John Klar: OneCare Vermont guarantees worse patient (and taxpayer) care

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.

John Klar

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.

John Klar is an attorney and farmer residing in Brookfield. © Copyright True North Reports 2022. All rights reserved.

Image courtesy of Public domain
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6 thoughts on “John Klar: OneCare Vermont guarantees worse patient (and taxpayer) care

  1. Welp Vermonters,
    Consider yourself warned.

    I had just read this article and then the very next one I read is this:
    “Largest Private-Sector Nurse Strike in US History unfolds across Minnesota”.

    My first thoughts, after having read this article here, was “Wow, imagine if something like this went on in Vermont- given the mess they already have going on”.

    So I’m reading the article and what is right there in the middle of it but a giant Tweet from none other than Bernie Sanders blabbering on about how he stands in solidarity with the nurses..

    My big issue with this is what makes nurses or teachers or anyone think they are simply worth more or more important than the rest of us are?
    We are ALL but spokes on a wheel here..
    The man that fixes the school buses that are vital, the plumber keeping your boiler going so you don’t freeze to death, the farmers that grow the food you eat. We ALL are needed and we all are important.
    But how much can anything or anyone afford to pay for all these people that have decided they are the “special” ones? the bottom line is that at the end of the day, all the money comes out of us and We The People are enduring and trying to survive a disaster !!

    This is slightly off point here on John’s article, but it’s about the medical situation and that Bernie is watching this, and no doubt thinking of what he can do with this, seems important. I’d be kinda worried.

    Here is the link:
    https://www.zerohedge.com/political/largest-private-sector-nurse-strike-us-history-unfolds-across-minnesota#comment-stream

  2. Phil Scott has repeatedly expanded the government and went along with VT’s massive budgets.
    He supports Act 46 and One Care. He locked down the state because of fear. Is it any surprise he’s so popular with democrats?

  3. Rememberf 2014 and ShumlinCare? He hired the guy from MIT….Jonathan Gruber to design ShumlinCare…and he also was a key designer for ObamaCare. Jonathan Gruber was caught red handed padding & scamming his fee’s to VT by about $400,000. Remember that ? Nothing happened to him – because he is Democrat. Also recall that Jonathan Gruber is ON VIDEO calling the “American Public stupid”…and that is how he can do what he does. The STUPIDS are the Democrats (stupid) that believed him….Repubs (smart) saw it would fail, or never be cost effective….all a lie. See it all happening now:

    “You’ve got to hand it to MIT economist Jonathan Gruber. The guy dubbed the “Obamacare architect” is a viral YouTube sensation. A few months back, he was caught on tape admitting that Obamacare doesn’t provide subsidies for federally-run insurance exchanges; it’s now the topic of a new case before the Supreme Court. Today, new video surfaced in which Gruber said that “the stupidity of the American voter” made it important for him and Democrats to hide Obamacare’s true costs from the public. “That was really, really critical for the thing to pass,” said Gruber. “But I’d rather have this law than not.” In other words, the ends—imposing Obamacare upon the public—justified the means.

  4. For all the times Phil Scott has extolled his intent to make or keep Vermont affordable, he is certainly dogged by the actions of Vermont’s legislature and the ‘boards’ legislated into power. I use the word power, because these unelected boards are ideological bureaucrats pushing an agenda so contrary to Scott’s words- and have the weight of regulation and fines behind them. Scott himself appoints members to the GMCB, but it’s all the same people with the same ideology. Empty promises from Phil Scott, perhaps?
    One Care is the outcome of then governor peter shumlin’s zeal for single-payer healthcare. Now more than a decade after the debacle of shumlincare and obamacare Vermont’s health care system has morphed into a unstoppable juggernaut of taxation, subsidy and fantastically expensive hard to get services. Basic medical care seems a daunting challenge to obtain, but the premium for the required health plan still gets paid each month and costs increase each year. We have allowed this industrial scale conglomerate to form, grow and control healthcare in Vermont, not for the patient benefit, but a self serving dollar driven bureaucracy that happens to provide medical care. Exactly as Klar writes, we allowed this to be legislatively codified into law that we, forced premium payers, taxpayers and consumers cannot change. The dollars involved are too great, the politics involved too difficult to penetrate.
    Onecare will continue to gobble up state and federal tax dollars, insurance premium dollars well above any rate of inflation- and still require more dollars. This system was designed broken and planned to fail- to usher in some form of single payer system in Vermont, with the added insult of ‘we told you so’ from those that created it. At the state GMCB board level, the same players still are playing- Robin Lunge and more in the background. No, this is politics and bureaucracy at it’s zenith. This is elections have consequence- and every Vermont resident suffers for it.

    • As the founder of Vermonters for Health Care Freedom and who warned of this calamity, it is sad to see all of our predictions come true. The most concerning is the lack of access to care that many Vermonters have been facing since before COVID and which has only become worse. Until legislators are willing to do the hard work of unwinding this regulatory mess it’s only going to get worse. Legislators must limit the regulatory power of the administration agencies. Unelected bureaucrats and the Green Mountain Care Board must be reigned in and the bureaucracy dismantled. Once that is done the Scott Administration needs to be forced from the legislature to dismantle and end the poorly conceived One Care scam. Anything less than these actions will allow the Green Mountain Care Board and One Care to continue to exist. This administrative bureaucracy will further destroy Vermonters access to care and the cost will continue to increase as it has since 2012. To the legislators and legislative candidates who want to restrain the runaway bureaucracy driving up the cost of health care and who destroyed access to care for thousands of Vermonters – be brave, be bold and don’t be deterred. You are the only ones that can get this done.

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