This commentary is by Mary Alice Bisbee of Montpelier, a former hospital and nursing home social worker and a sixth-generation Vermonter who may be reached at maryalicebisbee@gmail.com.
A few months ago, several Vermont nonprofits — including Vermont Healthcare for All, Vermont League of Women Voters and Vermont Physicians for a National Health Program — signed a petition to the Green Mountain Care Board that OneCare, the one and only affordable care organization in Vermont, needs to be shut down and its contract not renewed.
Now the state auditor, Doug Hoffer, is asking OneCare to provide salary compensation dollars that are paid to all employees so Vermonters can understand how OneCare is saving us money!
There is real concern that our tax dollars are being thrown away to this organization that has not been able to defend its budget and appears to only provide another huge layer of administrative costs on top of our ever-rising health care expenses. Capitation is not being used to pay many of our bills. I signed on to OneCare when it first came out and my bills are not being capitated!
One major concern is that OneCare is a for-profit company that tries to act like a nonprofit organization, but is unwilling to provide any safeguards to taxpayers about its finances, as required for nonprofit entities. As the price for health care services continues to skyrocket in the midst of a pandemic, is it any wonder that Vermonters are starting to question the validity of this huge, unfettered enterprise?
Vermonters and Americans in general (statistically between 70% and 90%, reportedly) are demanding that insurance companies and other entities like OneCare stop their extremely lucrative efforts to control health care costs and administration and instead provide national and/or state government initiatives to control costs. It has been shown in study after study that the lowest administrative costs for health care are those of government agencies — Medicare, Medicaid and Veterans benefits. Some statistics quote 2% to 5% administrative costs for government programs while health insurers costs are well over 10%.
Does anyone think that profit, CEO pensions or stockholder premiums could have anything to do with these increased costs?
The benefits provided by government programs are not sufficient at present. As a current Medicare recipient, I not only pay a substantial monthly premium from my Social Security benefits but also pay over $225 a month for a United Health Care co-insurance to cover my copays and deductibles. There is no coverage for dental, hearing aids, glasses or any sort of preventive services unless I choose a Medicare Advantage plan provided by a for-profit health insurer that is taking advantage of taxpayer money. I pay for homemaker services to Central Vermont Home Health & Hospice out of my own pocket at $24 an hour. This is available only because of my advanced age and physical disabilities.
What do younger folks do? Unless you are destitute and qualify for Medicaid, there is little in between. The state alternate plan for low-income folks is quite expensive, I have been told. While large employers like state government and public educational institutions have health benefits negotiated by union contracts, this is the exception. Small businesses, the self-employed and seasonably employed and unemployed can usually not afford such luxuries. And are they really luxuries? Not if you really need help, they aren’t.
If we can somehow just switch our priorities slightly to believe that government can sometimes solve social humanitarian problems far better than the private, for-profit sector, we could start to implement an entirely new and progressive tax structure that would lower costs, provide incentives to new primary care providers, nurses and other specialists to go into needed fields of practice, and perhaps choose to move to Vermont.
If private administrators lose their positions, they might be willing to train for these new provider positions or seek employment through the state and national health care services. Retraining is certainly more affordable than what we have now.
We need to start looking outside the box for answers, both at the state and national level. Health care is not a partisan issue. Health care should be a human right. All Americans, all Vermonters need and want coverage to keep us well and to be there when we have real health crises.
Now, during this huge pandemic, what better time to recognize this need and do something about real state and national health care reform? Contact your legislators and congressional delegation and demand change now.
