input from a wide range of stakeholders, including healthcare providers, healthcare administrators, Vermonters who lack health insurance or who have inadequate health coverage, employers, labor unions, members of the new American and black indigenous and persons of color, BIPOC communities, Vermonters with low income and older Vermonters. Beginning on or before September 15th, 2021 hold public hearings to hear from Vermont residents from around the state. Public hearings may be held in person or by remote means and a summary of the findings from these field hearings should be included as an appendix to the task force report. Then it says to the extent that applicable funds are appropriated in an earlier section of the budget. So $175,000 is appropriated in section B1106 of the Senate proposal on the budget. The task force through the office of legislative operations would hire a consultant to provide technical and research assistance, deliver actuarial analyses as needed and support the work of the task force. In addition, the task force would have the administrative, technical and legal assistance of the office of legislative operations, the office of legislative council and the joint fiscal office. Then there's the report by January 15th, 2022. The task force would present to the general assembly its findings and recommendations regarding the most cost-effective ways to expand access to affordable healthcare for Vermonters without health insurance and those facing high healthcare costs and the various options available to implement those recommendations. The first meeting of the task force must occur by August 15th of this year. The task force will select house and Senate co-chairs from among its members of the first meeting and the co-chairs would alternate acting as chair and task force meetings. A majority of the task force membership will constitute a quorum and the task force shall cease to exist on the date its report is due. Compensation and reimbursement for attendance at meetings during adjournment of the general assembly, the members of the task force are entitled to per diem compensation and reimbursement of expenses under two VSA section 23 for not more than eight meetings. And those payments will be made from moneys appropriated to the general assembly. And that is it. Okay. Thank you. Sure. Why don't we take the language off the screen at this point? I think it's, we can access it as needed. So this is, so again, just to state again, this is a proposal from the Senate in the budget with an appropriation attached of $175,000 to primarily provide for the engagement of a consultant as needed and some of the, and the some of the per diem expenses and attendant expenses in holding meetings and hearings as laid out here. Representative Dahlia? Yeah, just on a technical background piece is one option among the options to say, well, we endorse creating this task force but we don't think a consultant is needed. So we don't endorse the money in terms of what we tell appropriations or is it an all or nothing kind of? Well, I mean, I would just say for my take on it right now is it's not all or nothing, but it's also the case that appropriations might say to us, we think the task force is a great idea, but in fact, we are not going to appropriate $175,000. Understood, understood. It was more for newer members on process. Yeah. Yeah, it could go either direction, because in fact, again, I'm trying to put all these proposals in context of a conference committee. This is $175,000 and a policy proposal, neither of which are in the house budget. And so it is not uncommon or it is actually quite common that if in fact, one body wishes to include something of a substantive nature from a policy point of view and or a financial point of view that there's some concomitant balancing at times that the other body needs to adjust to advice in order to reach the same agreed upon bottom line, et cetera. So yes, that is completely possible. It's not a package deal. From my point of view, that's the Senate might feel differently about it, but that's not my point of view, right? It's also the case from my point of view that the specific language of the proposal in that it's being presented to the house from a Senate proposal is also subject to modification, perhaps by suggestion of our committee or by the appropriations committee. And I think it's important, I'm just gonna say this and this is the broad piece. This is in the budget. The appropriations committee, as you need to understand has the final word on what's in the budget. They do and increasingly, they're turning to the policy committees for input and guidance, but they do reserve the right in the larger picture of what they're dealing with to modify provisions and or make decisions. But I would think they will turn to our committee for recommendations. And I think it's important to understand too that they then have to, just as when they created their budget, they have to prioritize among all of the different pieces of input, but then beyond that, they have to prioritize what they're willing to give up and get in a negotiation process with. So they may agree with something we asked for, but it may fall somewhere on their list of what they're gonna push back on if we're not, I mean, if we agree with it. No, I think that that's what I was trying to communicate as well. Representative Black. So I'm opening up to committee questions at this point, clearly. So our committee questions, comments and then, and again, we will, this will not be our only opportunity to talk about this. So I guess I'm confused