Bill Schubart: Heart surgery has given me insight into our healthcare system – VTDigger

I have written extensively on the state of health care in the nation and here in Vermont.

As the former president of then Fletcher Allen Health Care about 20 years ago, a Vermont resident and part of Vermont’s aging demographic, I want all of us to have the best care possible at a price that the broad economic spectrum of Vermonters can afford, or as I believe is long overdue a government consensus that, in the richest country in the world, healthcare becomes a human right.

Today, we have a network of nonprofit hospitals in the state that vary widely in timely access and cost. Many needy Vermonters are desperate to get the health care services they need and are simply aging while others are resigned to long waits or even simply go without.

As a former hospital president and retired businessman, I am a privileged person. I didn’t earn my retirement security the old-fashioned way, by inheriting it, but instead I earned it in the course of co-starting and running different businesses. I’m not in the 1 or 2 percent, but I’m in the 60^th percentile for retirement income and therefore consider myself both lucky and privileged.

When I learned recently that I would need minor but invasive transcatheter aortic valve replacement (TAVR) heart surgery to live a few more years, I was able to plan for it. The cost was largely paid by Medicare and I was able to meet the copay requirements, which were reasonable. My adult children, struggling to remember what the acronym TAVR stood for, simply said, Dads having trans-something surgery, confusing many who know me.

Had I been among the 36 percent of Vermonters who, by the Commonwealth funds definition, are underinsured, I would have had to forgo treatment, enter into a charitable arrangement with the hospital, or receive treatment, and file for medical bankruptcy. Non-profit hospitals in Vermont are expected to treat everyone who comes in need.

A distant family member, a healthcare professional who was recently treated at UVM Medical Center, had to negotiate a reimbursement deal, as he was between insurance plans. He now pays $950 a month for his new policy along with his monthly debt relief payment to the hospital, or $22,000 a year.

I have another family member in New York whose health insurance costs $4,000 a month to cover him and his wife and child. $48,000 a year represents 64% of the median household income of New Yorkers.

I could go on.

But I decided to write about how excellent the care I received at UVM Medical Center.

I arrived at 6:30 on a Friday and returned home the following day at noon. The procedure, during which I was wide awake despite the administration of painkillers, lasted about 75 minutes. I spent four hours convalescing and then one night under observation.

During that time, the medical team that cared for me was humane, focused and attentive. My doctor thoroughly explained the risks of the procedure, what could go wrong (but didn’t), and what my recovery would be like. It was precise and accurate on all counts. The lion’s share of my care was provided by attentive nurses, who focused not only on my physical care, but also on my mental well-being and sense of security.

I met and got to know about 15 LPNs, RNs, RNs, and service personnel. We had wonderful, unhurried conversations, both about my recovery and the current state of health care.

I was surprised by the deep concern many felt about the failures of the health care system itself. Several had heard of and personally referred to the term non-pecuniary damage, a situation in which a person’s reasons for committing to being a health care worker (or educator) come into ultimate conflict with the systemic practice of the institution for which they work. Others have spoken of compassion fatigue.

Many staff members have openly expressed their concern not with the quality of healthcare, but with its economy of exclusion. Their perceptions were informed by their experience with patients and reflected how much they had thought about the larger issues beyond their commitment to excellent patient care. I learned a lot from these conversations which unfortunately confirmed some of my fears, not about the quality of care in our hospitals, but rather about affordable and timely access to it.

In summary, my experience was amazing. It literally and spiritually lifted my heart to be among such busy professionals. I felt better within two days of my treatment and I feel better every day. In the 1950s, when I was a child, my newly diagnosed condition would kill me within a few years. Much progress has been made in the following years.

Credit where credit is due. We have a group of professional and committed healthcare professionals in Vermont in our various offices, clinics and hospitals. Medicine, like life, is both science and art, and both are fallible. Our judgments must be relevant to reality.

What we need at this point is an institutional and regulatory framework that makes our healthcare infrastructure available to all Vermonters while reducing (or largely eliminating) the appalling costs and severe delays. Early diagnosis and treatment are the standard for quality health care.

Again, thanks to the team of dedicated medical professionals at UVM Medical Center who took such good care of me. I will always remember the quality of your care, but I will also persist in my continued efforts to ensure that the quality you have provided is available to all my family, friends and neighbours.