The writer is retired president and chief operating officer of NYU Brooklyn Medical Center in New York.
BRATTLEBORO-A consultant re-summarizing problems already well-known to executives and board members feels very familiar to many of us.
Suggesting that hospitals alone should come together and begin solving problems over which they have very little control does what consultants have done for decades: It restates obvious challenges without providing feasible solutions.
The conclusion is tantamount to a group of oncologists coming to a support group of terminally ill patients and saying, "Hmm, we are fresh out of ideas here. You guys get together and figure out how to cure yourselves."
Dr. Bruce Hamory listed 16 problems facing Vermont's hospitals today. I'd submit that, of the 16, only two are addressable by hospitals alone.
His list falls into four basic categories:
1. A lack of access to providers and procedures.
2. Payments that are below the cost of providing care (by private insurers, and the Medicare and Medicaid programs).
3. Costs are too high to keep these hospitals running as going concerns.
4. The social support systems for aging, indigent, and mentally ill patients put an undue burden on hospital infrastructures.
Problems facing Vermont hospitals are not very different from those facing the majority of hospitals in the United States. Here is why hospitals will never be in a position to single-handedly solve these issues.
1. Hospitals have no control over the price they are paid for their services. (Imagine telling a bakery that despite what it really costs to make a loaf of bread, they'll be paid $2 per loaf.)
2. A lack of an adequate number of doctors, nurses and other vital health care providers has a great deal to do with national salary structures, incentives to stay in rural environments, and shrinking numbers of these professional trainees.
3. It is laughable to suggest hospital leaders could impact the challenges of an aging population, homelessness and the societal trauma of the mentally ill. The suggestion yields a complete lack of credibility and usefulness to Dr. Hamory's report.
The real answers lie in the willingness of our national, state, and local leaders to put aside political divisions and ideologies and work with hospital leaders to address these inveterate and worsening issues.
Only when we make health care accessible to all Americans, pay a fair price for services rendered, provide incentives to train and retain new professionals, and address the growing numbers of poor and unhoused individuals in our communities can we ever clear the way for a sustainable, sound, and robust health care system in Vermont and in the United States.
Claudia Caine
Brattleboro
The writer is retired president and chief operating officer of NYU Brooklyn Medical Center in New York.
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