Dear Editor,
In his recent commentary for VTDigger, James Hodge was correct in his observation about proposed hospital transformation plans: Simply applying the same prices to a small hospital as a large hospital will not work in our current system.
Things would be quite different, however, if we had a universal publicly financed single payer, or at least a single payer for hospitals. We would then have global budgets for hospitals, which would actually give them more freedom to do what Hodge says they need to do: figure out what to prioritize in order to best serve their communities.
With a global budget, they wouldn’t have to eliminate a necessary service like maternity in favor of a service that pays more but might not serve the local community’s needs as much, such as orthopedics. That is exactly what happened at Copley.
If we fund our hospitals as a public good, then smaller hospitals will have more leeway to plan based on need rather than simply fit into a cookie-cutter model imposed from above.
Ellen Oxfeld
Middlebury, Vt.
