When Vermont peaceably secedes from the U.S. Empire, we will have a
great opportunity to re-imagine all aspects of our life here. We
can re-make the government, the transportation system, the
environmental regulations, the education system, the services for the
people who need help, and the health care system. What a gift
that will be! In the meantime, let’s share what we think might
work.

Consider the nation’s health care system.

Currently, we have a disease care system, one that favors people
with few resources and over a certain age (Medicaid and Medicare) and
those with fulltime employment with an employer who cares about
providing benefits. The rest of us are left without – unless we
can pay in cash (which includes my family, but that’s another story).

Doctors – and hospitals – are deeply embedded in this system of
disease care. Minor symptoms brought to the general practitioner
are soothed with prescription drugs and unnecessary tests. It’s a
break-and-fix system that doesn’t respect the whole people that we
are. Many minor illnesses (that may or may not become major) are
often linked to stress and daily habits – headaches, stomachaches, and
backaches to name the most popular. Where is there space in the
system for time to talk about the stresses and strains of daily life,
or the education to know the difference between a fleeting, minor
problem and a major one?

Here’s how I think the health care system could be fixed to serve us better.

First, there would be universal health care (and illness care),
period. Not by age, income, prior illnesses, employer, or life
situation; the ability for everyone to go to a health care practitioner
of their choice (physician, masseuse, nurse, acupuncturist, or
herbalist, just to name a few) and to use the hospital if necessary
should be for all. Not only would this cut costs and streamline
care, but it’s simply just.

Second, the new health care system would encourage personal
responsibility. Life brings with it aches and pains, and passing
illnesses like colds and flu. It also brings accidents that may
cause broken bones and other trauma. Many of our “bad” habits ---
smoking, excessive alcohol or illegal drug use, lack of exercise, too
much junk food – have health consequences as well. At some point,
many “minor” problems turn into major ones, such as heart and lung
disease or cancer. There are lots of things we can do to prevent
many of our bodily breakdowns, and just as many things we can do at
home to care for ourselves when we, or our loved ones, don’t feel well.

But, not everyone understands and knows about these
things. A true health care system (as opposed to disease care)
will provide the citizens of Vermont with education and support to help
care for minor illnesses and emotional upsets, to know when to call the
doctor, and change bad habits to good. With all we have to do,
it’s too easy to let that anger and stress settle into our bodies
without addressing the root cause. It’s too easy to sit in front
of the TV and have a beer or two than face our disintegrating marriage
or annoying co-worker. In time, illness will result. The
health care practitioner(s) we choose to see will help us face our
problems (physical and emotional), and offer suggestions (besides drugs
and surgery) to bring about balance and health.

Third, we should provide cradle-to-grave care, as much as
possible at home. Hospitals should be used for critical care
only, and the kind of life-saving surgery and treatment that is, at
times, necessary. Home health care services should be available
to anyone at anytime – without a doctor’s order – for support around
lifestyle issues and personal responsibility, care
post-hospitalization, pregnancy and childbirth, home modifications for
disabilities, and end-of-life care. We are generally more relaxed
in our homes, and will heal better. Trained professionals may
also notice environmental problems in your home that may contribute to
illness, and can help you correct them.

Fourth, emergency rooms will be used for emergencies only. Because
everyone will have access to the health care practitioner(s) of their
choice, many minor ailments that are seen in ERs (stitches, earaches,
sprains) can be seen in the office (or at home!). Every community
should have a health care practitioner available 24 hours a day to deal
with these minor problems and refer people to the emergency room if
appropriate. If our ERs are only caring for people with broken
bones, heart attacks and strokes, traumatic accidents, and the like,
long waits will be a thing of the past (as well as big bills). By
divorcing true emergency care from minor problems that happen to come
up “off hours” or to people without primary care physicians, it will
keep people with contagious illnesses like the flu away from people
with broken bones or in cardiac arrest.

Fifth, excess use of prescription drugs (and the attendant cost)
will be a thing of the past. Depression, insomnia, erectile
dysfunction, allergies, heartburn, and migraines will be dealt with in
other ways. So many of our bodily aches and pains are not really
“fixed” with a drug – they’re just masked. Sometimes talk therapy
will help, sometimes energy work, sometimes meditation or prayer,
sometimes a daily half-hour walk, sometimes a change in diet; the human
body is, in many ways, a mystery. Different things heal different
people – it’s not a one-size-fits-all system. As people take
increased personal responsibility, as they understand what makes them
ill and what best works to bring them to health, prescription drugs
will be needed in the rarest of cases.

Sixth, just to encourage personal responsibility even more,
Vermonters who do not use the hospital over a year’s time should
receive a significant financial rebate – $1,000 dollars or more per
person. Nothing like money to make people sit up and take notice!
It would be a simple, yet effective solution, encouraging good habits
and self-care while saving us lots of money.

In the meantime, everyone should support H.304, The Hospital
Security Plan, which would cover everyone in Vermont for
hospitalizations.

Check out www.takebackvermonthealthcare.org
for more information on this bill, and then contact your
legislators. This bill has bipartisan support, but your House
member(s) needs to hear from you to help it get out of committee and
onto the floor for a vote.