The Health Care Crisis is Already Here

Did you know that the Scott administration Covid policy isn’t aimed at reducing illness? Nope, they don’t care about that. The governor himself has said, over and over, that his goal is to prevent Vermont’s health care system from being overwhelmed. As long as the caseload is manageable, he’s fine.

Well, yeah, he’s fine.

But there’s a problem with that “set the bar low and jump over it” policy goal. It’s already failing. The health care system is already in crisis. It just hasn’t completely blown up yet.

And that’s only because of heroic and unsustainable efforts by health care workers and staff. The administration is desperately trying to patch things together and prevent a total blowup, and that’s all it cares about. Human Services Secretary Mike Smith has taken to giving weekly updates on efforts to add more subacute inpatient beds (to hustle patients out of the hospital as quickly as possible) and ICU beds — and the state is paying God knows how much to staff those extra beds.

I’ve also heard that the University of Vermont Medical Center is relying heavily on temporary nurses because it’s so short-staffed. If that’s the case at our crown jewel, imagine what’s happening in smaller facilities. Temporary nurses are in such high demand that they can almost write their own tickets, and the temp-staff agencies are making out like bandits. (Those agencies charge up to 100% of the staffer’s salary.)

The administration is willing to do anything, at any cost, because they don’t want to see Covid patients parked in emergency rooms or triaged for lack of resources. It’s not about quality of care of public health, it’s about avoiding a PR nightmare.

Even before a predicted holiday surge in Covid cases, which is likely to continue for two months or more, Vermont is already close to ICU overload. On November 12, VTDigger reported that statewide, ICU beds were 90% occupied. Only about 10-15% of those patients had Covid. Gov. Scott said recently that 10-15% was sustainable, but the system would be overtaxed if that number reached 25%.

And we’re talking about a handful of beds here. Vermont is tied with Hawaii for the fewest ICU beds per capita. We don’t have much margin for error in the best of times, and right now “the best of times” are a distant memory. Even at 90%, with staffing in short supply, how much stress is already on the backs of critical care staff?

The entire industry is facing a nationwide workforce crisis. Nearly one in five health care workers have left the field already. That will only get worse as the pandemic rages. And once this is all over (or under control), you can expect a flood of departures among those who are holding on for dear life out of concern for their patients. Honestly, I’m surprised that the health care exodus isn’t even worse than it is. The Atlantic:

Since COVID-19 first pummeled the U.S., Americans have been told to flatten the curve lest hospitals be overwhelmed. But hospitals have been overwhelmed. The nation has avoided the most apocalyptic scenarios, such as ventilators running out by the thousands, but it’s still sleepwalked into repeated surges that have overrun the capacity of many hospitals, killed more than 762,000 people, and traumatized countless health-care workers

The crisis may not be visible on the outside because health care staff are holding things together with chicken wire and spit. The Scott administration will be satisfied if things don’t just grind completely to a halt, but make no mistake: The longer this goes on, the worse things will get. And the bigger the coming backlash will be.

Even before anybody knew what coronavirus was, Vermont had a health care workforce crisis. Literally! A 2019 report from the Vermont Health Care Workforce began with this line:

Vermont health care providers are currently faced with a workforce crisis… from unlicensed personal care attendants to nurses to physicians.

At the time, one in five nurses and one-third of all primary care doctors in Vermont were 60 or older. How many have already left? How many more will be squeezed bone-dry before the pandemic is over?

In focusing on catastrophe avoidance, the Scott administration is neglecting its duty to protect the public health. And it’s setting the stage for a real, honest to God health care shortage that will make our current situation look like a walk in the park.

But sure, governor, tell us things are under control. Just don’t try saying that to anyone who works in an ICU.

3 thoughts on “The Health Care Crisis is Already Here

  1. montpelier28

    I’m on my 4th primary care doc in like 7 years of so. Same practice. I hear VT docs don’t get paid enough to live here. Imagine the rest of us lol. Thanks.

    Reply
    1. John S. Walters Post author

      Doctor pay is low, nurse pay is low, health care staff pay is low, everybody’s pay is low. There’s essentially a Vermont Lifestyle Tax. If you want to live here, you have to accept a lower salary than you can get elsewhere. Some people make the trade; most will not.

      Reply
  2. Walter Carpenter

    “I’ve also heard that the University of Vermont Medical Center is relying heavily on temporary nurses because it’s so short-staffed.”

    I’m sure you’ve read the Seven Days reports on traveling nurses at UVM and the atrociously long wait times at the UVM network to match the atrocious CEO salaries there. Also, there is a report in the today’s Digger about how OneCare has failed to meet its targets after six years and millions of dollars thrown at it (worth an investigation in itself) from the Vt taxpayers, so the feds have lowered the goalposts. They won’t continue with Act 48 because it is “too expensive,” and everyone is worried about long wait times… yet:)… you can see where this is going.

    Reply

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