about the process. Isn't this essentially S120? This is, well, let's talk about that. So a creation for S120 that we haven't gotten. This is a portion of what, a portion or a version of what was once in 120, which was a Senate bill from the House Health, Senate Health and Welfare Committee, which they chose to move. And there was a few days there when people were asking, you know, well, when are we getting 120 or what's happening with 120 and 120 didn't make crossover. And they chose at the last minute to take certain sections of 120 and embed them in the budget. We have never received 120. It has never left the Senate. Yes. But that's a way of... And we will never see it. Well, we won't be taking it up this year, I think is pretty... I think that's pretty certain. I think that's pretty certain. But that is a way that House and Senate, you know, go back and forth is things can show up in the budget when they haven't shown up anywhere else. And I'll say it again, and I'll say it in light of what your question, the Senate has somewhat of a different process and culture internally where they tend more than the House to put policy pieces in the budget. And part of that, I think over the years, my observation is part of that is because they have the budget, they have the last shot at the budget. They are in the position where they, in this instance, there was a bill, S120, which clearly had not made crossover, barely was making it out of the committee and much less through the Senate and would have ended up in our rules committee. It ended up in their rules committee. They were gonna have to get it out of their rules committee, take it through the Senate floor. By the time it got to us, it would have gone to our rules committee and et cetera. They made the strategic decision, let's put some language in the budget. Let's bypass the committee, let's bypass the traditional sending a bill process. And just to point out, I'm sorry. Well, I wanna just say, that's why I'm couching all of this as this is not a given. None of what you're talking about is a given because in fact, this all bypasses the process and it's typically the house process of putting policy language in bills and having the committees go back and forth to sort out the bills. We've done a lot of that, but the Senate chose in the later hours to embed a number of policy provisions in the budget. The house appropriations committee will need to take a look at what their approach is to policy being put in by the Senate. I was just gonna add that sometimes you will see that happen with a bill that for instance, did pass the Senate and is in our committee and they're worried about whether we're gonna take it up. And so they also put it in their budget. Yeah, sometimes they put it multiple places. Or also on another bill, right? That's being sent, a house bill that's being sent back. There's all sorts of ways. Different, this is the end of the session, yeah. So, but it doesn't, but nevertheless sometimes, sometimes people send you things from the other body that you actually wanna warm up to and you're like, oh, this came a different way than we would have anticipated. And now we have to work through all the processes of what that means. Well, I think a good example of something that was coming to us late in the game that we recognize the urgency and we actually told folks, go and try to get this out from the Senate. And that's the, I forget the numbers, 10, 30. Yeah, I can't keep track of the numbers. Yeah, exactly. And that turned out to be put in the budget. I didn't, they asked, if I wanted to put in the budget, I said, I cannot ask you to put something in the budget because my appropriations people are going to say what? So does that help, Alyssa or Representative Black just kinda, yeah, so that, yes, that does reflect, but this is not all of what was in 120 and it's a different, so it's what we have. So what's more than in front of us? Perhaps proving how diabolical I am to me, it makes perfect sense and it sounds genius, so. Yeah, there's different ways to look at this and it happens from both sides at different points in time and I could regale you with stories. And as to why someone stands on the floor and reports a bill that has to do with amusement parks and the amendments have everything to do with natural resources and healthcare. And you have to try to explain that things got amended. There's nothing, and there's nothing anymore about amusement parks in it. That could also be. Sometimes. It could also be. Okay, so we're getting a little off track, but yes, in terms of process, that's where we are. So Representative Burroughs and then Representative Peterson. Thank you, Chair Lippert. I have a comment about the language and that is that I find it very unfortunate that members of the, or a member or any member of the disability community is not included in people who would be consulted. Thank you. Okay. Take that comment under consideration. Representative Peterson. Yes, thank you. It looks like a good opportunity to reduce costs. To me, that should be at the heart of what we're doing here or one of the things that we're doing. My concern is that it looks like, and maybe I'm wrong, and maybe I've read it wrong, it's all legislators. It is all legislators. It's absolutely. And not some of the experts we have with us all the time to me are the people that work with this daily and should be proud of the process to see how we can make things more cost effective. Just a thought. Yeah, no, let's be clear. This is, as proposed, is a six-member panel task force. Happens to be labeled a