FAMILY · FREEDOM · FUTURE

Health care system change is absolutely essential in Vermont if we want to control costs and improve access. A workable solution has proven elusive in our unique environment. As a physician directly involved in patient care and a leader in primary care, my experience tells me that enabling health-care providers to “work up to their license” is essential. Nurses are a prime example of an underutilized resource due to the payment system restrictions in force today. As a practicing primary care physician, I get it. Caring for people is what I do every day, and I’m ready to take that work beyond the walls of my office. Over the past twenty years, I’ve cared for an extraordinary range of Vermonters and I have learned something meaningful from every single one of them. Families, employers, towns, school districts, workers, and health‑care providers are all navigating the same pressures. I want to take what I’ve learned in my practice and use it to do something to help NOW and into the FUTURE at the state level. Rather than focus on the problems, I would like to hone in on what people need and what existing strengths we have to get there in VT. Many factors contribute to Vermont’s high health‑care costs: a limited mix of payers, the growing dominance and pricing structure of the University of Vermont Health Network, heavy regulatory demands, and mounting pressures on an already strained workforce. Vermont’s small and aging population limits our economy of scale, which means we must make deliberate, thoughtful choices. Every policy decision should center on access to care and the affordability of that care. We also need to take a hard look at health insurance rates, which are driving up town budgets, school budgets, and employer stress across the state. There are clear steps we can take. We can expand and support our primary‑care workforce so more care happens where it belongs—close to home, without unnecessary specialist referrals. We can enhance any fixed payment population health models to innovate in medical homes to focus on prevention, education and get away from fee for service. And we can begin with a thorough audit of all of the state offices charged with health care, including the Green Mountain Care Board, paired while defining health care leadership in Vermont. Despite the complexity of the system, Vermonters share common values. People want care that is personal, timely, and grounded in respect. They want to feel safe and supported by their care team. I want that too, and I’m committed to helping build a system that delivers it—one that truly serves the people who call this state home.

Vermont is at a crossroads. After years working closely with families, schools, and community systems, I’ve seen how deeply our economy and local budgets are being strained. We need the number of workers to be balanced with the populations that need help like older folks AND the up-and-coming workers—our children. To make this happen, we need to spend less on state government, increase workforce opportunities, decrease the cost of health care, and make housing more affordable. It’s becoming too expensive for many people to stay in Vermont. A recent VTDigger story called that reality “Domestic Migration.” I know many folks who have moved out of state just so they can work one job OR even one less job, afford a house, pay off loans, and more. Low population density makes it almost impossible for all Vermonters to have the ample services they deserve and an affordable cost of living. What hits me the hardest are the Vermonters who leave the state because their health insurance and drug costs are too high to sustain their needs. This really affects older Vermonters who have Medicare but need additional pharmacy plans and supplemental health insurance while still paying out of pocket. I really hope to speed up positive change on the health-care front so Vermonters feel some relief. We owe it to our parents, grandparents, veterans, and hard-working neighbors to take comfort in the fact that health care is available to them. Meanwhile, it’s tough to plan for economic prosperity without the help of the federal government. In this time of uncertainty, however, we need a plan to sustain ourselves. We have already been going it alone with forecasting in the health-care realm. The Rural Health Transformation Program investment of resources can help stabilize costs while we streamline existing systems. Our state government has too many offices working on similar health-related concepts without clear leadership. Ideas such as regionalizing services like fire and rescue will help long‑term. But we also need targeted revenue measures such as nicotine and cannabis taxes, as well as stronger public‑private partnerships to build essential infrastructure. Vermont’s natural strengths—agriculture, clean energy, and tourism—can drive sustainable growth if we invest wisely. In addition, expanding educational and workforce pathways, from tech training to agricultural programs, will give young people real opportunities to build their futures here.

Let’s be clear—everyone remembers their childhood when they watch kids play. A Vermont kid has this wonderful land to explore and the sense of community spirit we have built. After two decades working directly with Vermont families, schools, and community programs, I’ve seen how weakening support systems are affecting our kids. I’m running to change that. When the safety net frays, young people feel it first, and the impact shows up in their health, education, and sense of belonging. Children need opportunities to play, move, explore, create, and test their own limits. They need social interaction, shared experiences, and space to grow into themselves. Right now, too many kids are spending too many hours alone on screens, without guidance or connection. The consequences are showing up everywhere: chronic absenteeism, rising anxiety, a loss of purpose or belonging, and increased exposure to drugs and alcohol. These are not isolated issues—they are symptoms of a modern reality that isn’t serving our young people. My experience has shown me what is possible when we invest early and consistently in people—it is way less costly and more preventive. I’m committed to expanding access to childcare, steadying mental‑ and physical‑health resources, and ensuring families have the economic stability they need to raise thriving children. This is the long game: building a stronger foundation now so Vermont remains vibrant, resilient, and full of opportunity for the next generation with a stable or, ideally slowly growing, population. We need kids with skills, dreams, and good health to take care of us and this place over time.

After years working directly with children and families, I’ve seen how limited hours and scarce after‑school options force parents, especially single parents and those in demanding jobs, to patch together unstable care. Most families need coverage from early morning to early evening, yet few Chittenden County centers offer those hours. Child care should be abundant, high‑quality, and aligned with the real schedules of working Vermonters. Child care is one of Vermont’s most important workforce pathways. Act 76 moved us forward but we need far more capacity. I support expanding the VT ECE Youth Apprenticeship program, which blends classroom learning with hands‑on experience in community preschools, and extending it into after‑school programs to support grade‑school students. High‑quality, reliable child care should be the norm. Care should be available for all preschool and grade‑school children during the hours parents are working. This is how we help families stay in Vermont and ensure their children thrive.

