Editor’s note: This commentary is by Dr. Anna Carey, who lives in Burlington and works at a family practice in Cambridge.
[U]VM’s presentation to the Green Mountain Care Board of its “Inpatient Bed Replacement Project” has four objectives.
Quality: To meet the first objective, the University of Vermont Medical School intends to build “a new inpatient building that is highly patient-centered.” As a family doctor in Cambridge, I am familiar with this highly touted and relatively recently branded concept of “patient centered care” as if previously we couldn’t care less about the patient. But remember we have bandwagons to board. (Yet, I do kinda remember decades ago in medical school hearing about some old guy Hippocrates’ riff on caring for the patient.) But no matter, we’re listening to UVM Medical Center officials present “the cutting edge.” Apparently the proposed seven-story inpatient building will meet the newest contemporary care standards and the building itself will be “highly patient-centered.” Now this is really neat. When checking into a concierge-style single room at UVM Medical Center, one is treated in isolation. No more pesky roommates, rather a gated community atmosphere.
Bed Need: Let’s see, the goal here is “careful consideration of health care reform goals to reduce inpatient bed utilization” so let’s build seven stories to house 128 patients (please refer to next objective).
My rural patients who can’t afford a doctor’s visit much less their needed diabetes, asthma and heart medicines will be reassured of UVM Medical Center’s fourth and final goal.
Financial Feasibility: Hey, Fletcher Allen Health Care had millions to rebrand itself to UVM Medical Center. Presently UVM Medical Center has the “financial feasibility” to build the gilded hospital tower while maintaining a strong A credit rating to its key “nonprofit” stakeholders.
My rural patients who can’t afford a doctor’s visit much less their needed diabetes, asthma and heart medicines will be reassured of UVM Medical Center’s fourth and final goal.
Affordability: “Hospital rates and charges resulting from the Project will not adversely affect patients and payers”: With a construction budget of $187,297,729 for 128 beds that means almost $1.5 million per room, a bargain per testimony of more than a handful of primarily black-suited men. Consider the following: October 2007, U.S. Census Bureau states hospital construction was rising 15 percent greater than 2005 and major discussion directed toward attracting the baby boom generation. Meanwhile evidence-based medicine data for the single occupancy room remains in debate.
What prevents UVM Medical Center’s ongoing goal to maximize their power of scale? What prevents their quest for a “Too Big to Fail” entity? Certainly the former FAHC’s embrace of the accountable care organization (ACO) was an aggressive act toward consolidation and concentration of power to the detriment of the universal health care goal of the Vermont citizenry and the Green Mountain Care Board. As a rural family doctor, I urge the GMCB to wisely deny UVM Medical Center’s current goal to further silo-style health care. Rather continue to prepare for universal care for all Vermonters.
