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With all due respect, I disagree with 68vette on the characterization of Burlington's Fletcher Allen and of smaller Vermont hospitals. Small hospitals do not equal bad hospitals. Porter Medical Center in Middlebury is a top notch facility. Porter is smaller simply because it services a smaller population base. It does not lack facilities or resources to handle major medical emergencies. They've got CT and MRI technologies and top shelf specialists. As I said before, my son had a horrific arm injury and he was in surgery within an hour after arriving at Porter, and after a 4 hour surgery the outcome was 100% satisfactory. With the wrong specialist, his arm might have healed asymmetrically or stopped growing.
In Middlebury, you can live in the country _and_ be less than 10 minutes from Porter Medical Center. I grew up in Burlington in the "new" north end and I was easily 15 minutes from Fletcher Allen; longer during rush hours. Furthermore, Fletcher Allen was - in my opinion - when I lived in Burlington - severely understaffed and unable to handle high loads of incoming E.R. patients in a timely manner. I once sat in Fletcher Allen's waiting area for 5 hours with a concussion and multiple lacerations on my face. And to add insult to injury, the attending E.R. doctor at Fletcher Allen sewed my lip back together slightly askew creating an extra flap in my lip that I have to this day. Compare that experience to my experience down here in Boones Mill, VA. After being kicked by a horse, and arriving within 15 minutes at my county's rural hospital, I waited less than 15 minutes to be seen, and within an hour I had x-rays that were reviewed by the attending E.R. folks. Literally 65 minutes after arriving, I had been treated and released.
Fletcher Allen is a great institution. I'm simply saying that Porter is also a wonderful institution, sized appropriately according to the population it serves.
And I don't know. If the choice is between dying of a heart attack at 80 on my own piece of heaven in the wondrous rural Champlain Valley, or plodding along until 85 or 90 in a concrete jungle.... You can just spread my 80 year odd ashes in the back 40, thank you very much.
The debate over quality of medical care revolving around location and size of facilities is many times moot as the true test in an emergency basically comes down the luck of the draw in having the right personnel on duty who have the skill and expertise to deal with a specific situation. I have experienced and observed emergency medical care from NYC to Alaska and also the military. However, 68vette does make a very valid point regarding the preference to live near a facility that has the means to deal with conditions that some have, especially if specialized treatment and equipment are needed for treatment. Cardiac care and treatment frequently makes the news and this week some study has concluded that even as an inpatient the time of day/night makes a difference in your level of care and survivability.
Interesting points-of-view--all appreciated--regarding various things medical. Much of the time that we've lived in Delaware, the nearest board certified cardiologist was an hour away. Luckily, we weren't negatively affected, and now there are a couple cardiologists of fairly good reputation (this seems to be debatable) here, but as we get older, we don't want the excessive risk. We're aware that, wherever we go, there will be some risk.
Sean, your point about preferring to live in the lovely countryside is a good one, and surely has its own benefits in terms of lifting one's heart, in more than a metaphorical sense. We have stayed in and around the Middlebury area many times and feel very comfortable there, but we have concerns about the affordability (including property taxes) of the sort of house (or condo) we'd want. Here, we have a large house on half an acre, but we'll be lucky to get $275,000 for it, and we don't want to take on more than a mini-mortgage. So though Vermont has long been at the top of our list, we continue to look elsewhere.
68vette, you mentioned living near Hanover, which we're considering. Where would you live on the Vermont side? Or would you go over to NH? I think Hanover itself has become more and more expensive, hasn't it?
Sean, back to you. Oh, I do remember about the billboards! And, though I've spent quite a lot of time in NH too (all those camp summers), I half feel as if I grew up in Vermont. Funny thing is, I was looking around for information about our earliest Vermont ancestors (arrived in 1789 from Massachusetts) and found someone with whom I share great++++++grandparents, about whom I'd known nothing, living a mile from where those greats settled centuries ago.
I work in at Fletcher Allen in Burlington. I work primarily in neonatal, pediatric and adult critical care. If health care is very important to you or you need a specialist I would recommend living near Burlington or Hanover. As seanpecor stated the smaller hospitals are fine hospitals, but they are also limited due to their size and resources. I have worked in health care for over twenty years and have worked at Fletcher Allen for over ten years now. I'm just stating this because of my own experiences and some of the horrific tragedies I have witnessed over the years. I will never live outside of 5-10 min from a hospital. My personal feeling is if you have major health issues, you should follow the same rule. When something bad happens, every minute counts. I don't want to sound negative but many people who move, especially to a rural state like Vermont, don't think about how close they should live to good health care. For example the survival rate for a myocardial infarction(heart attack) is very low when you are over ten minutes away from a hospital or a defibrillator.
68, last Saturday I seperated my shoulder cross country skiing. Coming from a long line of men who don't go to hospitals unless we're seconds from death, I of course went home for 3 hours instead of going right to the hospital. Let me tell you, no one can accuse me of having a low pain threshold after walking around with a shoulder seperation for 3 hours. Anyway, I went to the Fletcher Allen ER. I can't tell you how impressed I was with the ER. I was in and out in no time, twice, since I stupidly went home after the first visit and disclocated again due to my own stupidity.
The staff, doctor, x-ray staff etc we're fantastic. I've been in a few ER's over the years and this was an absolute pleasure.
Many companies here are being crushed by the cost of healthcare and a "healthcare collapse" is in the future in my opinion. Take a look at this recent article that illlustrates the cost of providing healthcare being faced by many smaller companies here. Keep in mind that most of VT is smaller companies as VT is not very friendly to large companies and none of them want to do business here.
