Editor’s note: This op-ed is by Steven Farnham, a resident of Plainfield.
VTDigger recently posted Morgan True’s article headlined, “Hospitals wary of urgent care facilities in their backyards.” I was provoked by the headline right away, thinking that the hospitals were engaging in “protectionism” of their fiefdoms. Upon reading it, however, I found myself interested in the article for quite the opposite reason I expected, but I’ll get to that in a moment.
Remember all the fear-mongering about doctors fleeing Vermont for higher paying jobs elsewhere if we enacted state-sponsored health care? Yet, now that state-sponsored health care has been established, making payments more certain and predictable …
Lookie here – a for-profit health care provider wants to set up business all over Vermont.
And they’re offering their services cheaper than the already established providers. That’s right – those that have to pony up startup costs are going to offer services for a lower price than those who have the advantage of being the established business – and a not-for-profit business at that. Well, they say they’ll offer these services at better prices.
Who’d’a thunkit?
Could it be that the existing providers have been gouging the bejeezus out of us for years? (Many leaders in the drive for single-payer have been saying as much for two decades.) Hell, I can afford a $50 X-ray out of pocket. I don’t need to send that bill to my insurance provider.
Maybe the reason all these procedures have been so expensive for so long is merely to “necessitate” the insurance industry’s participation in what could otherwise be affordable services without insurance.
Could it be that all the anti-single-payer crowd was really afraid of is – competition – which would force all providers to lower their prices? Why should an X-ray cost six to 12 times more just because the person receiving it entered the building through the door marked “Emergency Room”?
We might do well to examine another business that has “benefitted” from competition – the post office. Once a solid, thriving bastion of Americana, it has for the past several years been teetering on the brink of collapse.
So let the WalMarts of health care populate the state, and we’ll be seeing “falling (health care) prices” everywhere, right? Well, if single-payer didn’t drive all the (good) doctors out of Vermont, working for the cheap wages paid by a “health care WalMart” probably will.
We might do well to examine another business that has “benefitted” from competition – the post office. Once a solid, thriving bastion of Americana, it has for the past several years been teetering on the brink of collapse. Not the least of the problem is that Congress is doing everything in its power to deep-six the post office, but leaving that aside, what else ails the USPS?
Quite simply, all its most profitable business has been usurped by for-profit parasites like DHL, FedEx, and UPS. And the post office has been left with the “unfunded mandate” to provide the least lucrative of the remaining delivery services.
So one might ask – do we want our medical service and health care providers to suffer the same fate as the USPS? Do we want to allow for-profit business to take all the lucrative parts of health care, and leave only the most über expensive, and least lucrative to our existing not-for-profit providers and infrastructure? Do we want a situation five or 10 years into the future where the facilities providing the most sensitive and delicate care are ill-equipped, because they are struggling for their financial survival?
I believe that would be an extraordinarily misguided approach. Many of us, myself included, have been howling for some time about the appalling price of health care. And I believe the medical establishment has responded at a glacial pace at best – but that they are responding nevertheless.
I believe the best approach is to continue working with existing providers to rein in health care costs, and that we should not commit them to burning the candle at both ends – trying to reduce costs on one end, and gear up to fight competition on the other.
I do not know if it is within the power of the Green Mountain Care Board to deny ClearChoiceMD a certificate of need. If not, the Legislature should, with alacrity, empower GMCB to make such a determination. Health care, like so many other things, is something we should buy local. And to me, that means telling ClearChoiceMD, “Thanks, but no thanks.”