task force. Three members of the House, three members of the Senate, not all of the same party. We have set up a number of other task forces or study committees, et cetera, but this is not akin to that. This is a task force that will take public input and we'll hear from and we'll elicit input about topics from other staff and experts and has the ability to also hire a consultant to assist with that if necessary, or as they deem necessary. Yeah, now the very structure of the task force is also completely open to consideration as well. Because the Senate proposed it this way, it's not set in stone. Right, like Elizabeth's comment, we could say we wanna add people who shall be consulted. I mean, that's not a given. Yeah, okay. Representative Goldman? Well, it seems that this process is sort of echoing what I hear you say a lot, Chair Lippert, about how budget is policy. So this seems like a really good example of that. That's my first thought. My second thought is, well, maybe we'll save money, but maybe we'll also help people. So I think the helping people part is a little more primary for me. And my third thought is on page 115 in section one, it references individual small group plans and large group plans. Does that mean we don't have any access to Medicaid that this group won't be able to access anything having to do with that? I don't know that it says they wouldn't have any, I mean, that this is looking at out-of-pocket costs and there are almost no out-of-pocket costs in Medicaid aside from prescription drugs. So I'm not sure it's as relevant for that. Group, I mean, but I don't think it, I don't think it precludes. Yeah, I'm wondering about access because, you know, if you change sort of what the accessibility might be or some standards, because it does say expand Medicaid to people over 26, you know, to echo the ACA. So I just wasn't sure, I didn't want to exclude at least having that be part of the conversation or I wasn't sure if that made sense or not. I think that fits to my mind and some of the other potential things that they're supposed to look at. So particularly the opportunities made available by the federal government to expand access through existing public healthcare programs or through creation of newer expanded public options. So that might include looking at that aspect. I mean, because it's such a big part of our, well, it's a big part of our health. I know we can't touch Medicare, but I was just thinking about this other part. Well, what it does, I think one of the things it does focus on and something which I for one, I'm very interested in and I think numbers of people are is what opportunities are there with a different administration in Washington thinking differently about healthcare than what we've had for the past four years. We've played defense for four years, heavy defense because affordable care, I mean, this is just objective. I mean, my tone may be, make it clear, but the Affordable Care Act, which was a premier achievement of the Obama administration was in fact, actively being taken, trying to be taken apart by the subsequent Trump administration, both in terms of repealing it and then going through the courts to invalidate it. What we were positioned to deal with healthcare here in Vermont during that period of time was how do we protect what we've done in Vermont from the possibility? I mean, it's a whole different world from the possibility that if the affordable care had been repealed, I mean, I don't wanna go off on a tangent, too far off on tangent here, but what I'm wanting to point out is that one of the things that I think is potentially actively, apart from whether this task force does it or we approach it a different way, let me put it that way. Something I'm very interested in is what are the opportunities that are newly created by the new Biden administration that may allow Vermont to take further steps to ensure access to healthcare and affordable healthcare to as many Vermonters as possible within the parameters of what the Biden administration's and new initiatives or what new initiatives we could propose to the Biden administration. And that's a very different playing field than where we've been for up until 2021. Rep. Zahe, you had, is your hands up or still up or nearly up? Yes, up for a comment. This is a sort of maybe picky on element, but it struck me when we were reading through the language, one of the best prior reports when we talk about, they're supposed to read and review the recommendations of all the prior reports. One of the best ones I ever read in terms of really articulating issues and public input, Vermont actually created a process of a series of small focus groups all over the state that really got into depth about people's goals and ideas and so forth. And that was all put into a report. However, that was sometime in the late 90s because I was reading it as a new member to catch up on issues. We might want to put a time on that saying, thou shalt look at reports post whatever year. I don't think there's anything that requires us to go back to the 1700s and read any reports that were available back. I don't know, it's wide open there. Right. Well, language is wide open to what they have to do. Yes, right. So I would like to suggest this that, so it's good to have this in front of us right now. I would like to ask members to be thinking about as you hear this, digest it. What does it, is it something given, if you were given your druthers, is this something which you would want to help move forward or modify or help move forward or help move forward and modify or