Editor’s note: This commentary is by Vicki Harrison, MSN, of Barnard, retired from 45 years in social work and community health nursing, with a subspecialty in mental health and substance abuse.
Vermont has the fourth-highest cost of health care in the U.S.
Vermont has the fourth-highest number of physicians per patient in the U.S.
Why does Vermont have more than 50% of its population unable to utilize their health care? Most likely 60%, counting the Medicare Advantage, no monthly additional premium folk, who never know what will be billed to them, thus cannot utilize their “health care.”
M.D.s brought MBAs, business, into health care in the 1990s to make more money and eliminate care coordination with health care peers who provided other aspects of health care. This included the Tower of Babel, electronic medical records that could not be readily portable. Electronic medical records were created by many players, in fabulously disconnected ways, and have been an onerous part of any health care provider’s new job when changing worksites.
Why we refuse to acknowledge publicly that there is nothing private about the internet is a fantasy that is beyond me. The University of Vermont Medical Center just spent $63 million of your health care dollars on this fact. But look the other way, more waste in the system, so you stand absolutely no chance of health care coverage, you who live under OneCare administrative rules, Tower of Babel EMR fiascoes, internet intrusions, and medical staff being paid through OneCare in a pandemic when health care was barely utilized in Vermont.
We paid the wealthy doctors, in the upside-down U.S., to provide no health care in a pandemic, while people who traditionally worked in unions to protect their wages and working conditions wondered how to feed their families, how to pay their mortgages.
Forty years of working with the vulnerable of our country, improving their options, innovating while the powerful created a monstrosity of costs for us to bear. No Vermont health care access for over 50% of the people and we still keep paying. Now, OneCare, an administrative data agency, wants an 18% budget increase. Did you get an increase in your budget? How many jobs do you work to support your family, if you have a job? Don’t you love the bootstrap philosophy of our governor at $7.50 hourly while he and his wealthy Vermont imports watch their stock market gains from the funds saved paying you a pauper’s wage?
A recent writer touted the benefits of coordination under OneCare. This writer clearly does not know about the coordination of care that visiting nurses provided for a century prior to having their role diminished by the MBAs and M.D.s. We provided care to moms and babies, the ill and elderly shut-ins with a network of highly skilled community providers. We had extensive mental health services, both inpatient and outpatient continuum, locked and unlocked, substance abuse treatments in our communities prior to the 1990s, when folks like the current Gov. Baker of Massachusetts deconstructed mental health care. Baker was rewarded in his career as a healthcare MBA for managed care, then making more money than goodness, and of course, a governorship later. How does the game work? Who gets the rewards? Certainly not we, the people.
Another writer recently discussed that business in the U.S. has been allowed to take over our U.S. government. Corporations were mistakenly made “individuals” by judges, in line with the privileged type who currently call themselves originalists as jurists. These folks truly need to retire from the judiciary and go to work at Plymouth Rock or Sturbridge Village to gain their fill of “originalism.” Then they can go home to their simple lodging, stoke the fire, bake the bread and get their fill of this fantasy.
The U.S. originators made lots of serious mistakes, just like the M.D.s and MBAs. In the 1790s, women and children were chattel, humans were bought, and Native folks killed. Lots of mistakes. Don’t you tire of that fantasy sport of those early citizens being so grand? We must build on the “good” they employed, but recognize its limitations. Balance. Rights and responsibilities.
Independent community agencies worked toward excellence in the diversity of approaches to building community well-being prior to the 1990s. The M.D.s brought in the MBAs to apply business principles, but more truly to escape the healthy checks and balances provided by multiple community agencies to a community’s vision and team players. The U.S. powerful have been ditching healthy checks and balances for 40-plus years.
OneCare Vermont, with its 18% budget increase, wants to provide health services in a U.S. with almost no safety net. This is impossible, but let’s keep throwing money at it. Like paying M.D.s for doing nothing (but not workers!), administrators, pencil pushers, data analysts on an arcane computer system that is not secure, even if you want to believe this with all your heart.
I have prior discussed multiple ways that U.S. healthcare as a business is a faucet open, stealing all our common good. This cannot be ignored. Vermont does not exist in a vacuum. OneCare is one of our faucets open. No country that provides health care to all its citizens has these community public health-destroying business principles working against them.
We, the U.S. citizens, have paid for this U.S. health care system and U.S. business has stolen it. We must regain it. Deconstruct the players not providing direct health care. Make way for the elimination of profit in health care so we citizens may have health care. The so-called “public option’” is one of the few ways forward.
