First Among Equals

A bill in the Vermont House shows that “Vermont First” is not always a distinction.

Vermont is the pilot project for the nation. The U.S. Post Office printed its first stamp in Brattleboro in 1846. The Social Security Administration issued the first check, $22.54, to a Vermont widow in 1940. The first program to force universal health care came with a Vermont law that banned cherry picking in 1992. Now the Vermont Assembly would legislate our non-profit hospitals out of business.

An Act Relating to Health Care Cost Containment is now in the hands of the House Committee on Health Care.

Buried among the Medicaid information technology funds, task forces, hospital budget review programs, and certificate of need rules, this bill will require that insurers participate in the Blueprint for Health and will prohibit hospitals from paying for “marketing and advertising.” It also sets up the State to take over any hospital in financial jeopardy. Shades of General Motors. The experience we have had with the State Hospital at Waterbury shows how well Vermont runs health care in the real world.

That experience matters not. The Vermont House has 94 Democrats, 5 Progressives, 3 Independents, and 48 Republicans. The Vermont Senate has 22 Democrats, 1 Progressive, and 7 Republicans. Senate President Pro Tempore Peter Shumlin (D-Windham) is running for governor. House Speaker Shap Smith (D-Lamoille-Washington) has not announced.

The “Blueprint for Health” in the bill will become a new statewide infrastructure/prevention/care management bureaucracy. It includes “an integrated approach to patient self-management, community development, health care system and professional practice change, and information technology initiatives.” The Blueprint Bureaucracy has the carrot of withholding Medicare payments from “under performers” and the stick of taking over the hospitals. Vermont docs and other providers receive about 40 percent of their revenue from Medicare and Medicaid.

  • “Marketing and advertising” means promotion, or any activity that is intended to be used or is used to influence individuals seeking health care services to use a specific hospital to attain those services.
  • Individual hospital budgets established under this section shall: … include a finding that the analysis provided in subdivision (b)(9) of this section is a reasonable methodology for reflecting a reduction in net revenues for non-Medicaid payers; and not include spending on marketing and advertising.
  • The term hospital shall also include all corporate or other entities affiliated with the licensed hospital…

I’m glad the Legislature has finally noticed that the skyrocketing cost of health care is a wee bit of a problem. That’s why House Health Care Committee Chair Steve Maier (D-Middlebury) says he included a provision to prohibit hospital from spending money for advertising and marketing. “It’s not producing health care,” he told the Burlington Free Press.

When I read about the bill, I thought this was a First Amendment issue. After all, even Vermont Law School constitutional law scholar Cheryl Hanna told the Burlington Free Press the legislation raised significant constitutional questions.

That’s a red herring.

The bill is another land grab, perpetrated by a legislature determined to gobble up all segments of health care from patient’s the first tiny down payment to the last visit to the morgue.

Here’s how that works. Hospitals get squeezed by shrinking Medicare payments, swelling Medicare patient loads, new budget caps mandated by the Blueprint for Health bureaucracy, and fleeing traditional payments. Hospital owners leave the state when confronted by a power grab at their books. Hospitals fail. Hospitals get taken over by the Blueprint for Health bureaucracy.

I would be werry werry afwaid if I were a hospital owner or administrator in any state in the union. After all, as Vermont goes, so goes the nation.

Did We the OverTaxed People sit out the last couple of election cycles? If we can’t learn from the Vermont experience, we could learn from the Sunni Arabs who sat out Iraqi elections in 2005. The need to protect their own interests brought Sunni Arabs out in droves on Sunday.

2 thoughts on “First Among Equals

  1. Tomorrow Mrs Poleczech has mandatory surgery; and it is not in a nonprofit hospital. The total bill could run as high as $35,000. However, regardless of the amount the hospital/surgeon charges, the insurance company will only pay a previously mediated lower amount.

    What this means is that someone without insurance who obtains medical services will get billed a much higher amount and will not pay it. They are usually referred to as undocumented immigrants or illegal aliens.

    I forget who we are supposed to like. Is it the Sunni or the Sheite? And why are we calling them Arabs if they are in Iraq?

    Wot’s this posting about anyway?

    — George

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