HOT to Go? No!

[Re “The Café HOT. to Permanently Close as Owners Return to NYC,” May 6]: From the day Travis and Allan Walker-Hodkin opened in the thick of the pandemic with just a takeout window, they brought quality food and service to Burlington with smiles and neighborliness. A special place, it was where I took first-time visitors as evidence of some of the best food and charm Burlington has to offer. I wish the brothers all the best and know they will bring their light to their next venture. It’s hard to say goodbye to such good neighbors.

WTF, UVMMC?

[Re “UVM Medical Center Is Losing $460,000 Every Day,” April 17, online]: I don’t really know where to begin with this quote from Dr. Stephen Leffler, University of Vermont Health’s CEO: “It is more than we can sustain at this pace, and it’s driving urgency to make changes quicker than we might do otherwise.” Vermont’s health care regulators are finally holding our largest health care deliverer to a cost structure rooted somewhere in the universe of reasonableness, and it is really putting pressure on its leadership.

Maybe we begin with: “What the fuck?” Over here in the cheap seats, we have been managing annual double-digit increases to health insurance costs for over a decade with seemingly endless wait times for service and provider and staff dissatisfaction (and comparative undercompensation).

Yes, doctor, it appears the time has come to shift focus from monopoly-enabled revenue negotiation (pretty good work if you can get it) to the hard business of delivering a quality product on time at a reasonable cost.

The following are all excellent ideas: “boosting provider productivity and trimming administrative costs, including reducing staffing redundancies. Scheduling changes were made to increase patient volume and reduce cancellations.” Why did it take so long?

Missing Info

[“UVM Medical Center Is Losing $460,000 Every Day,” April 17, online] failed to mention the University of Vermont Medical Center’s $1 billion-plus in reserves. Did the reporter lack time to investigate how UVM Medical Center losses compare to the institution’s profits in the $1.5 billion range over the past three to five years?

VT Healthcare 911, an organization advocating for health care regulatory reform, has produced useful information about UVM Medical Center’s operation. The org’s website has a piece titled “Turning the Ship Around Is Possible,” which provides ample data and history that could have rounded out the Seven Days story.

UVM Medical Center responded to its cumulative losses from Medicare in the $365 million range by pushing up profits from commercial insurance payers. The vhc911.org website explains that UVM Medical Center systematically cost-shifted losses into profits extracted from Blue Cross Blue Shield health insurance payments, while Blue Cross Blue Shield did nothing to challenge hospital rates for services, and UVM Medical Center’s “commercial profits increased by over 500 percent between 2020 and 2024.” Commercial profits were used to support “growth of the Health Network’s centralized business operations and top-heavy management expenses and subsidized the losses at its New York hospitals” and accumulation of $1.5 billion in cash assets.

The additional information on this website will help everyone understand why employers and households are going broke from health care premiums. At the same time, House Speaker Jill Krowinski and House Health Care Committee chair Alyssa Black rejected requests to allocate funding in S.197 for a financing and operations study to initiate a universal primary care plan in Vermont.

Not Just Docs

I agree with Trine Bech’s letter to the editor in the May 13 edition that the salaries and benefits paid to medical professionals are “unconscionable and a national problem” [Feedback: “Some Docs Make Too Much”]. I want to expand on that notion and include education administrators and lawyers. I recently learned that some divorce attorneys in Vermont are charging as much as $350 to $500 an hour determined by task — e.g., a phone call versus court attendance.

Whatever the service, no person is worth this kind of money — no doctor, no lawyer, no educator. Our nation will not heal as long as greed continues to prevail over providing necessary services for reasonable compensation.

Europe’s Example

Right on, Trine Bech [Feedback: “Some Docs Make Too Much,” May 13]! Years ago I lived in Europe for several months after being warned, “You can’t easily change your doctors” and “They pay high taxes over there.”

When I was in the UK as a grad student, I saw that all this had a hollow ring. First of all, the citizens do pay high taxes, but look at what they get: national health care. Free college tuition.
And there is a choice in doctors. My experience was that each patient could be issued a card that had a “Doctor A” line and a “Doctor B.” If you’re unhappy with “Dr. A” and want “Dr. B,” you simply fill in the line with the new doctor’s name and mail the card! It’s time for a change.

