Insurers block hospital care

March 23, 2011

Rutland Herald

I appreciate the paper’s good report on the hearings held on March 14 across the state of Vermont. Each person who testified was limited to two minutes. Most of us spoke from our hearts and our own experience and therefore the timing was not precise. I was not able to finish my testimony for this reason so the quote from me which you used in the article, though accurate, needs a bit of clarification.

My point was that it is the insurance companies who make the decision to deny care (or make it unaffordable), not the hospitals. This is a crucial point because the fact is that if the person is willing to pay out of pocket, all the services at the hospital’s disposal are available while they are admitted or being treated as an outpatient. Since most people do not have the huge sums of money necessary to pay for their own care, of course, it is the decision of the insurance company that determines whether care is delivered or not. The hospital or clinician, is not the one who determines the level or type of eligibility of the patient for particular services. My point was to advocate for the elimination of the middle-man (the insurance companies) so that clinicians can provide the best care possible to address the needs of patients.

The interference by insurance companies in the doctor/patient relationship was amazingly illustrated by a physician who also testified that she received a paper from an insurer requiring her to become the legal guardian of her patient in order to advocate for a particular treatment or drug that she felt was necessary for good treatment. Can you imagine? If the doctor is not even able to advocate on our behalf, patients are truly at the mercy of insurance plans. And there is no recourse. If we had a single-payer system, well regulated by the state (that’s us!), we would have some control, even if not complete, over the terms of service. The experience of other countries with a single-payer system is exactly that. None are perfect satisfying everyone; but all are more equitable, affordable, and accountable than the U.S. system of private insurers.

A final correction: I did indeed proudly serve with the excellent staff of Porter Hospital for 13 years, but I am no longer working there and was not at the time of my testimony.

The Rev. DIANA F. SCHOLL

Middlebury