not interested in moving forward? And so that's the kind of committee discussion that we're going to need to engage in over the next period of time as we come back to this as well as others. But this in particular, and we've heard advocacy around this today. I mean, this was the language that, I'd hoped we would have it on the table before we heard our witnesses today because I had some sense that that would be part of what was being talked about. So we're going to need a committee to think about whether is the structure what we would want? Is the, are the charges the right charges to this task force? Is it the right timeframe, et cetera? And I would ask you to be thinking about that. And then we will based on, because we just had the conference committee set up today, literally on the floor as we, before we left the floor conference committee was set up and they are going to need to give us and other committee chairs and policy committees parameters about how to approach the budget issues that are relevant to our committee. We've tried to take a jumpstart, get a jumpstart on that. That's what we've been doing over the past few days because, because I also point out, I don't mean to beat a dead horse here. We have the good fortune that most of our legislative work between the house of the Senate has been pretty well resolved. I mean, we have, we still have H 210 to resolve tomorrow and that's on our agenda, but most everything else has been resolved. So we're not, we're not engaged at this point in conference committees, whereas some other policy committees have some very significant policy differences with their parallel policy committee in the Senate and may be engaged in their own conference committees. We are to a degree freed from most of that. And we, but then again, we have more, I don't know if we have more because I don't know what's happening with those, but we have a number of issues in the budget from a policy point of view and very few from a financial point of view. It's frankly, it's a bit of an unusual situation from my point. Another thing I wanted to mention on the same lines about what to think about is from seeing a lot of legislative task force in the past, is it framed in a way that it will have something that committees will read and want to engage in and want to follow up in next year? Sometimes we ask for those things and we don't then do it. And in addition, is there too much to reasonably have on the plate of a summer study committee as there's sometimes called? Do we, are there things that we think should be prioritized over others because maybe there's too much? I'm not trying to prejudge, I haven't drilled down in depth, I've read through it, but, or as Bill already mentioned, things that we might want to add or suggest instead of and so forth. Rebson Goldman, Rebson Cina. I was wondering actually along the lines that Ann was saying, I was kind of anticipating that the report that comes out of this task force would then come to us. I mean, that would seem likely, right? Yes, and I was gonna add to what Ann was saying. It's like, what would you like something, what would you like to come to this committee? Basically, that's another way to frame the question. What would a product be? If this were to be used as a vehicle for creating a product to take us into the next stage of healthcare, what would you charge this group or a similar group that you would structure? What would you, how would you structure it and how would you charge them to bring back a product that would position this committee to best take next steps? That's really what I'm thinking about, frankly. That's really phrases it well, but that's kind of what I was thinking. So do we need to include recommendations and timeline to the task force, recommendations for potential legislation or maybe you don't do that with this? Yeah, I don't know. But, so my other question is, do you think, does anyone think that this language addresses the underinsured as clearly as it needs to? I'm not sure. I'm not sure. I'm not sure it does. And that's one of my, that it's not, doesn't seem specific to me, but maybe it's sort of implied and I just wanted to make sure that we had that on the table too. Yeah, I think, well, let's, again, we're gonna, this is not our only occasion for putting those kinds of thoughts on the table. And I'm gonna ask us like to come back to this with suggestions, questions and thoughts once having looked at it further today. Representative China. So I've been reading it over and over, just kind of thinking about what is missing and I've landed on two things. One was just spoken about. So I'll just second what Leslie said. I think there needs to be specific language related to under insurance because I read it and it's vague. It talks about, and I could read it again. It's talking about out-of-pocket costs, but it's not really getting into it, or naming it maybe. So I don't know if there's a way to strengthen that if we would recommend that that language be strengthened. So it's clear that we want them to look at how people are not accessing healthcare because of under insurance. And I don't have the answer. I read it a few times, but it doesn't seem strong enough. The second thing is that the legislature made a commitment to Vermont. In, you know, I can't remember the act now. Is it was at 48, Act 48 that we always talked about? 