OneCare Vermont Guarantees Worse Patient (And Taxpayer) Care

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Vermont’s seemingly endless bureaucratic expansion is encountering the limits of the public and the economy to withstand. This is true in the bloated school system, the oversized bureaucratic agencies, and the massively underfunded state pensions system. But perhaps the most gargantuan bloated farce in the room is in the Emergency Room: OneCare Vermont.

This travesty of spendthrift excursions has played “hear no evil” in response to the endless credible voices who have called for its accountability, yet the failure of the state to terminate this entity has cost Vermonters many millions of wasted dollars, deteriorated its already-weakened health care system, and pummeled the morale (and numbers) of actual frontline healthcare workers — the ones all those signs say the public supports.

OneCare Vermont is a scam. It has presented zero evidence of efficacy, even as its overspending has been well documented. Administrative expenses have swollen while patient care has declined. When will it be ended, like the bad dream it has been?

Rutland Regional Hospital’s Dr. Louis Meyers raised the alarm in 2020:

“Well, I think that it’s a huge top-down administrative program that is run from the University of Vermont. I think it sort of takes over. … It’s very time-consuming and expensive for the hospitals to meet some of the requirements that OneCare has to get that money. I mean you have to provide them just tremendous amounts of data, which usually means you have to hire extra staff. … They’ve been very secretive and they haven’t been very transparent about how OneCare is spending the money,” he said. “They haven’t been transparent about their cost overruns, which are really increasing — they’re huge. I mean, they are spending a lot of our taxpayer money, much more than was targeted.”

It appears Vermont’s government believes it can simply dole out unlimited administrative authority to rogue bureaucratic agencies, but this was challenged in the recent case of West Virginia v. EPA, which curtailed a pattern of deferring to such agencies (often called Chevron deference). Vermont must hold runaway money-thievers like OneCare Vermont accountable rather than let them run amok in wasteful nonperformance:

Since 2020 … essential population health management investments have declined $3.8 million, or 11.6%, while concurrently total salaries and fringe increased $1.3 million, or 15.6%, and total administrative costs increased by $1.24 million,or 8.9%. … Against this backdrop of decreased spending on mission in favor of increased staffing spending for less work, it’s important to consider the compensation of the OneCare’s leadership. … OneCare’s leadership is commanding $1.3 million greater — or double the national median compensation for the same roles.

A Vermont state audit similarly found:

The latest report by State Auditor Doug Hoffer runs the numbers on the first three years of the state’s contract with OneCare and concludes that the start-up and operating costs far surpass any savings realized to date. … Since it was launched in 2017, OneCare has cost the state $25.6 million more than what it would have paid under the fee-for-service Medicaid model, Hoffer’s analysis found. … The auditor deemed $12.7 million in spending by the state as “unaccountable expenditures” and found the department “lacked the proper financial oversight” to ensure OneCare spent the money appropriately.

Numerous voices have been raised to alert Vermonters to this OneCare fraud:

The state’s health care experiment has added extra bureaucracy and cost, resources that should be directed to increasing Vermonters’ access to health care, five [nonprofit] organizations argued.

But OneCare Vermont simply continues to line its members’ pockets with impunity, even during COVID:

The Green Mountain Care Board has suggested that OneCare flatline salaries because of the pandemic. The company instead proposed a 2% increase across the board and had planned to restore Covid-related salary cuts and position reductions. All told, salaries and benefits would cost $9.8 million, up from $8.3 million this year.

Whistleblower complaints go unheard, while pigs sup at the trough. Many members of the OneCare Board are also highly-paid hospital CEOs, such as Gifford Hospital’s Dan Bennett. Gifford has lost money, suffers horrid morale, and chases away good doctors and nurses while patient care declines. Yet, Mr. Bennett gets an additional annual fortune for a part-time position on a clearly wasteful board — why is that not a conflict of interest?

The problem is national, and stems from lack of accountability:

Bureaucracy is destroying value in innumerable ways, including slowing problem solving, discouraging innovation, and diverting huge amounts of time into politicking and “working the system.”

Instead of saving money while improving care, OneCare Vermont is clearly accomplishing the opposite: healthcare premiums for Blue Cross Blue Shield and MVP Healthcare will increase substantially in 2023. Vermonters are struggling so that wealthy opportunists can prosper.

An ER physician named Dr. Ron (Robert) Holland applied for a Green Mountain Care Board position but was ignored, likely because he called out this fraud in his application for the position, He said:

Employed physicians are vulnerable to the conflict between the Hippocratic Oath and the requirements of the competitive market. Their employers compete in the health care market with a focus on the bottom-line and increasing revenue. Physicians focus on patients and their needs. … The time and intellectual effort used for irrelevant documentation buys short-term enhanced revenue but fundamentally is worse than wasted use of providers as irrelevant documentation impairs use of the record and fosters physician burnout. Inefficient, uncoordinated care generates more revenue. The highly trained US physician has become a data entry clerk.

Vermont is losing good doctors and nurses, and effective patient care, while the pocket-liners reward themselves gluttonously. This will continue until Vermont legislators pull the plug and drain the tub of this vile profiteering. As I wrote in a 2019 article: “Vermonters are burdened with increasingly unbearable property taxes. Health care costs skyrocket, state worker pensions are substantially underfunded, and yet the government creates more and more employment for state agencies. Examining the track record of entities like OneCare Vermont, citizens are doubting whether anyone cares, especially within the bloated dome of the Montpelier Legislature.”

It’s time voters demanded accountability from their government and stopped this predatory bureaucratic drain on their wealth and health. Please vote for candidates — whether Democrat of Republican — who will end this thievery.

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