This commentary is by Manny Mansbach, a member of the Vermont Workers Center, which has been working for economic justice and human dignity, including healthcare as a human right.
Since Brattleboro Memorial Hospital (BMH) announced they plan to close southeastern Vermont’s only birthing center in the next six to nine months, Windham County residents and officials have begun mobilizing to find a way to keep safe birth alive in our community. It is imperative that these efforts gain steam and this harmful decision is reversed. It is also crucial that we look clearly at how we got into this mess, and how we get out.
The story of the BMH birthing center must be set in the context of an active war on healthcare by the Republican Party, along with a colossal bipartisan failure to act to protect and expand healthcare access for Vermonters over many years. Yes, part of the problem at BMH was undoubtedly mismanagement, but you don’t need to be an expert to see that the healthcare system is badly broken. Birthing centers closed in Springfield in 2019 and at Copley Hospital in Morrisville last November. Springfield Hospital recently announced plans to close adult day services this fall. Without a serious reordering of our priorities, this crisis will almost certainly be followed by more tragic closures all across the state.
Gov. Phil Scott has been in office for about a decade, and in that time our healthcare system has steadily gone downhill. Today, despite the pressure from BMH and community activists, he is sending strong signals that no help will be forthcoming from the state. Democrats, on the other hand, have also not offered any meaningful healthcare policy initiatives in the legislature. Even modest proposals to increase access to healthcare have been watered down, changed to studies, and then shelved without any action.
Legislators have repeatedly made it clear that leadership has had no appetite for working on anything significant around healthcare. What there has been appetite for is to continue rearranging the deck chairs on the Titanic, with payment reform schemes, failed Accountable Care Organizations like OneCareVT and the recently abandoned AHEAD model, and misguided reports from pricey consultants, amounting together to many tens of millions of wasted dollars that in a rational system could have been used to provide actual healthcare.
Instead of moving towards community-based care, we are left with just a few dominant large hospital systems. Now that some hospitals are stressed and failing, local communities are left underserved and are instructed to tighten their belts and make do with less.
The solution is not imposing austerity and managing the carcass of a healthcare system, but recognizing the band-aids are not enough and insisting on a much better way. Rather than trying to overwork and underpay our healthcare workers, and attempting to cut our way to a less costly system, we need to protect our healthcare dollars from insurance companies, enormous non-profit hospitals and private equity firms that skim millions from the system and rob people and communities of the funds that could otherwise be going toward real care.
While there may be generous donors willing to contribute to save the Brattleboro birthing center, we can’t just fundraise our way out of systemic crises. We should not have to hold bake sales to have dignified healthcare in the richest country in the history of this planet. Delivering healthcare should be the responsibility of our government, funded by our tax dollars.
It’s time to stop viewing healthcare as a product to be sold, to recognize healthcare as a common good and demand it as a human right. We need to insist on a system that is designed to include, rather than exclude, people who need care. The powers that be keep telling us that we can’t do any better than this, when the truth is we can’t do much worse. We can and must aim higher. Let’s come together to demand an equitable, transparent, accountable and accessible system.
As we enter election season in Vermont, it is clear that we need healthcare champions who are willing to do more than offer vague, empty platitudes about favoring healthcare for all. We need leaders who are committed to working toward what we deserve and need: a publicly funded universal healthcare system.
The inspiring upwelling of energy that is arising to save the BMH birthing center must now also be directed toward demanding a system that puts people first. Instead of accepting a few crumbs from the healthcare table and hoping to call that a victory, we need to rise collectively to insist on the full meal. Only then will we get the kind of healthcare that each one of us absolutely deserves and needs.