48? Yeah, so the universal Vermont's attempt at creating a universal healthcare system, we kind of stalled in the middle of that, but a lot of that language is still in our statutes and many people still would like for us to keep pushing towards a universal publicly financed system. And I don't see why we wouldn't mention that here in some way. It's not that explicit. So if there was a way to strengthen it, saying that the ultimate vision is a universal healthcare system and that everything we do should be taking steps towards that, even if it takes a hundred years. And it really shouldn't though, but I'm just saying. And then the other piece is around that was that it specifically mentions raising the age of Dr. Dinosaur and lowering the age of Medicare. I think it should also specifically mention universal primary care, because that's another one of the ideas that's been thrown out there over the years. And a bill passed out of this committee after clearing the Senate, but it died in appropriations two years ago, was it? Or three years ago? Four years ago. It was that long ago. So I mean, it's- I think a three or four, yeah. It would have been anyway, yeah. Yeah, so it's an idea that- It wasn't last biennium, it wasn't last- No, I thought it was the second year of my first biennium, but it could have been the first year. But either way, the reality is that a bill did pass the Senate related to universal primary care. It came back to this committee. This committee actually suggested that it move closer to the original bill it came from. Or the version that- To the closer to the version that left the Senate health and welfare, because it got changed in Senate finance, I believe. Whatever the case may be though about the details, the point I'm trying to make is that that was a viable idea in the past. I think it should still be something that we consider as one of the many possible ways to make health care more affordable. We know that investments in primary care reduce overall health care cost. That when we spend money on prevention and give people access to health care early, it saves money on the expensive things that happen later. So I really think we need to consider adding language that talks about universal primary care or increasing spending on primary care as a way to improve health and reduce the cost of the health care system. So that's what I thought of as I was reading this. So thanks for listening. Yeah. So we're gonna, I'm trying to think we're gonna, I haven't been taking notes right here myself, but we're recorded as we know. And we're going to need to take some of this, if and as the decision is made to try to structure this and refine it in a way that is more aligned with what this committee's structure and goals would be, structure for it and its goals would be, we're gonna wanna, we're gonna, I mean, we know of all the time in the world, but we're gonna need to bring some of these ideas to the table with some language and work with Jen to redraft possible suggestions. And then that will happen, that will need to happen over the near term. So thank you, Brian. I mean, Brian, thank you. I forgot something. Okay, go ahead. Just when you thought it was safe to go back in the water. So I don't, I keep rereading it to make sure I'm not missing something before I speak, because I hate when I say something and then someone's like, on line four, it says it, but I don't see the accountable care organization mentioned in here, does anyone, and how can we talk about affordability without talking about this institution we've created that's supposed to reduce the cost of healthcare? That's just a question I have. It's actually. Yeah, can I just refresh? We didn't create the accountable care organization that the feds did, CMS did. We have the all-pay model. Well, we have the all-pay model that we created that makes use of an ACO to be aligned with it, but we didn't have anything to do with creating the ACO, the ACO model. I guess I meant we as a society. Well, okay, we, the broader, not we as this committee, I wasn't there when that happened. The feds for Medicare, right? Yeah. The feds for Medicare created it, yeah. But I think you're accurate in saying that there's not a lot of reference to that here. That might be strategically a good thing or maybe not a good thing. That's depending on your point of view. Yeah. Alyssa? Black? That's fine. So, I mean, I've been listening to everyone. I actually watched a lot of this testimony. In the Senate? In the Senate, because I was really interested in it. I think, and I won't go into, I mean, I don't know what their thinking was necessarily, but I think this was sort of an attempt to kind of get away from, you know, I mean, in this committee, and not that they're not all wonderful people, but, you know, we hear from the same people over and over and over again on every single topic. And I think this was an attempt to, instead of looking at our healthcare system from the views of who we listen to all the time in committees, that it was just addressing, okay, what is the affordability like for actual real Vermonters out there and what is impacting their affordability? So I think it does address a lot of the, you know, like the ACO. I mean, if you're answering these questions and you're listening to people, you're also, you're answering the question, how is the ACO affecting their cost shares or how is it not affecting them? And is it doing what it should be doing? So I mean, I think it was really, frankly, it sounds like it's a listening tour. Part of it is, definitely. Which I think is important for legislators. I mean, that's why it's not for other people. It's for legislators to get out there and find out sort of really what's going on from the everyday Vermonter perspective. I think that's a key part of