Editor’s note: This commentary is by Louis Meyers, of South Burlington, who is a physician at Rutland Regional Medical Center. He is a Democratic candidate for the state Senate in Chittenden County.
In Great Britain’s Brexit process and Boris Johnson’s massive electoral win there are echoes of the situation we have with Vermont’s OneCare.
In Britain, people were increasingly disenchanted with being part of the European Union. As their individual finances stagnated, they saw an increasingly rich, powerful, and obtuse organization in Brussels, whose decisions were making their lives worse, not better. Individual businesses may have had access to broader markets, but were also inundated by an avalanche of expensive and time-consuming picayune rules, regulations and paperwork. Many felt that England’s national strength and character were being erased in the pursuit of an amorphous idea of being “European.” In Boris Johnson — whatever his faults — the majority of Brits apparently saw someone who was cheerfully undaunted, not wed to a rigid philosophy, and someone who would represent England first — rather than the European Union.
In Vermont, many people — both medical providers and the population at large — are beginning to see OneCare as something akin to the European Union. The University of Vermont Medical Center and Dartmouth-Hitchcock Medical Center clearly run the show. They have bought up most of the independent practices and hospitals in the state and the decisions made for those practices are now made in OneCare’s corporate boardrooms by very highly paid executives, few of whom have any clinical experience. Medical providers in the field are inundated by computerized paperwork and spend over half their time on non-medical clerical work. The medical practices have been homogenized by required algorithms for patient care and practices have become franchises — similar to McDonalds.
Because of mandated requirement to provide “same-day access,” patients often are shunted to any provider who has an opening in his or her schedule — rather than the clinician who actually knows them.
Physicians have lost their autonomy and the discretion to make decisions and recommendations which are in their individual patient’s best interests. And as the OneCare process proceeds, we continue to see increasing costs and decreasing overall quality.
I believe there is a better general solution, and that is to loosen the bonds of OneCare. It remains to be seen what kind of withdrawal deal Britain will negotiate with the European Union, but here in Vermont I would like to see our independent practices receive more support in order to remain independent and to flourish. Logistical and clinical help from UVMMC is always appreciated — but not the overall loss of control which OneCare currently demands.
In England, the majority of voters have now decided that it is time to take back their country.
In Vermont, the future of health care can once again be bright — we simply need to demand it.
