by Lenore Broughton
ST. ALBANS – Moderator Dr. David Groening asked the twenty-five plus physicians and dentists attending the forum on healthcare if any of them had already been looking for a job outside of Vermont because of Act 48, the law that puts Vermont on a path to single payer healthcare. Over half of the doctors raised a hand.
The event at the Northwestern Regional Medical Center gave doctors a chance to speak directly to their legislators (and vice versa) regarding medical related legislation, including (but not limited to) Act 48, and H.559 – An act relating to healthcare reform implementation. Local Senators Randy Brock (R-Franklin) and Sara Kittell (D-Franklin) and Representatives Lynn Dickinson (R-St. Albans City), Peter Perley (R-Enosburg), and Carolyn Branagan (R-Georgia) got an earful. The doctors’ comments were universally critical of legislature’s actions.
This negative response from the medical community in the St. Albans area mirrors the response Rutland legislators received at a similar event hosted earlier by the Rutland Regional Medical Center.
A big area of concern for the Doctors was the fact that tort reform was not being pursued as a cost cutting measure in Vermont’s reform efforts, even though enacting tort reform was a significant recommendation by Dr. William Hsiao, who’s report in 2010 was supposed to be a roadmap for future legislative action. Citing a 1996 study of heart surgery by Kessler and McClellan, the Hsiao Report estimated that tort reforms could save 5 to 9% of total health by expenditures through a reduction in defensive medicine. Paul Harrington added that in 2003 a report issued by the Health and Human Services Department noted that the cost of defensive medicine was between 70 and 126 Billion dollars a year! Still, the concept was quickly discarded by Vermont legislators.
(It is worth noting here that both the Speaker of the House, Shap Smith (D-Morristown) and the Senate President Pro Tem, John Campbell (D-Windsor) are both, in their private occupations, trial lawyers.)
Dr. Tom Dowhan, an ophthalmologist, pointed out that the million dollar lawsuits are a drop in the bucket of health care costs. It’s the defensive medicine that is practiced as a result that is so costly. Twenty percent of the tests that are given are absolutely useless, said Dowhan. “I would rather be treating the patient the way I’ve been trained as a board certified physician” than ordering $1,600 MRIs when he knows the patient doesn’t need one.
Dr. Robert Beattie, an orthopedic surgeon, formerly from Canada, agreed with Dr. Dowhan as didDr. Ed Haak, D.O., medical director of Northwest Medical Center Emergency, who illustrated the point. Dr. Haak explained that it only takes one lawsuit. The terror instilled in doctors experiencing a lawsuit assures that they will be practicing defensive medicine for the rest of their lives, surely a huge cost to society.
It was with some dismay that Dr. Beattie recounted from an earlier meeting that Dr. Alan Ramsay of the Green Mountain Care Board “danced around” and defended the of abandonment of the tort reform agenda.
Senator Kittell interjected to say she had not heard that tort reform had been thrown out. This is a surprising but revealing statement, and illustrative of a problem we’re seeing with legislators and important legislation. Apparently, Kittell voted for the bill without knowing what was in it.
Senator Kittell offered, “we have $18 Million from the Federal government to make the plan and figure it all out.” Eventually we all have to pay as taxpayers.
Dr. Linda Ulrich attended with her husband, Dr. Chuck Verderber, both dentists in a private practice together. Dr. Ulrich said:
I don’t think any of the conversations we’ve just had add to our attractiveness to young professionals coming here. Chuck and I… we think about someday retiring here but there’s no hope at all if things keep going the way they are, of attracting someone to come to Vermont and take over our practice and accept the debt that we have and go on treating 4,200 patients in Franklin County. There’s just no way. Sweeping dentistry into this health care thing with the kind of debt we have as small business people ….it would be the most irrational thing you could ever think of. You’d never attract another dentist to the state. You can’t get pediatric dentists. I don’t know what your plan is to attract physicians to the state but everyday Chuck and I review our patients’ health histories and our patients have doctors who have moved, retired early, it’s always some kind of story and it seems like we’re becoming less and less attractive and I really worry. My ability to get good medical care in this state when I’m 70…the odds of this are really low if we don’t very carefully calculate this out and I’m very, very disturbed about having some vote taken on Thursday that leads us further down a path, that locks us further and further into a future we know nothing about. Not one nickel of its cost has been explained. And everyone keeps opting out. IBM is out, the teachers may be out, businesses with over 50 employees…Who is this going to be left to? The guy who owns the Fairfax market and the guy who owns the shoe store? Who’s going to be left to pay for this?
Senator Kittell said she hadn’t come prepared to the meeting. “I’m not on that committee. And I didn’t quite realize….Anyway. I’d be glad to get more information but I can’t get you that financial information yet because the plan isn’t known…. It’s a work in progress. I think the tort reform…come down and go to the judiciary committee, go to the health care committee, get your medical society all together, just like we did with the Rest Areas, years ago…. 14,000 signatures…. About tort reform, I hear this all the time. We’re a small state. Health care is about relationships. It seems like we can work this out”.
Representative Peter Perley, who had been quiet up until that moment, was asked by Dr. Bill Roberts, an anesthesiologist, to make a comment. Perley admitted he was very “mixed up”. To that Dr. Vanderber retorted, that in the face of such confusion, the right thing for legislators to do was to vote for Vermonters, on principles, and not just along party lines.
Senator Brock said, “The thing I hear most about Health Care Reform in Vermont is that we’re going to save money. But how can we say we’re going to save money when we don’t know what we are going to spend? There’s a fundamental piece of illogic there.” He also pointed out that the exchange which the Federal Government has asked us to set up by 2014 for Obama Care is being used instead to further the implantation of Single Payer.
Representative Branagan reminded those present that, “Governor Shumlin [had] said not to worry about costs because he would set tax rates to cover them.” Summing up the frustration felt in the room, she said “the problems we face now over health care in Vermont are primarily because of politics.”
Rob Roper contributed to this article