Op-Ed: Hospital report deserves a critical look

October 23, 2024  |  By Rep. Larry Satcowitz

When I was a high school math teacher my students were regularly tested on their skills and problem-solving ability. The tests did a decent job of measuring what they were designed to measure and provided useful feedback. 

This was good, as basic mathematical literacy is vital in our modern world. Mathematical reasoning and skills, however, are relatively easy to assess compared to most of the other aspects of learning that we expect our schools to provide. Some are so hard to measure that we don’t even try. Of course, that doesn't mean that those qualities don't matter. Indeed, they can be critically important. When we focus just on what we can easily test, it can be easy to lose sight of the bigger picture. In many schools across the country art, music, PE, and recess were cut. It was a disaster.

I fear we may be doing something similar with rural hospitals. The Green Mountain Care Board recently received a report that analyzed the costs of hospital care in Vermont. This study recommends a number of changes to the services offered by four small, community hospitals.

Some of these recommendations are quite drastic. Gifford Medical Center, located in my town of Randolph, is one of those hospitals. Some of the proposed changes to its operations would have large, negative effects that would ripple out far beyond the institution. It is not enough to measure a hospital simply by how efficient and cost-effective it is in delivering care. There are many individual patient, local community, and regional benefits that would be lost with the elimination of the services suggested.

When we do examine these relatively easy-to-calculate financial measures, however, we should make sure we get it right. 

The report is centered on making the case that hospital costs are increasing faster than our ability to pay for them. It contains side-by-side charts showing median household income in Vermont increasing 22% between 2018 and 2022 and hospital costs increasing 38% between 2018 and 2024. Do you see the problem? Those charts don’t cover the same time intervals. The second one covers two additional years. If you instead calculate the increase in hospital costs for the interval between 2018 and 2022, it comes out to 22% – the same as the increase in income. 

There are other problems with how the consultants presented the data in the report, but this example is the most blatant and easiest to describe. These misrepresentations undermine my confidence in the entire report. It’s as if they started with their conclusions and then figured out how to support them.  

The Agency of Human Services will decide on the next steps. I urge AHS to keep in mind the broader effects of the proposed changes, take a critical look at the data in the report, and closely examine the premises upon which the report’s recommendations are based.

State Rep. Larry Satcowitz, D-Randolph, represents the Orange-Washington-Addison District in the Vermont House.