Health Care Facts

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(HOST) This week, VPR commentators are taking a Hands-on Health Care approach to considering what it may take to cure Vermont’s Health Care ills. Today, commentator Nils Dauliare reflects on the realities behind the health care debate.

(DAULAIRE) Now that spring is here, the politics of health care are heating up in Montpelier, and along with mud season, the name-calling has started: Socialized medicine. Profiteering. Rationing. Patient dumping. Second-rate care. It’s like listening to a ping-pong game.

Health care is a real crisis, and name-calling won’t solve it. We need a thorough, mutually respectful discussion – one that commits all sides to making tough choices based on the facts.

Fact: One of seven Vermonters will go without health insurance at some point this year. If they suffer a catastrophic illness, they can lose their savings, their homes, their businesses.

Fact: People without health coverage often go without routine and preventive health care because they feel they can’t afford it. But in the long run they – and all of us – incur greater costs because of avoidable illnesses and their consequences.

Fact: Every patient who comes to a Vermont health facility without insurance or the means to pay raises the costs for everyone else.

Fact: Our doctors today spend too much time and most of their office budgets handling all those forms required from all the different insurance companies – something they never learned in medical school. It’s expensive, it’s wasteful and they hate it.

Fact: Of the more than $5,000 spent this year, on the average, on health care for every Vermonter, three quarters will be spent on high-tech, intensive care for the very sick and terminally ill. That doesn’t leave much for the 90 percent of Vermonters who just need reliable, basic health care.

Fact: Small businesses are the backbone of our state’s economy, but health insurance is the fastest-rising and least-controllable cost that these businesses incur.

Fact: Equity calls for providing a level of care that treats all of us alike, but efficiency calls for options and experiments. Both call for avoiding entrenched bureaucracies, whether they are operated by government, insurance companies or hospitals.

Fact: There are few incentives in today’s patchwork system to work towards either greater equity or greater efficiency.

So what do we need to do about these facts?

First, let’s drop the name-calling and get to the underlying issues. Do we really want all Vermonters to be assured of a certain basic level of care? If so, what level can we afford? How can we achieve it while reducing transaction costs and frustrations for patients and providers alike? And most importantly, how can we make sure that we support and pay for care and prevention that have been proven to make a real difference in improving health, rather than expensive drugs and therapies that may not help at all? Developing a health care system based on facts rather than on opinions could give us all the care we need at the price we can afford.

Here’s one final fact: Not dealing with these questions today will cost all of us tomorrow. We’ve shown we can tackle tough issues in Vermont and lead the way with common sense. Now let’s get going.

This is Nils Daulaire.

Dr. Nils Daulaire is president of the Global Health Council, headquartered in White River Junction. He spoke from our studio in Norwich.

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