Spend our tax dollars on healthcare, not pricey consultants

Dear Editor,

I read with interest the VTDigger article of Nov. 2 about how Vermont is using the $195 million in Rural Health Transformation funding. As someone who uses the services of Brattleboro Memorial Hospital, I am keenly aware of the financial challenges it and other rural hospitals are facing. As access to birthing care has shrunk, I am relieved that Brattleboro Memorial will receive funding to keep birthing care accessible in southeastern Vermont.

I was less pleased, however, to see that $5.1 million is being granted to McKinsey, a high-priced consulting firm notorious for its role in the 2008 subprime mortgage debacle, for consulting with authoritarian governments and for insider trading, among other things. Particularly relevant to healthcare, McKinsey designed a marketing plan to “turbocharge” sales of OxyContin in order to inflate the value of the company, fueling an epidemic that continues to destroy lives, families and communities in Vermont and around the country.  

In 2021, Vermont received $1.5 million in a multistate settlement with McKinsey for its role in fueling the opioid epidemic. Now we are paying over $5 million in precious healthcare dollars to that same company. And if paying high-priced consultants has a familiar ring, look back no farther than 2024, when Vermont paid $1.05 million to Oliver Wyman for a report that told us that healthcare is expensive here — as though we didn’t know that — and recommended regionalizing, whether or not that makes sense given Vermont’s geography and lack of public transportation.

This past January, Becker’s Payer Issues reported on five predictions McKinsey senior partner Adi Kumar made for healthcare in 2026 in a report called “McKinsey Perspectives on Healthcare Industry Trends and the Year Ahead.” In the face of reduced federal subsidies, Kumar encouraged payers  — i.e., insurers — to play the “productivity game,” advising CEOs to figure out “how to do more with less.” We don’t need to spend $5 million to predict the kind of advice the state will get. Unsurprisingly, a firm that consults with corporations on how to maximize profits looks to austerity as the solution and, increasingly, sees artificial intelligence as the magic bullet. 

Though these grants are called Rural Health Transformation funds, they are actually not transforming the system that created the problems in the first place. The thrust of Vermont’s grant spending appears to be on regionalization, shared services and the use of telehealth and AI. While each of these can deliver some benefits when used appropriately, counting on them to solve our healthcare crisis is wishful thinking. 

It is cruelly ironic — and intentional — that the federal government created this grant program at the same time that it has taken health insurance away from people who counted on Affordable Care Act subsidies and from many immigrants and is about to kick more people off Medicaid starting in 2027, with the intention of cutting $1 trillion from Medicaid and the ACA over the next 10 years.

Or maybe it’s not ironic. It seems that the cuts and the grants are two sides of the austerity coin. But while austerity is the name of the game for individuals, families and our community hospitals, there is once again plenty of money for costly consultants who deliver no actual healthcare and who aren’t tasked with transforming the system into one that guarantees access and affordability to all Vermont residents and ensures that our hospitals no longer have unreimbursed care. A universal and unified public system would benefit both patients and hospitals but is nowhere to be found in all this spending.

Ellen Schwartz

Brattleboro, Vt.

Read the story on VTDigger here: Spend our tax dollars on healthcare, not pricey consultants.