This commentary is by Vicki Ward of Barnard, who holds a master’s degree in family nursing and a post-master’s certificate in psychiatric and mental health nursing.
Sadly, U.S. health care has taken the path of U.S. capitalism. Money, power are the priorities. Though up to 50% of folk — including over three-fourths of those folk paying monthly for health care insurance — are unable to access health care, those in power plow on.
Doctors, hospitals, Vermont businessmen, Vermont administrators, Vermont state government officials persist in this monolith model. All health care and related health care concerns will be administered by hospitals, administrators, paraprofessionals, overseen mostly by doctors. Politicians with their MBA/MD allies have corralled all resources for this model.
Community resources — which used to have varied areas of expertise, housing, food, job training, health care — worked together to care for individuals. Consolidation of resources into the hands of money is unfortunately the current fate of those of us still in the U.S. All evidence states that this consolidation cost more money, not less. We experience this every year. Though Vermont had low usage of its facilities last year, 6% increases in costs were given to these mammoth systems.
This means community resources that often identify unique populations with unique needs — such as immigrants of various backgrounds, HIV folks, substance abuse, mental health challenges — lose this expertise as the community funds disintegrate and all assistance goes to the Russian oligarch experience of “we are your helpers now.” It will become like the deconstruction of U.S. mental health and substance abuse care of the 1990s. Very few care vestiges will be left. Few professionals with expertise will exist. Those who do will be vastly underpaid for their specialty skills. Memories fade so swiftly.
Vermont OneCare, with its admirable goals, might work in a Scandinavian country where housing, living wages, food, reasonable work are regarded as a social good and implemented as such for all. Ah, but, like every other system in which health care is a human right, the Scandinavians never consolidated their health care and human services into monied interests.
Ever seen your health care costs come down in the U.S.? Haha! They might now, if you want only telehealth care and the only way you get to see a health care professional in person is if the telehealth person authorizes this, after you pay for the telehealth visit.
The pandemic expanded telehealth for some health care needs, but as always in the U.S., the health care money extremists will find a way to bury you under their monthly “health care fees,” while you imagine and play roulette, spinning the wheel that telehealth will truly identify your health concerns.
As a 45-year community health worker, from paraprofessional to dual-boarded nurse practitioner, I can assure you, you are spinning the roulette wheel.
Though “one-stop shopping” sounds good, most of us have found we find better bargains and better buys by having a variety of options. Diversity is a sustainable aspect of nature, but humans persist in species extinction daily. In 50 years, we have extinguished half of life on earth.
I think about this often, as I find it extraordinary that we ignore the truly emergency topics of our time and just go along, extinguishing diversity in human and natural world constructs.
Medicare Advantage plans, growing in popularity with their coverage of some monthly costs, are extremely attractive if you have yet to need or witness what U.S. health care costs when you are sick and need it. What we forget is that we then lose the more expensive option of a Medicare supplement plan that more thoroughly covers health costs, though we may yet to need it. We also will never be eligible for the lowest cost of this plan again.
Ten years later, when we are sick, the supplement plan can refuse coverage or its cost will be exorbitant. Thus, most of the middle and lower class lose their estates to exorbitant health care fees, and their inheritors never build wealth. The money goes to U.S. health care and its bottomless pit.
Vermonters seem reluctant to imagine that what is occurring in other states could happen here. A recent New York Times expose verified that blue states express one set of values in their position statements, but do not live those values. Blue states exhibit the same value choices for their inhabitants as red states do. Likely, why we are still hooked together.
Democrats and Republicans alike have sold out the common good values expressed as vision in the 1960-70s. All the money now goes to the giant conglomerates, whether product sales or health care.
There is a way out of this, and we must refuse this continued aberration. As the youth begin to realize our profound generational failure in ignoring the yellow light of environmental degradation in the 1960s, we can begin to refuse these rotten choices.
Notice how the pandemic has caused destruction of most local stores and what is left is conglomerates? This pandemic hastening must be reversed. U.S. Health Care for All as a Human Right must become a lived value.
