Huge Health Insurance Rate Hikes: Public Comment through 7/24

Blue Cross and MVP Health Care want to raise rates by an average of 15.5% and 12.8% for individuals and 14.5% and 12.5% for small businesses. The affected plans are the ones people buy through Vermont Health Connect. This comes as an estimated 29,000 Vermont residents are being kicked off of Medicaid and forced to go uninsured or buy these expensive private plans.

If you are impacted by the rate hikes you can comment to the Green Mountain Care Board (GMCB), the state’s regulatory body. If you or your small business are currently purchasing one of these plans, if you are at risk of losing Medicaid, or if you are uninsured due to cost, you are or will be affected by these rates.


Medicaid Bait and Switch

One of the best things that happened as a result of the COVID pandemic was the rules relaxation and resulting expansion of this country’s Medicaid program. There also were a number of other factors that contributed to a major increase in Medicaid enrollment. The bottom line is that this country finally started to move in the right direction with its Medicaid program.

According to the National Library of Medicine, “From 2017 to 2019, national Medicaid enrollment declined by 2.6%. The COVID-19 pandemic reversed this course abruptly, with Medicaid enrollment increasing by 15.5% from February 2020 relative to April 2021. While existing research points to massive job loss as one primary driver of this increased enrollment, this study found that approximately three-fourths of Medicaid enrollment growth could be traced to declines in the rate of disenrollment relative to 2019, with only one quarter explained by higher rates of new enrollment during the March to October study period.”


We Need To Understand CPR Better

Cardiopulmonary resuscitation (CPR) is something that has become ingrained in our culture. When someone collapses people are supposed to feel compelled to start pumping on someone’s chest. Communities offer a number of ways for health professionals and lay people to learn the technique and an industry has developed around the use of CPR.

But I wonder if enough people take the time to look at the big picture and weigh the pro’s and con’s of CPR. The technique has been in popular use since the 1970’s and it’s interesting to note that the idea of cardiac compression first came to light in 1878 from experiments with cats.

During my career as a nurse I have done CPR hundreds of times and I have come to the conclusion that it is a good tool to have but it should be used wisely and only after carefully weighing the benefits and possible outcomes.


Drug Shortages, Deadly Consequences

We live in a world that has become dependent on prescription medications. It has been that way for decades despite the fact that too many people cannot afford them. And although cost remains a major barrier, people now have to contend with worsening shortages in the supply of drugs.

There have been shortages of critical drugs in the past, but it seems as though the current shortage of life-saving drugs may be showing us how the pharmaceutical industry is driven by profit while the value of human life is marginalized. Nothing new. Not exactly a revelation.


A New Revelation About Dying

One of the greatest privileges working in health care is to be able to make the passage into death a little bit easier for people and their families. Nurses and doctors and other providers do their best to ease pain and provide comfort despite the fact that we know almost nothing about the process of dying.

Death is something that has mostly been dealt with in religious and philosophical realms. The fact that we can’t experience death and then come back to talk about it makes it difficult to know anything about the passage.

Of course, there is something of an exception to this when people have what are called near-death experiences surviving after cardiac arrest or remembering being brought to the brink under general anesthesia. The common thread is seeing a bright light and a long tunnel and having a feeling of complete calm. Beyond that we don’t know much, but a study done in 2014 at the University of Michigan with four patients opens a new window into the act of dying.


Learning To Accommodate

Regular physical activity has always been an important part of my life. Baseball was my go-to sport growing up and it was a rare day (weather permitting) that I was not riding my bike. If there is a day without movement I feel as though I should be guilty of some sort of crime.

As the years have passed it has become necessary to make accommodations for the constant decay of the body. But despite that decay I have always found a way to figure out how to get some sort of exercise on a regular basis.

After spending a working lifetime in healthcare and reading all kinds of medical reports it is clear to me that if you want to prevent a lot of health-related problems one of the best things you can do is to exercise on a regular basis.


Brattleboro and VT COVID-19 Regional Dashboard Summary – April 2023

Here’s the April 2023 dashboard summary. We continue semi-regular COVID-19 dashboard numbers from the Vermont Department of Health, and MA and NH counties that surround Brattleboro, as long as they continue providing them.  That won’t be much longer. All seem to be wrapping up in the next month or so.  Scroll down the new comments for the latest.

VT, NH, and MA all seem to be doing weekly updates now, near the end of the week.


A Helpless Hostage of the Dental System

If you want to have the experience of being powerless and victimized by an elite corps of professionals simply seek dental care. I have watched the prices of dental care soar to obscene limits over the years and have felt helpless and hopeless because I know there is nothing I can do to change the situation.

The dental profession’s expertise is not in question. Practitioners are extremely well trained and they provide a high level of care. The problem is the business model that controls the delivery of dental care.

Most dentists are either private business owners or work for entities that are private businesses. While there are a number of health related regulations that dental practices must follow, when it comes to cost it is the wild west.


