Health

BAH is pleased to be offering another volunteer training for the Serious Illness Program. The training will be starting in April with days/times to be determined to allow for maximum flexibility and accessibility.
 
The Serious Illness Program was created to offer support, solace, and assistance to people going through a life-altering serious illness that may or may not carry a terminal prognosis. 
 
This is a wonderful opportunity to spend time with clients who are learning to adapt to the changes a serious illness brings. 

A group of lawmakers has finally decided to tackle the issue of obscenely high salaries paid to hospital CEO’s and administrative leadership in Vermont. Every time this issue has come up hospital spokespeople hide behind the mantra that they have to pay high salaries to attract qualified candidates. That may be true, but we are living in Vermont, not New York or Boston, and I think we can still attract excellent candidates without having to lure them in with salaries that could pay for three or four front line health care providers.

The purpose of the recently drafted bill states, “This bill proposes to require hospitals to provide information about employee compensation and administrative staffing ratios to the Green Mountain Care Board as part of the Board’s hospital budget review process. It would also direct the Board to ensure that the ratio of administrative employees at each hospital to employees delivering health care services directly to patients is aligned with national averages for similar hospitals and that the compensation for a hospital’s executive and clinic leadership does not equal more than 10 times that of the hospital’s lowest-paid employees who deliver health care services directly to hospital patients.”

Vermonters who purchase their own health insurance whether they are young or old got some really bad news recently. The Green Mountain Care Board (GMCB) approved increases in the small group market for Blue Cross and MVP that border on outrageous. The GMCB is charged with the task of assuring the solvency of insurance companies so the consumers’ needs for affordable insurance do not enter the mix very much.

Blue Cross asked for a 24% increase and ended up with a 22.8% increase which translates to an average annual increase of 19.8%. MVP asked for an 11.5% increase and the board gave them 11.1% which is a 14.2% increase over last year. The board does have a time when the public can comment before the increases are finalized, but when people tell them they can’t afford another double digit increase they show little sympathy and hide behind statements that the cost of health care is rising too fast.

Everyone is taking a hit, but seniors may have a harder time than others because a lot of us are living on fixed incomes and have to live within a budget range. This kind of increase blows any budgeting out of the water. I have a Vermont Medigap Blue Plan D Medicare supplemental policy with Blue Cross of Vermont that cost me $191 a month last year. I was notified it will cost me $234 in 2025. It will cost me an extra $516 next year for the privilege of buying a Medigap policy. The cost of Medicare Part B is also slated for an increase.

When I first read the report “Act 167 Community Engagement: Recommendations”, I almost laughed because I had a pretty good idea of how hospitals would react. The passage of Act 167 was a recognition that Vermont’s health care system needs serious change if it is to survive and this report was commissioned to find out what to do. It focused on the state’s hospitals.

Many of the recommendations make sense, but what I find difficult to understand is how all of the affected hospitals could possibly make the changes called for in the report. They talk about regional centers of excellence where only certain hospitals would do specific procedures. There could be fewer hospitals doing joint replacements and those who continue would become more expert at the procedures.

There is also a call for hospitals to share staff. That makes sense from an intellectual perspective, but how many nurses are going to want to travel an extra hour or more to work each day just to fulfill the aims of systemic restructuring?

In a recent article in vtdigger it was noted that Vermont health insurance rates are among the highest in the nation. Just another painful fact for people to digest who live in a state that is also among the highest for property taxes.

Subsidies do lower the cost of insurance for many Vermonters who pay, on average, $243 a month for an individual marketplace plan. The article describes many of the details about the costs of health care but the only important information comes at the end of the piece when Mike Fisher, Vermont’s health care advocate, states, “Many of us have been looking at this health care financing ‘not-system’ – the way we finance care- have been saying for a number of years that it’s unsustainable and that it can’t possibly continue. But it feels like we’re in a much more acute stage of that.”

Serious Illness Program

Support for Those Going Through Life-Altering Illnesses

Have you or someone you love been diagnosed with a serious illness, or coping with an exacerbation of an ongoing serious illness such as organ disease or cancer?

The time of a new diagnosis, or treatment for a recurrence or exacerbation of an ongoing illness often calls for added support. If you or your loved one are going through cancer treatment, or experiencing a healthcare crisis due to cancer or organ disease we can help.

I make no claim of being a therapist or an expert on human behavior. But when you have been around for nearly eight decades you do come to understand a few things. I have learned that people who are unhappy about the course of their lives, people, who feel they are trapped in their lives with no way out and people who feel that the world around them will not allow them to succeed, often turn to drugs and/or addictive behaviors to ease their pain.

This is not a judgment call but simply an observation. I suspect that if you were to do a survey among people who have turned to drugs or alcohol or who have any kind of addiction at the center of their life, you would find most of those people to be among the unhappy.

The alarm is being sounded. Vermont’s health care system is in crisis and if we don’t take serious measures to change things the non-system we have will become financially unsustainable by 2030. According to a recent article in The Commons, “Dr. Bruce Hamory and his team were hired by the Green Mountain Care Board (GMCB) in response to the Vermont Legislature passing Act 167 for health care reform. The legislation is intended to create a sustainable, affordable, and equitable future for Vermont’s 14 hospitals and health care providers in general.”

Act 167 has a few good elements and I am sure that Hamory and his team have come up with a some good ideas to make the delivery and accessibility of health care in Vermont better. At one of a number of state-wide meetings held in Brattleboro on July 17 Hamory said that we have to stop tinkering around the edges and make changes to help health care in Vermont financially viable.

But everything I heard makes me believe that all of the ideas that have been presented recently continue to tinker around the edges, as have all of the efforts of health care reform since the failure to enact a single payer system in Vermont played out during the Shumlin administration.

When I first heard about a Vermont bill that became law on July 1, 2024 I thought the state had entered into a new era of health care affordability. The news report outlined some of the circumstances under which people could receive free hospital care. When I read the bill it turned out there is mostly nothing new, but it’s worth talking about it because some people need to know about hospital policies regarding free care.

Because all of Vermont’s hospitals are non-profit they have some degree of requirement to provide free care to needy individuals. That used to apply to hospitals that took money under the Hill-Burton Act but I think those days have passed and free care is still part of a hospital’s budget.