Proponents tout OneCare as a revolutionary new health care system that pays medical providers to “keep people healthy” instead of treating them for illnesses. A corollary is that OneCare patients pay for “quality” rather than “quantity” of health care. The rationale is that currently providers are rewarded for performing (often unnecessary) procedures — “fee for service” — whereas OneCare compensates them per patient and thus incentivizes efficiency, economy and better outcomes.
Surely these grandiose but never-proved claims are both an insult to health care providers and an indictment of insurance coding requirements. Haven’t conscientious medical practitioners always recognized prevention and treatment as two sides of the same coin? Prevention takes precedence but both are essential.
We don’t need a new payment scheme to further enrich insurers and administrators; we urgently need a system that keeps people healthy by guaranteeing everyone accessible, appropriate, affordable medical care, regardless of age, wealth or employment. An excellent first step would be universal primary care, enacted in Vermont in 2011 (Act 48) but still awaiting implementation.
OneCare does nothing to provide care for more Vermonters. It has lost millions of public dollars thus far with no tangible health results and now seeks a five-year extension.
OneCare is an enormous swindle perpetrated via deceptive semantics and opaque financing. It is like the Emperor’s new clothes of Andersen’s fairy tale. There is no “there” there; only unaccounted outflow of the people’s money. It’s time to end the OneCare hoax and establish health care as a human right and public good.