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April 17, 2017

A For-Profit Surgical Center is a Good Idea for Vermont

A group of local investors want to build a $1.8m surgical center in Colchester, VT for surgeons who prefer not to operate in a hospital setting, according to a story in VTDigger last week. Opening such a center, even when no public money is involved, requires a certificate of need from the Green Mountain Care Board. Vermont’s non-profit hospitals (there are currently no “for-profit” hospitals in the state) are urging the Board not to grant the certificate saying that it would result in an increase in health costs.

From the VTDigger article:

“The investors argue such centers save patients and insurance companies money because both Medicare and private insurers pay them less than hospitals for the same procedures. These types of facilities are called ambulatory surgical centers and are both licensed and regulated by the U.S. Centers for Medicare and Medicaid Services

“Christina Oliver, the vice president of clinical services at the University of Vermont Medical Center in Burlington, said the proposed facility is not needed because the hospital’s operating rooms and procedure rooms are working far below capacity. ‘We have open time available every day that is staffed but unused,’ she said.”

I am an admirer of and contributor to UVM Medical Center; but I think that the for-profit surgical center hospital should be allowed to open. The quality of care I've gotten at UVMMC has been excellent; once the hospital saved my life. But that doesn't mean that Vermont won't benefit from competition to keep medical costs down.

We will attract more doctors to the state if they have a choice of being in a wonderful research and teaching hospital like UVMMC or providing care in a smaller, more flexible organization.

There may be plenty of surgical operating rooms in Vermont, as Ms. Oliver said; but I know from experience that does not mean that minor non-emergency operations can be scheduled expeditiously. If a for-profit operation can provide faster care in these cases, that will be a help to many Vermonters.

We are not cost conscious medical consumers in Vermont because we have neither enough choice of providers nor transparent pricing to compare. The proposed center will offer both choice and transparency.

Finally, "for-profit" is not an epithet. A for-profit provider will fold if it does not offer something better than its non-profit competitors. There will be, and should be, quality regulations to assure that efficiencies are not achieved by cutting corners which shouldn't be cut.

It would take a lot to convince me to choose some other provider over UVMMC or Copley; they have set a high bar for quality. Nevertheless, prices are anything but transparent and waits for non-critical care do exist. Competition should be allowed.

The Green Mountain Care Board has a website for public comment. If you have an opinion on this issue – pro or con, please post it at http://gmcboard.vermont.gov/board/comment. Of course your comments are welcome here as well.

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