Talking Turkeys

[Re “Tick Tack,” May 20]: A relative of mine lives in southeast Massachusetts and has wild turkeys going through her yard all the time. They apparently eat up all the ticks. She never sees ticks — not even on her long-haired dogs.

‘Lifesaving’ Info on Ticks

[“Tick Tack,” May 20] gave readers a broad overview of Vermont’s tick problem. It did not mention testing for tick-borne infections. Left untreated, tick-borne infections can be physically and mentally debilitating.

It is essential that you get accurate testing, both to confirm the presence of an infection and to identify which disease is present. 

However, accurate testing in Vermont is not easy to obtain. Standard testing, referred to as two-tier Serologic testing, can miss active infections from multiple species. It is also considered old technology, having been developed in the 1990s.

In my wife’s case, standard testing missed the fact that she had six different infections: Lyme, babesia, bartonella, tick-borne relapsing fever, Ehrlichia and anaplasmosis.  

Babesia is a microscopic parasite that infects red blood cells. The other five infections are bacterial.

These six infections were only discovered after her doctor sent blood samples off to IGeneX labs in California. It was IGeneX’s multiple species testing that uncovered my wife’s tick-borne diseases. 

Doctor-prescribed IGeneX testing is expensive. It may not be covered by insurance. 

As an alternative, consider IGeneX’s AcuDart at-home test kits. The screening test panel covers multiple species of four tick-borne diseases. The kit is then sent off to IGeneX in Milpitas, Calif.

Please note: I don’t work for IGeneX. I want to pass along this information because it was lifesaving for my wife.

‘Real-World Consequences’

Anyone reading “Promises Too Steep” [May 13], specifically the segment on PCB testing, could be forgiven for accepting the basic premise that the law was passed “without understanding its real-world consequences” — mainly excessive expenditures and disrupted learning. What this viewpoint ignores is the mounting scientific evidence of the harmful effects of PCB exposure.

Dr. Keri Hornbuckle, a leading PCB researcher, recently concluded that attending or working in schools with unsafe levels of PCBs represents the worst case for human exposure. Especially vulnerable are young people, pregnant women and any adult with long-term exposure.

PCBs are known carcinogens, but newer research implicates even low levels of PCBs in neurodevelopmental disorders in children, including ADHD, learning disabilities, sensory defects and developmental delays.

Real-world consequences?

Recent research may yield a more effective and less expensive path forward — measuring emission samples from various surfaces in addition to the current protocol of testing air samples — benefiting school districts in Vermont and nationwide.

The House Education Committee’s proposal to halt testing ignored this new approach as a possible cost-saving option. Fortunately, the Senate rejected the House’s proposal, leaving the door open to further testing and creating a fund to help finance it.

Meanwhile, heading for trial is Vermont’s lawsuit against Monsanto, the sole manufacturer of PCBs, including proof that it knew about their toxic effects but continued selling them. The Burlington School District is suing, too.

By ignoring the science behind the PCB issue, the article authors have framed the issue as one more reckless mandate. However, had this law not been passed, 111 schools would not have learned that they are safe, while 46 would be still unaware of the risks within their walls.

Favorite Nadel

Thank you for introducing us to illustrator Marc Nadel [From the Publisher: “Portrait of an Artist,” May 13]. You mentioned several of his spot-on characterizations of political figures and races but neglected to include my favorite. It was the February 11, 2015, issue featuring the House of LeMay — nominated again this year for the “best drag performer or group” Daysie — representing the League of Drag Queen Voters promoting the upcoming mayoral election as well as the 20th annual Winter Is a Drag Ball.

Marc captured each of the trio’s personalities with humor and flair.

It is said, “You can’t judge a book by its cover.” That may be true, but you can tell an award-winning newspaper by its eye-catching, gotta-pick-it-up front page.

Corrections

Last week’s cover story on Migrant Justice, “From Farm to Front Line,” incorrectly described the academic status of labor organizer Natalia Fajardo. She was an undergraduate student.

The news story headlined “Burning Question” misidentified where the Vermont Department of Forests, Parks and Recreation conducted a prescribed burn this spring. It was in the Sandbar Wildlife Management Area.