This commentary is from Walter Carpenter of Montpelier, who works in Vermont’s tourism industry and is a writer and health care activist.

Now, it appears the divorce proceedings between the University of Vermont Medical Center and UnitedHealthcare that threatened the lives of some 5,000 Vermonters are over.

Although they have reconciled for the time being, it could easily happen again and more than 5,000 Vermonters could suddenly be put in danger. In our health care illness, we are all vulnerable to these forces at all times.

The question we should be asking ourselves and our business, cultural and political leaders is: why do we allow our health care, and therefore our lives, to be placed at the mercy of buy-and-sell shenanigans? what we call a market? ? Why?

I sympathize with those 5,000 Vermonters who suddenly find themselves forced to go elsewhere for treatment if they need it because two market giants had a spat.

To understand what it is, you have to go through it. In 2005-06, it was my turn. I well remember that feeling of fear, of utter helplessness in the face of someone else’s decision that suddenly threw my life and the lives of my colleagues onto the odds and our nation’s unique belief that this invisible entity called market should decide the fate of our health care.

I was working at a company in Vermont. Like so many companies in this era of mega-mergers and monopolies, this company was owned by another company. The parent company was out of state. We were part of a family of companies.

In 2005-06, they changed insurance companies. They did it without our input. We had no choice in the matter. It still makes me laugh when supporters of the status quo exhort me about “choice”.

The new company was UnitedHealthcare. A CEO I knew at our parent company who was high up in the corporate strata told me, “United was probably the lowest bidder. That would explain why what we got was so poor.

Before them, we were with BlueCross BlueShield of Vermont. While hardly great, it was at least local and we could complain about the inevitable backlash that for-profit health care threw at us – like the inevitable co-pay increases, claims or prior authorization denials. , etc. – to the appropriate state agencies or our representatives.

Blue Cross once increased my co-pay from $50 to $250 after surgery. They cited how their costs had increased. I quoted how my salaries did not increase to cover their additional costs. They sympathized, but implied that it was my bad luck. Representatives and the state agency (BISCHA at the time) replied that they would “look into it”. I haven’t heard of it anymore.

With United, all of our medical providers were knocked out of the network in one fell swoop. We could use them if we wanted to, but only at the uninsured rates, which are much higher than the insured rates.

At the time, United had very few “in-network” doctors in Vermont. Their closest doctor to me in Montpellier was in the Northeast Kingdom; nearest “in-network” hospital was Dartmouth-Hitchcock in Leabanon, NH Doctor I lost was two blocks from me; the hospital was just up the hill.

This had serious ramifications for me. The first symptoms of the (naturally caused) liver disease that nearly killed me in late 2006 were forming. Without a GP, the guardian of our managed care world, I couldn’t enter the system and the symptoms had all the opportunities they needed to come together into a force strong enough to do the job.

When I finally found a GP, my skin took on a sickly yellow tint, then it became a fight against time. I almost lost it.

Sixteen years later, we’re still going through this and with more crises adding up – fantastic wait times, shortages of doctors and nurses, ever-rising costs, wacky CEO salaries and all the other which we know perfectly well now. Covid has only exacerbated these issues.

So-called “value-based care” has done nothing to mitigate them, despite the billions of dollars we have invested in it. Like HMOs, PPOs, and every other experiment before it, value blames and punishes us for these evils, instead of the corporate system that suddenly put all 5,000 Vermonters in danger and nearly killed me.

Journalist TR Reid put this into perspective in his 2009 book The Healing of America. He framed our dilemma as a moral question: “Should we guarantee medical treatment to all who need it or should we we let Americans die of disease? lack of access to health care?

We’re still grappling with Reid’s moral question. Why?