This commentary is by Lee Russ of Bennington, a retired legal editor who was the lead editor/author of both the third edition of “Couch on Insurance” and the Attorneys Medical Advisor.
Imagine a group of people watching a house burn. They are gathered around a fire hydrant and a hose is coiled at their feet. As the house burns, the people discuss how they might make it rain to put the fire out. Maybe prayer would work? Maybe a rain dance? Maybe seeding the clouds? The house continues to burn.
Absurd, right? But a pretty good analogy to the current health care nightmare and our reaction to it.
In the political debates preceding the November election in Vermont, the subject of health care was mostly missing. That’s pretty odd, given how prominent that subject has been in the state’s media, chronicling doctor shortages, lengthy wait times to see a doctor and, of course, the ever-growing cost of health care.
Consider the silence the equivalent of praying for rain to put the fire out.
It’s easy to understand why so many ordinary people are talking about it so frequently. How do you explain why so few political figures want to even mention it?
Health care amounts to a huge economic pie. The public supplies the ingredients: money in the form of insurance premiums, co-pays, deductibles, taxes and the cost of services not covered by insurance. The health care industry feasts on the pie: Health care industry company profits have grown considerably each year for the last three years, while revenues for these companies have declined each of the last three years.
The fact that lower revenue can consistently produce higher profit tells you that health care is a necessity, not some consumer product that people can do without if they don’t like the price. The industry can charge pretty much any price it wants.
The enormous amount of money in health care has triggered a feeding frenzy. In essence, vultures are circling our health care. Private equity, renowned for siphoning huge profits from their endeavors at the expense of everyone else, is sinking its claws deeper and deeper into health care: “Private equity firms are financial termites devouring the woodwork and foundations of the U.S. health care system.”
Commercial interests are even metastasizing Medicare into privately run Medicare “Advantage.”
It’s a different story for ordinary people. The cost of health insurance is rising considerably faster than incomes, prompting the chair of the regulatory body to call the rates “unaffordable.”
The Vermont State Auditor reported that premiums were rising more than three times faster than the state’s median wage. The inevitable consequence is that people are sinking into medical debt. There are reportedly “around 30,000 Vermonters with medical debt in collections and tens of thousands more who are paying down medical bills that have not reached collections.”
And who is there to defend us?
Not the federal legislature, which is beholden to the very vultures feeding on the carcass of the public.
And, to date, not the Vermont executive and legislative bodies, which have inflicted another vulture, the “accountable care organization” OneCare, to dine on taxpayer dollars without providing or improving care in any way.
During the recent Green Mountain Care Board hearing on OneCare’s budget, a board member remarked that he was looking for evidence that OneCare was producing outcomes “that matter to patients,” but “I can’t find them.” Consider OneCare the equivalent of seeding the clouds or doing a rain dance to make it rain to put the fire out.
Also dining on the health care pie: administrators, who are proliferating far faster than doctors in the health care field. Even in the small state of Vermont, high health care administrator salaries — in the hundreds of thousands of dollars per year — are everywhere, from our hospitals to OneCare to insurance companies.
If the people charged with protecting the public interest do not do their job, the size of that health care money pie continues to grow like a cancer. It metastasizes to every organ of our society. And the public gets sicker and sicker, both physically and economically.
The recent election has produced a large turnover in the Vermont Legislature. Dare we hope that this infusion of new legislators will finally supply the courage to really address at last our state’s dying health care? Perhaps to even discuss solutions like a publicly funded universal care plan?
Will somebody finally notice the fire hydrant?