Another Drug Company Hustle

On the surface it looks like an amazing step forward. Eli Lilly, one of the major producers of insulin, (among the three companies that control 90% of the insulin market)1 announced that it is lowering the cost of some of its older insulin products by 70%. It was a shrewd and coldly calculated move to make the company look good in the public eye and fend off the inevitable mandates that the U.S. government is working to implement.

Recently, legislation was passed to cap the price of insulin at $35 a month for people enrolled in the Medicare D program. Democrats tried to get the bill to apply to all Americans but their efforts were stymied by the pharmaceutical lobby that owns more politicians than most other businesses.

Eli Lilly knows that it is just a matter of time before new laws are enacted to lower insulin prices across the board so they made a pre-emptive strike in the insulin wars. According to the New York Times, “Lilly trumpeted its decision as a victory for patients. In reality, though, Lilly’s moves are more limited than they initially appear. Lilly’s existing $35 cap on out-of-pocket payments will be easier for privately insured patients to take advantage of.


Brattleboro and VT COVID-19 Regional Dashboard Summary – March 2023

Here’s the March 2023 dashboard summary. We continue semi-regular COVID-19 dashboard numbers from the Vermont Department of Health, and MA and NH counties that surround Brattleboro, as long as they continue providing them.  Scroll down the new comments for the latest.

VT, NH, and MA all seem to be doing weekly updates now, near the end of the week.


COVID Vigilance Needed for Those Over 65

The hypervigilance phase of the COVID pandemic is over but the disease will, most likely, never go away. That’s not earth shattering news but many of us, especially people over 65, should be mindful of the disease and protect ourselves as much as we can. New variants pop up and each one seems to be more communicable than the next.

The fact that a significant number of people have had COVID and have been vaccinated makes casual transmission less likely, but the threat will always be there. Consider these statistics from the CDC.

Every week over 260,000 people contract COVID, over 2000 people die from COVID in the U.S. every week and 3500 people a day are in the hospital because of COVID.


Medicaid & Health Resource Drop-In Hours

In Dec. 2022, Congress voted to eliminate the extra federal funding and requirement that states keep people on Medicaid. Vermont will be starting Medicaid redeterminations on April 1. According to the Urban Institute’s projections, up to 29,000 Vermont Medicaid recipients could be affected.

The Vermont Workers’ Center is hosting an informational session in the Meeting Room at the Brooks Memorial Library in Brattleboro on Feb. 22 between 2 p.m. and 4 p.m. All are welcome to stop in to find out whether they will be affected, what their rights are in this process, and how to be sure that they aren’t cut off for bureaucratic reasons. People who are not on Medicaid and have questions about health care access are also welcome, as there will be other health care resources available. For more information, email windham@workerscenter.org.


U.S. Health Care Continues to Have The Worst Outcomes

It shouldn’t be a revelation to anyone who has used the U.S. health care non-system that we have the worst health outcomes of any high-income nation. The health care statistics about the U.S. delivery of health care are alarming, but that has been the case for many decades and the situation shows no sign of changing anytime soon.

If we cut to the chase, the reason that we spend more per person on health care, that we have the lowest life expectancy at birth, that we have the highest death rates for avoidable or treatable conditions and that we have the highest maternal and infant mortality rate among high-incomes countries is because of the profit motive.


Medicaid & Health Resource Info–Drop-in Hours

In Dec. 2022, Congress voted to eliminate the extra federal funding and requirement that states keep people on Medicaid. Vermont will be starting Medicaid redeterminations on April 1. According to the Urban Institute’s projections, up to 29,000 Vermont Medicaid recipients could be affected.

The Vermont Workers’ Center is hosting an informational session in the Meeting Room at the Brooks Memorial Library in Brattleboro on Feb. 8 between 2 p.m. and 4 p.m.


Brattleboro and VT COVID-19 Regional Dashboard Summary – February 2023

Here’s the February 2023 dashboard summary. We continue semi-regular COVID-19 dashboard numbers from the Vermont Department of Health, and MA and NH counties that surround Brattleboro, as long as they continue providing them.  Scroll down the new comments for the latest.

Vermont and MA have very limited looks at what are going on these days, with weekly snapshots. NH attempts daily updates but doesn’t always give new totals, and didn’t update at all at the end of January.


Hospital At Home A Flawed Model

There has been a movement over the past few years to energize the concept of providing some degree of hospital level care at home. Medicare has been modifying its rules to pay for projects that move in this direction and some policymakers are touting this concept as a welcome addition to the health care system.

The Hospital at Home program is quite simply a bad idea. Why would we want to beef up the hospital system of care when it is clear that we should be putting the majority of our health care dollars into prevention, not into patching things up after they go bad?

Hospital care should be the care of last resort. When things break and diseases take hold hospitals do a good job of fixing things. But hospital type care should not be a model for how a health care system moves forward into the future.