Vermont Can Lead the Way

November 13, 2011


By Dr. Ted Shattuck
Opponents of Vermont’s attempt to provide universal health care access to all of its citizens are using the usual weapons — anecdotal stories, budgetary uncertainties — to derail this vital process. While there is much talk of economics (more later), we need to keep our eye on what is really at stake: our moral right to health care, both as individuals and as a nation.

Our own Institute of Medicine estimates that 22,000 to 45,000 Americans die of preventable deaths each year due to a lack of basic health care. That’s more than the entire population of the city of Rutland each year. And that’s also after the federal provision of mandated emergency room health care access to all who arrive for acute care. It’s just that you can’t get the preventive or chronic care there necessary to foster good health.

Universal health care is not new. President Franklin D. Roosevelt proposed it in his second “Bill of Rights,” along with the right to a job and to a pension. Other industrialized countries have health care for all — Japan, Britain, France, Germany and Taiwan — and all have lower health care costs as a percentage of gross domestic product — a lot lower with a 5 percent to 11 percent range of GDP versus the U.S.’s 17 percent of GDP. On top of lower costs, they are also ranked higher in overall quality than the United States, which is ranked only No. 37. And it is just 17th in maternal health and childbirth quality.

How is that true? There are many factors, but the drug and insurance industries impose their “tax” on the system. Economics 101: It’s for-profit model. Despite spending 17 percent of our GDP on health care, we don’t cover all of our citizens. The U.S. spends approximately $8,000 yearly per citizen while France (ranked No. 1) spends almost $4,000 on each of its citizens, all of them, or just 8 percent of its GDP.

In the U.S., 20 percent to 24 percent of health care dollars are spent on administration, marketing and profit, versus 5 percent in France. For us in Vermont, where we have been and are more frugal, Mid-Vermont ENT (my former employer) must still spend an estimated $180,000 per year on billing alone; filing, refiling and fighting to get paid by these insurance companies for the care delivered. Remember, these insurance companies don’t like to part with “their” money or “your” premiums.

Canada, which gave us the name “Medicare,” was discussed in an op-ed article by professor Robert Letovsky. It ranks in the top 10 of all industrialized nations for health care and is ranked above the U.S. in overall quality of life. Medically, its doctors remain “private” practitioners while its medical schools have helped introduce both team medicine and evidence-based medicine into the U.S. Both of these concepts have greatly improved the delivery of health care to you as patients in Vermont. They were developed in a country where the patient, not profit, was put first.

Finally, Vermont was the first state to outlaw slavery, to provide free public education and to support marriage equality. It can show the moral way again by being the first state to provide health care to all its citizens.


Dr. Ted Shattuck practiced medicine in Rutland for 30 years. He graduated from McGill University in Montreal in 1970.