The economics of healthcare is sick in Vermont
My parents retired to rural upstate NY, where they lived happily for 20 years. But naturally, as they aged, their health declined. At one point, my mom had a pulmonary embolism, and landed in a community hospital in Bennington VT, about 30 miles away. She got the care she needed, but when she was later diagnosed with multiple myeloma, she had to go to Boston for the care she needed.
Vermont is a fairly rural state overall. Fine if you’re young and healthy, but Vermont’s healthcare programs are struggling:
“Rising health costs are a problem across the country, but Vermont’s situation surprises health experts because virtually all its residents have insurance, and the state regulates care and coverage prices.
“For more than 15 years, federal and state policymakers have focused on increasing the number of people insured, which they expected would shore up hospital finances and make care more available and affordable.
“Vermont’s struggles are a wake-up call that insurance is only one piece of the puzzle to ensuring access to care,” said Keith Mueller, PhD, a rural health expert at the University of Iowa in Iowa City.”
What about Medicaid and the ACA?
“With its broad Medicaid coverage and low unemployment rate, Vermont for many years has had one of the lowest rates of people without health insurance.
“Vermont for years has had the highest monthly Affordable Care Act marketplace premiums in the country, and the gap is widening.”
A common charge against the Canadian healthcare system is “rationing,” the delays in treatment for some conditions. Looks like Vermont is rationing, too:
“Long waits for care have become increasingly common, according to state reports and interviews with residents and industry officials.”
*snip*
“At least part of the cost spike can be attributed to patients crossing state lines for quicker care in New York and Massachusetts. Those visits can be more expensive for both insurers and patients because of long ambulance rides and charges from out-of-network providers.
“Patients who stay, like Lynne Drevik, face long waits. Drevik said her doctor told her in April that she needed knee replacement surgeries — but the earliest appointment would be in January for one knee and the following April for the other.
“Drevik, 59, said it hurts to climb the stairs in the 19th-century farmhouse in Montgomery Center she and her husband operate as an inn and spa. “My life is on hold here, and it’s hard to make any plans,” she said. “It’s terrible.”
Some patients in VT hospitals are being housed in hallways and storage closets, and there is pressure to discharge patients without the optimal home or community care setup to relieve overcrowding.
The linked article blames regulation for much of the problem, but that’s really just gaslighting. The problem is that we, as a society, need to shoulder a greater tax burden to see that citizens in one of the wealthiest nations on the planet get the healthcare they need. And things will only get worse when Trump and Mike Johnson repeal the ACA, as they’ve promised.
Vermont’s healthcare business model is failing
Vermont is a fairly rural state overall. Fine if you’re young and healthy, but Vermont’s healthcare programs are struggling:
“Rising health costs are a problem across the country, but Vermont’s situation surprises health experts because virtually all its residents have insurance, and the state regulates care and coverage prices.
“For more than 15 years, federal and state policymakers have focused on increasing the number of people insured, which they expected would shore up hospital finances and make care more available and affordable.
“Vermont’s struggles are a wake-up call that insurance is only one piece of the puzzle to ensuring access to care,” said Keith Mueller, PhD, a rural health expert at the University of Iowa in Iowa City.”
What about Medicaid and the ACA?
“With its broad Medicaid coverage and low unemployment rate, Vermont for many years has had one of the lowest rates of people without health insurance.
“Vermont for years has had the highest monthly Affordable Care Act marketplace premiums in the country, and the gap is widening.”
A common charge against the Canadian healthcare system is “rationing,” the delays in treatment for some conditions. Looks like Vermont is rationing, too:
“Long waits for care have become increasingly common, according to state reports and interviews with residents and industry officials.”
*snip*
“At least part of the cost spike can be attributed to patients crossing state lines for quicker care in New York and Massachusetts. Those visits can be more expensive for both insurers and patients because of long ambulance rides and charges from out-of-network providers.
“Patients who stay, like Lynne Drevik, face long waits. Drevik said her doctor told her in April that she needed knee replacement surgeries — but the earliest appointment would be in January for one knee and the following April for the other.
“Drevik, 59, said it hurts to climb the stairs in the 19th-century farmhouse in Montgomery Center she and her husband operate as an inn and spa. “My life is on hold here, and it’s hard to make any plans,” she said. “It’s terrible.”
Some patients in VT hospitals are being housed in hallways and storage closets, and there is pressure to discharge patients without the optimal home or community care setup to relieve overcrowding.
The linked article blames regulation for much of the problem, but that’s really just gaslighting. The problem is that we, as a society, need to shoulder a greater tax burden to see that citizens in one of the wealthiest nations on the planet get the healthcare they need. And things will only get worse when Trump and Mike Johnson repeal the ACA, as they’ve promised.
Vermont’s healthcare business model is failing

High insurance coverage with very high premiums plus substandard hospital care and at least some quasi-rationing of care suggests that aggregate health of Vermonters is really bad at ages pre-Medicare. What are they doing up there? Also, ACA was “sold” on the basis that it would lower my family’s cost by $2500/year. That was an absolute steaming pile, and per Gruber, this con job was deliberate. ACA was a spectacular increase in public funding for healthcare. Go make it work before telling anyone the next step is a lot more tax dollars for healthcare.
Eric:
You have no basis for the comment concerning commercial healthcare and the ACA.
@Eric,
More than 45 million people are currently enrolled in Marketplace or Medicaid expansion coverage under provisions of the Affordable Care Act (ACA). You obviously know nothing about the topic.
@Eric,
“Medical costs surged in the early ’80s, but steadily came down over the next 20 years. Since 2000, medical inflation has been fairly well controlled, averaging about one percentage point higher than overall inflation.
“More recently, medical care wasn’t affected by the post-pandemic surge in prices. So medical inflation has been well under the overall rate of inflation. As a result, net medical inflation over the past dozen years has matched overall inflation exactly.”
https://jabberwocking.com/raw-data-medical-inflation-has-plummeted-over-the-past-three-years/