At my job we have been faced with 30% increases every year and my company was not able to provide a cost of living raise this year due to these increases. I believe my company pays $450 for a single person and $1200 for a family a month. On top of this the health benefits offered here are a far cry from what I recieved in CT. No vision coverage, dental coverage that covers basically a cleaning, much larger out-of-pocket expenses, etc. I have also had quite a few friends that had really bad experiences at Fletcher Allen in Burlington. One dealing with cancer that ended up going to a hospital in Boston as she was recieving horrible treatment compared to what she recieved when living in Boston.
The employment situation here is getting worse by the day. The wages here are insulting for the cost of living here. It is a weekly occurence on the local news to hear about which company this week is laying off workers. Even the bigger employers in the Burlington area pay terrible wages. UVM one of the biggest employers in the Burlington does not even pay most of their employees livable wages For what it charges for tuition (38K out of state) they pay their employees some of the lowest wages in the country. Unless you move here with considerable wealth you are going to struggle to make ends meet here. I have had 7 friends move out of here in the last 6 months and I am joining them in June as the few small benefits of living here are simply not worth it.
I still choose Vermont. That's because it's where I feel that am home; I'm willing and able to do whatever it takes to stay. This is the life that works for my husband and me.
I don't see health insurance (among other systems) being particularly workable anywhere in the US. My friends and family in Massachusetts, Florida, Connecticut, New Hampshire, California, and elsewhere all seem subject to very high costs for coverage and the systems in all those states seem to be in trouble.
It's true that some employers, especially in states where big business thrives (and therefore, at least to me, offer lower quality of life) offer great insurance plans. And some families are able to pay high rates for tons of coverage.
Here's how I see it:
The private health insurance industry was not created to cover every need that could possibly fall under a medical rubric: annual checkups, dental, vision, etc. I believe that the private health insurance industry was created so that emergencies and catastrophic care would not bankrupt a family -- just like fire coverage. (Maybe someone else here knows more about the history of health insurance. If so, please share!)
Here's what my husband (mid-50s) and I (mid-40s) do. We pay $133 a month to MVP for health coverage. That's the total for both of us. We have $25,000 deductibles each and 50% coverage on prescriptions after a $250 deductible (each) is met. We maintain our health through preventive measures. We pay out-of-pocket for check-ups, dental care, vision, etc. We are happy this way. I'd rather give the money for my care to my trusted providers than pay high premiums to an insurance company for lower deductibles. My husband and I accept that if something major happens to one or both of us, we'll be out $25,000 - $50,000, which we would repay as we were able. It's a gamble we chose with our eyes open.
I agree that the cost of paying out-of-pocket for even basic services is very high. I understand that people living with chronic conditions may require regular treatment and/or expensive prescriptions, and may need much more help paying for those than my husband and I have available to us. But I believe that a big factor in those high costs is systemic: Private health insurance is being used as a catch-all to cover every medical service imaginable for nearly everyone in the system. The unwieldy, bureaucracy-heavy insurance system necessitates much higher costs just to pay for its own existence. Obviously, other factors -- such as malpractice suits/insurance, poor hospital management, and over-ordering of tests, procedures, & prescriptions -- also contribute to high costs.
I believe that if we want insurance to cover everything -- checkups, maintenance, dental, vision, psychotherapy, integrative/complementary care, preventive care, etc. -- then I'd love to see a shift toward viable universal health care. But private insurance? I just don't think the system can sustain itself when people are demanding more coverages for less money, employers are going broke covering their employees & families, and providers have to hire staff just to deal with the insurance paperwork.
Last edited by Sherylcatmom; 02-23-2008 at 11:37 AM..
Here, we have a large house on half an acre, but we'll be lucky to get $275,000 for it, and we don't want to take on more than a mini-mortgage. So though Vermont has long been at the top of our list, we continue to look elsewhere.
Not sure if you would have seen this house in Cornwall, VT (just south of Middlebury) because its FSBO:
And so on. If you want you can email/pm me your ideal home qualities/budget and if I stumble over anything I can email it to you. I'm still actively checking out FSBOs and MLS listings in the immediate area around Middlebury.
Hi, I suggest looking at Dartmouth College and/or the hospital, Mary Hitchcock and look at properties "right over the river" such as Wilder, Norwich or even further south, Hartford, Hartland and Windsor. Also, there is a park'n'ride at Ascutney VT and the drive from there is approx 30 mins although futher south. There are a lot of people who work at either the College or the Hospital and commute...and there are some excellent housing options in these VT towns and communities.
I know of two recent IT jobs. One big Burlington company; Salary 40-50k: One small pharma in N. CT salary 140k. Both were jobs were looking for identical skills. Guess where housing is cheaper. Be afraid of VT, be very afraid.
must move.... we just found out that the CTO IT job we were considering pays 90-110k ..... I just can't imagine if this is what they are paying their CTO's what others are making... With the COL and real estate... It would be a challenge to say the least...
We're a bit disappointed... but perhaps we could consider moving if we secured a remote work arrangement...
It's a tough one... we love the area... but damn it's tough... The wages are really difficult...
must move.... we just found out that the CTO IT job we were considering pays 90-110k ..... I just can't imagine if this is what they are paying their CTO's what others are making... With the COL and real estate... It would be a challenge to say the least...
We're a bit disappointed... but perhaps we could consider moving if we secured a remote work arrangement...
It's a tough one... we love the area... but damn it's tough... The wages are really difficult...
That sounds about right. I don't work in IT myself but have several friends that do some here in VT, some travel for work. You know if you lived here it wouldn't be a fun vacation area anymore. There are exceptions but I think most VT'ers end up recreating outside less than the average tourist.
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..... I just can't imagine if this is what they are paying their CTO's what others are making... With the COL and real estate... It would be a challenge to say the least... 
