Rutland Herald
Misinformation about Vermont’s health care reform effort is proliferating. At the recent forum hosted by the Republican legislators for Caledonia County, Darcie Johnston, of Vermonters for Health Care Freedom, made three major points about Vermont’s health care reform that are just plain wrong.
She claimed that it will: 1) severely limit freedom of choice, 2) increase the cost of health care, and 3) create a huge bureaucracy. I’ve practiced medicine in St. Johnsbury for 20 years, and I firmly believe that the current reform efforts are a critical step towards solving these problems, not causing them.
Regarding freedom of choice, my patients are routinely told by their insurance company which doctor they can and cannot see. If they change jobs, they all too often find that they must change doctors because their old doctor is not in their new employer’s plan. More often than not my patients are self-employed or work for small businesses that cannot afford the exorbitant cost of insurance and so are uninsured. Even insured patients often have very high co-pays and deductibles and must forgo needed care.
This is not freedom of choice and is frustrating and scary for patients and doctors alike. It undermines continuity and quality of care. Furthermore, if people become ill and can no longer work, they often lose their job and their insurance coverage with it. What kind of freedom of choice is not having health insurance when you need it the most? I have seen patients with life-threatening illnesses forced to spend their limited time and energy worrying about how they or their family will pay for care instead of focusing on getting well. And I’ve seen the devastating effects of my patients having to declare bankruptcy because of a severe illness. Not only is this not freedom of choice, it is ethically and morally wrong.
The cost of health care has skyrocketed in recent years and much of the increase in cost has gone for administrative bureaucracies that “manage” the business end of care, rather than to pay the health care providers who actually deliver it. In addition, CEOs at the nation’s five largest for-profit health insurance companies garnered $54.4 million in compensation in 2010. Furthermore, those same firms netted $11.7 billion in profits in 2010. And while insurance companies make out like bandits, your local physician wastes precious time and money processing and filling out claims to multiple insurers; jumping through multiple hoops to get even routine care “pre-authorized”; and hiring staff to follow up on insurance company mistakes (which occurred in one out of every five medical claims in 2010 among the seven largest for-profit health insurers, according to the American Medical Association). Talk about waste and bureaucracy. With a single-payer plan we can eliminate all this waste, and lower costs. That’s the idea, and the data exist to show that this is the case.
Single-payer health reform refers to how we pay for services, with the goal being to simplify and save money in the process. The reform effort under way will no doubt address how to best deliver high-quality health care in a cost-effective way. All stakeholders (employers, practitioners, hospitals and citizens) have a voice in these decisions through an open and transparent process. That is much more than can be said for insurance companies that make decisions to deny care behind closed doors without the patient or doctor having any voice in the decision.
I applaud our governor and legislators for their efforts thus far in placing health care reform high on the agenda and beginning the work. I am one among many physicians who fully supports and is grateful for their effort.
Alice Silverman, M.D., is a psychiatrist with a practice in St. Johnsbury and president of the Vermont Psychiatric Association.