I believe deeply in the value of public education as a product of that system and as a parent of three CVSD students. Our top priority must be delivering high‑quality learning opportunities for every student while keeping costs manageable. The “system” is too big for its number of pupils at present. Vermont’s real challenge sits at the crossroads of sustainable funding, quality education, and equity. Health care costs represent a major culprit of the education cost cliff we are standing on today. Act 73 attempts to address some of these issues by shifting to a statewide funding formula that allocates resources based on a base dollar amount plus student need. While this approach aims to level the playing field, it also reduces local control and risks underfunding education, especially in Chittenden County. My three children, niece, and nephews have accumulated over fifty years in Vermont’s public schools, and many of my patients attend them as well. Our educators understand their work and know our children. Vermont must support them in meeting student needs, rather than talk over them at the policy table. There are several practical steps we can take to strengthen our education system that are not addressed by Act 73: stabilize rising health insurance costs, ease the financial pressure on average Vermont taxpayers, increase taxes on nicotine products, end programs that divert resources away from our own local schools, and enforce the minimum class size requirements outlined in Act 73. At a minimum, small districts should be required to share resources through Cooperative Education Service Areas (CESA) and Boards of Cooperative Educational Services (BOCES) while exploring long‑term consolidation options. In addition, we must take a hard look at the administrative bureaucracy surrounding education to identify opportunities to streamline costs. Many schools in our towns already serve as strong models for the rest of the state. Any changes we pursue should be guided by two core goals: 1) improve learning outcomes and ensure every child has the foundation they need to succeed, and 2) reduce the financial burden on taxpayers.

Smart, responsible housing growth in Chittenden County is essential to Vermont’s future. We can expand housing while protecting the natural landscape that defines us and attracts new families to move here. Doing nothing puts our future at risk. Building necessary housing in Chittenden County while respecting nature requires smart growth principles that concentrate development in existing, walkable centers and infrastructure-rich areas. Towns such as Williston and South Burlington have committed to high-density in large designated areas while prioritizing infill and redevelopment wherever possible. Towns such as Charlotte and Underhill need to balance protecting their rural nature while contributing to housing needs in village centers. Meanwhile, Vermont’s population is declining. That means our schools have declining enrollment, there is less economic investment in our communities, the pool is dwindling for health care—all of which leads to increased costs per resident across the board. It’s incumbent upon our generation to secure a viable future for our children and their children. Housing is an integral part of that solution. It will be important to prioritize infill, redevelopment, and density in designated areas and far from wetlands and wildlife habitat. Encourage Accessory Dwelling Units (ADUs), townhomes, and duplexes that offer diverse, affordable options and blend into the existing community fabric. Invest properly in infrastructure, municipal services, and public transportation in designated growth areas to support higher density and prevent sprawl, which protects working lands and forests. As building costs rise, programs like the "Homes for All Toolkit" will be critical as they train a new generation of small-scale developers to create housing that aligns with community character. By promoting compact, mixed-use development and protecting natural, agricultural, and forest areas, Vermont can tackle its housing crisis without sacrificing its environment.

The mind‑body connection shapes every part of our well‑being—our mood, resilience, productivity, and even our health‑care use. My two decades as a pediatrician have shown me how early experiences, strong families, and supportive communities build lifelong mental health. Fresh air, social interaction, recreation, and low stress helps save money in our use of health care. Strong communities support the mental health of their residents, especially older and low income Vermonters. Recreation, time outdoors, time with others, music, and working together boosts mental health and leads to better quality of life. My role as a pediatrician lets me get inside how people live and stay strong. Having a sense of who you are and where you are going is so important and, if that falters, help should be there where you live and from a source you trust. I have led a team of experts on youth mental health through CHIMHP (Child Health Is Mental Health Partnership) which led to state policy on communication between different agencies surrounding mental health. We have some great facilities in Vermont for folks who struggle with mental health, but definitely not enough and not the right type of care. In the last twenty years of practicing medicine in Vermont, the number of places to go have dwindled and many folks end up out of state for care which costs the state millions of dollars. We need addiction care, psychiatric inpatient care, and intensive outpatient programs for all ages. The state needs to prioritize this and make it happen. Appropriate care leads to less costs and negative outcomes in the justice and healthcare systems.

Immigration is about human dignity. We have guests in our majestic state who have arrived in many different ways, most of whom are workers and young families who come to Vermont seeking a new or better life. I see them in my practice every day. I believe it’s our duty to respect the humanity of all of our guests and new residents who contribute in a positive way to our community. For years I have cared for the children of migrant families as a proud Puentes de Salud provider. Before medical school, I translated for Spanish speaking asylum speakers in New Jersey detention centers and listened to their stories. It’s clear that we do need major reforms at the national level. Our national ICE and Homeland security reach has gone way way too far. They have murdered innocent people. Here in Vermont, we need to protect our communities from such violence. While allowing a path for legal immigrants to move to Vermont and feel safe here, the northern border should be as secure as possible. Deportation is an expensive but appropriate action for illegal border crossings. I also recognize that our workforce needs young capable workers. How can we enhance the drive to contribute and gain a path towards a safer status in our state? I support guest worker programs that operate within the boundaries of our national policies, especially in sectors where they are most essential. Industries like technology and agriculture rely on a workforce that can meet seasonal, specialized, or rapidly evolving demands, and guest worker programs help fill those gaps in a structured and lawful way. When these programs are implemented responsibly, they strengthen our economy, support local businesses, and ensure that critical industries have the labor they need to function effectively. In short, I support using national funds for deportation when indicated, but not for the over-built and overly aggressive Department of Homeland Security. I believe in legal migration to the US and hope it can be less ugly in my kids’ futures.