Medicare for all

By Ron Krupp, April 2, 2015

Stephen Brill’s new book “Bitter Pill” further elaborates on his Time Magazine article in spring 2013 entitled, “America’s Bitter Pill: Why Medical Bills Are Killing Us.” Brill explains in detail why hospitals are a big part of the problem. The University of Vermont Medical Center, formerly called Fletcher Allen, offers services at prices that bear little relationship to costs. Heart bypass surgery costs $9,319 in Argentina and an average of $67,583 in the U.S. That’s why medical bills are the biggest cause of bankruptcies in the U.S.

Fletcher Allen Hospital, which calls itself a nonprofit, earned on average 5 percent more than other comparable hospitals in the country. Part of the problem is the high fee-for-service payments to medical specialists and excessive salaries to hospital administrators.

The board of directors recently decided to change the name of the hospital to the University of Vermont Medical Center at a cost of $5.7 million. Our billion dollar Vermont medical monolith now wants to spend $187 million in the construction of a seven-story addition that would provide single rooms for patients. They also want to purchase more land and buildings in South Burlington for future development.

If the University of Vermont Medical Center were truly interested in serving the community, they would first begin by providing comprehensive emergency room (ER) service. I have heard numerous complaints over the years about the ER. Around Christmas, an 84-year-old woman, who is a friend of mine, was throwing up continually in the ER. She had to wait four hours to receive any care. Another friend last summer was basically escorted out of the ER into 95 degree heat when she complained that she had not been seen after waiting three hours. She was told her name had been called and now she was at the bottom of the list. Obviously, the process failed.

Part of the answer is to have an immediate care facility for non-emergencies located at the hospital or at a nearby location. There is a facility at the University of Vermont Medical Center Fanny Allen campus in Colchester for non-emergency urgent care. No appointments are necessary.

If we truly want to provide fair and affordable health care we would pass single-payer universal health care. Vermonters would receive high quality care at costs they can afford. In many cases, individuals who have so-called health insurance can’t afford the co-pays and deductibles that insurance companies charge. This results in many patients making the decision to go without medical care.

I’ve been told a number of times by primary care physicians that they have to spend excessive amounts of time dealing with insurance companies in order to allow their patients to receive proper medical procedures. Isn’t patient care their top priority?

Single-payer would provide cost controls through simplified administration, by eliminating much of the bureaucracy — paperwork, phone calls and more paperwork. This would result in savings of 15 percent. Single-payer financing has a number of other advantages over private health insurance. First off, it’s not-for-profit. There are not private shareholders and overpaid CEOs. In other words, corporate stakeholders would no longer be able to make enormous profits.

I’ve been told that single-payer won’t work in this country and people who need immediate care won’t get it. First off, there are 40 countries around the globe with single-payer systems including our Canadian neighbors to the north. Dr. Frank Pasley of Williston, who is now retired, worked for 30 years both in the U.S. and Canada near Buffalo, New York. He told me there was no comparison between the two systems. The Canadian model was superior. Patients of his who needed care for serious heart problems received it immediately.

I’ll conclude with the statement, “You be the judge.”

Ron Krupp is a gardener and author whose most recent book is “Lifting the Yoke — Local Solutions to America’s Farm and Food Crisis.” He lives in South Burlington.