The Assassination of OneCare Vermont by the Coward Douglas Hoffer

Not exactly convincing, I have to admit

The townsfolk are all horns and rattles, I never seen such a fuss. Must be that cold-blooded sidewinder Doug Hoffer’s back in town and up to no good.

This time, the ol’ gunslinger has taken aim at OneCare Vermont. Hoffer’released an audit on Monday finding that OneCare, which was supposed to glean savings from the healthcare system, has cost millions more than it’s saved.

The normal official response to a Hoffer audit is along the lines of “Well, he found some interesting information, but nothing we didn’t already know and weren’t already doing something about.” But the reaction to this audit is more direct, if not downright hostile. Mind you, they didn’t contest Hoffer’s findings, not at all. But they didn’t like his conclusions, not one little bit.

One might even detect a faint whiff of panic. Considering that free-lance health care expert Hamilton Davis just called OneCare “a dumpster fire,” I can see why Our Leaders would be unreceptive to a critical audit right now.

OneCare CEO Vicki Loner, Green Mountain Care Board chair Kevin Mullin, and Human Services Secretary Mike Smith sung variations on the same tune: OneCare can’t be evaluated on a purely dollars-and-cents basis. You also have to consider OneCare’s impact on quality of care — which, conveniently enough, can’t be quantified.

It’s kind of a surprising argument coming from people who normally keep a hard eye on the bottom line. Sounds like something a damn liberal would say: “Hey, it might cost more, but it improves people’s lives in nonspecific ways!” I mean, Smith slammed Hoffer for taking a “narrow approach to understanding the impact of the all-payer model.”

Damn right. A financial approach. After all, OneCare is supposed to save a lot of money on health care.

These reactions make plain what we already knew: Vermont has gone too far to change course. Or at least our leaders believe so.

Hoffer suggests a number of ways to make OneCare more accountable. Which, yeah, it is an Accountable Care Organization, after all. But I can’t see Mullin or Smith or Gov. Scott cracking the whip. In the language of poker, the administration is pot committed. And poker is an appropriate source of analogy, because this is a big-time gamble.

If these people were serious, this would be the time to show it. OneCare’s five-year contract with the state expires later this year, so a new deal must be struck. It seems that the Scott administration is in no mood to be confrontational in contract talks.

And the farther we go along this course, the more committed we become.


7 thoughts on “The Assassination of OneCare Vermont by the Coward Douglas Hoffer

    1. walter carpenter

      “Is Vermont looking more and more like a failing Socialist experiment to you-all out there??”

      OneCare is not a “socialist experiment.” It is true red-white-and-blue capitalism. That is why it is failing. The experiments in Socialism, like Canada, Denmark, Finland, Sweden, and so on are not failing. They are thriving in many more ways that we are not.

  1. bobzeliff

    First lets all agree One Cares management has be arrogant and indifferent to the general public and has NOT been as effective in implementing as most of us would hope. But all, Hoffer, you, all the press and most liberals who you would think would welcome true healthcare reform primary goal is move form the insurance company friendly FEE for Service to annual payment per head to provide the same or better care. Get the Doc and hospitals lump sum payment per person, less paper work, just focus on the patient!!
    Nope…you all take the easy shots, often poorly informed.
    Yep you guys will be successful in keeping the insurance company friend status quo!

    Do not recognize health care reform when you see it

  2. H. Jay Eshelman

    Act 46 was supposed to improve education outcomes and lower costs too. OneCare has the same deficiencies – specifically these programs don’t support a consumer/producer free market. Subsidize healthcare and education to your heart’s delight. But without free market incentives, outcomes and costs will continue to be unmanageable.

  3. John McClaughry

    I’ve long been a critic of the All Payer Plan as wrong headed since it appeared, but in fairness, one big reason it hasn’t delivered the savings is that it doesn’t have all the providers, and thus the patients, in its clutches.

  4. walter carpenter

    “But without free market incentives, outcomes and costs will continue to be unmanageable.”

    This is the tragic mistake we’re making in health care. For one, there is no such thing as a free market. There never was and never will be as this “market” is nothing but power relationships and it exists to extract as much wealth as possible into the hands of those who manipulate it. This “free market” certainly is not free to its innumerable victims. A “free market” is usually the freedom of corporations to do what they want without a government making sure they behave according to the law. As long as we put our faith in this non-existent marketplace in health care, our costs will continue to shock the rest of the democratic world that lives happily in single-payer systems.

  5. Paula M Schramm

    “Consumer/producer free market ” model does not fit healthcare, period. You don’t shop around for a surgeon or hospital when you’re having a heart attack. It doesn’t help to choose “an affordable” high co-pay plan when you turn out to have cancer where 20% of the monthly treatment is $10,000 and the cost of drugs put you in the “donut hole”. It’s not a sane health care system that forces those of moderate to low incomes to figure out how much to gamble on their unknown health care future.


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