it. I see two key parts. The one is that it's that. And it's also trying to say, which I think everyday Vermonters are not going to have, I see is kind of like two, at least two different pieces to it. One is just what you're saying. It's a listening tour. It's actually, it's like doing what we did just in the last few hours, hearing from people about what their world is like around healthcare. And it makes it very powerful and makes it very real. But those, but people are not going to come to the table who are struggling with specific challenges and say, and I think this is what could happen with the Biden administration. I mean, because that's not their world, but it's not, they shouldn't be expected to do that. But we should be expected to search out other people who can help us with those questions. And that's where you bring the two together in my mind. And I also think it was really hyper focused on the affordability piece, which gets into the, into uninsured or underinsured. And when they're talking about accessibility, I think it was really more about how affordability affects accessibility. So there's also a lot more information in the findings. I mean, there were findings that went with this and what the Senate Health and Welfare Committee passed that was not, were not included in what went into the budget. So there is, you know, there's more talk about uninsured and things, or underinsured and things like that in the findings. I realize they're not in front of you, but. Yeah. I have it in my way, that's funny. You mean in 120? People could be pointed toward those findings, but 120 also, I mean, it was had a broader scope. It was not just this task force. Right, but the findings went with the task force. Okay, I'm not, you would know that I did, yeah. Well, they were in a similar, I mean, the findings were not particularly changed from the bill as introduced, which was just findings and task force and then the additional provisions. Maybe you could help point people toward that. Sure, I will send you the link. Okay. President Peterson, and I'm going to suggest that we wrap this up in just a few minutes because we will come back to this, but I wanted to get this on the table. I have, and as perhaps some of you do as well, but I have other meetings scheduled in the next 20 minutes, so I'd like to. I won't take that long, Chair. Okay. If you've got time though, I want to tell you a little story that has a point, a couple of little stories, and it has a point. I worked for years for the Bell System Company as an engineer, and there was a number of us in the office in Rutland. And for years, we would design cable jobs and this, that and the other. And forever we would say, gee, why don't we provide TV over the telephone cable? We have the technology, we know we can. And the answer was always, well, you know, why not? But, and for years we would say that. Base level employees just, hey, why aren't we doing this stuff? Well, along comes a VTEL who does that. Now other companies are doing it. Now cable TV takes your business away. Same thing with fiber optic. If the company had listened to the engineers, there wouldn't be a H360. There'd be fiber cable off to everybody because we recommended it years ago. And my point is, I'll bet there's employees within the healthcare system here in Vermont that can make really, really, really good suggestions about how to save money, how to gain more access, how to bypass systems, how to coordinate systems, how to get rid of systems, eliminate redundancy. And I just fear if we're just gonna put us legislators in charge of the commission, we'll never get down to those people. I really think we need to get to some interested state employees. They say, gee, I know how to. Yeah, if we did, why don't we take this and maybe we don't need that section of employees. Maybe we can get by, there could be a million ways we could save money. Yeah, quite a lot. So I'll just suggest that the question is, how do you get to that information? How do you access that? And I'm not, I'm just saying, I'm not sure that you do that by having people on the task force. I think you do that by engaging people to come forward with their ideas in a way that they feel empowered or able to share those ideas. Yeah, if we'll do it, yeah, if we'll do it. Yeah, yeah. Okay, I'm gonna, one last comment from Representative Woodman and then we'll wrap for the day. I was just gonna say, maybe we have to go back to the very beginning of this healthcare journey to really look at what was originally proposed to maybe get to the answers that Representative Peterson was alluding to. So, can we go back to the very beginning, start all over, look at our roots, something like that. Well, at a minimum, everybody should go back and read the principles and- Go back to the 1700s, Anne, yes, I know. Okay, well, let's stop there for today. And we will come back to this. And I'm going to try to get guidance from the Appropriations Committee as to how, what timeframe and how to move forward on the various things that are in the budget. Tomorrow morning, we will join the House Human Services Committee. I would encourage people to do that. And if not everyone, but this is not, you don't have to, if you have other commitments that, as Anne said, or Representative John, you said, we also anticipate there were some other work that some folks needed to do. And then we're gonna come back to the committee at 10.30 and think about, we're gonna need to think about how to proceed with H210. And anyway, we're gonna take, we just have to keep moving forward step at a time.