Well, I’ve just read Randy Brock’s “health care plan,” all five-plus pages of it. And now I understand why he released it the way he did: under the radar, with the least possible fanfare.

The plan is a disgrace. On many levels.

First, it’s riddled with grammatical and spelling errors. (Example: It refers to Vermont’s health care plan for children as “Dr. Dinosaur.” Er, Randy, that’s “Dr. Dynasaur.” I detect the fine hand of one of your expensive out-of-state consultants.) That’s inexcusable for a position paper on the biggest single issue in your campaign. Geez, Randy, you’d paid Darcie Johnston $64,000 as of August 15, but you can’t afford a proofreader?

Second, it’s loaded with vague proposals,  off-the-rack conservative rhetoric, and ad hominem attacks on Governor Shumlin’s plan.

Third, it’s got quite a few provisions that would actually increase the cost of health care and/or the size of government. Strange.  

Fourth, it’s not a coherent plan —  it’s a goddamn laundry list of every idea under the sun. None of them are quantified, and many are presented with qualifiers like “encourage,” “explore,” and “review.” Which means that he has no idea whether those ideas are even practical.

Fifth, it’s got way more than its share of really dumb statements. Real headscratchers.

I could spend a lot of time parsing out the ins and outs of RandyCare, but there’s so little meat on these bones that it would be a dry and thankless task. Instead, I’ll focus on the dumb stuff.

So here, as a public service (so you don’t have to read this… thing), are my Top Ten Dumbest Things in RandyCare.  

The Wastrel Elderly. Brock calls for relaxation of “community rating,” which would allow insurance companies to charge lower rates to younger, healthier people than to the older and sicker. Part of his rationale is that community rating “requires healthier young families with children and mortgages to subsidize the premiums of their older, sicker, but sometime (sic) much wealthier patients…”

Jeezum Crow. Those evil, shiftless olds with their mattresses stuffed with loot! They’re the real problem! Yep, old people just have it way too easy. Let ’em pay through the nose if they want to stay alive.

Visit Vermont: Fall Colors and a Tummy Tuck! Randy wants to bring together hospitals and the tourism industry to promote “medical tourism.” You know, create vast new revenue streams by creating luxury medical services for the well-to-do. Yeah, get your elective surgery and go skiing!

Wait, that won’t work… Hmm…

Bring a chicken to the doctor. Randy wants to encourage Vermonters to buy low-cost high-deductible insurance coupled with tax-deductible health savings accounts. He explains, “When informed consumers themselves pay more of their health care expenses, their pressure will drive efficiency, innovation and affordability among providers.”

Because it works so well when you go to the hospital and start dickering over the bill.

The free market works so well that the state will have to help consumers deal with it. He wants the state to add new programs to advise Vermonters on how to stay healthy, how to shop for insurance, and how to avoid the pitfalls of the free market.

Hmm. On the one hand, Randy wants to unleash the power of competition by lifting insurance regulations, thus allowing insurers to flood the market with fine print-laden policies full of exceptions and hidden costs. On the other, he wants the state to guide consumers through the free-market maze. Apparently government is incompetent to manage health care, but it’s capable and trustworthy in advising the public.

Cut regulation — except when it should be increased. Randy says we should “Ensure that the Health Insurance Exchange… is easy to use, clear and has an abundance of choices.” So we’re going to liberate the insurance companies, but mandate clear, simple language in policies and contracts? Who’s going to review the language? Who sets the standards? And to paraphrase Mitt Romney, are we really going to depend on BUREAUCRATS to ensure ease of use and clarity?

The buffet approach. Randy wants to “allow consumers to purchase coverage ‘a la carte.'” So if I’m a single man — or, even better, one half of a gay male couple — I don’t have to buy ob/gyn coverage? Sweet!

And how far does the “a la carte” thing extend? If I don’t have any genetic markers, can I decline coverage for Lou Gehrig’s Disease? If so, how costly would ALS coverage become?

Price tags. He calls for “full price transparency, so that consumers can see the price at various providers for similar services.” So we’re supposed to check prices and drive to different facilities for different services, based on price? And do we really want medical centers cutting corners wherever possible so their posted prices are the lowest?

This also gets to the issue of quantifiability. It’s easy to list a price for a simple procedure, but it’s almost impossible for complicated conditions or treatments. And that’s where most of the health care dollars go.

One test per customer, please. He wouldn’t want a patient to undergo the same test twice, even if the patient is transferred from a local hospital to a tertiary care center. As he says, “If we cannot trust testing in community hospitals, we shouldn’t allow them to test in the first place.”

Which is wrong on all accounts. When a patient is transferred, it’s because the community hospital isn’t equipped to handle the case. Their testing standards are fine for routine cases, but when a patient moves up the chain, more thorough testing is usually needed. If you had, say, an MRI at Rutland Hospital and they ship you to Fletcher Allen, you might very well need another MRI conducted by more skilled, experienced specialists.

Also, a patient’s condition isn’t a static thing. It changes over time — often rapidly. Retesting is often required to track a patient’s progress. This idea is meaningless at best, dangerous at worst.

An army of bureaucrats? He wants “independent performance audits to examine every cost and the health-effectiveness of every mandate.” Has he really thought that through? That would be an immense task. Would he want the state to do that? Or the insurance companies? Oh yeah, we can trust them…

Health care, health care everywhere. He’d like to see “around-the-clock non-emergency room access to basic health care within one hour of every Vermonter.” Nice idea. We need more access, especially for low-income Vermonters who’d (under RandyCare) have cheap, high-deductible insurance coverage. Which means they wouldn’t be able to pay for non-emergency services. That’s the problem with high-deductible plans: they incentivize people to stay away from health care service until their problems become acute. So who pays for the services? And who pays for establishing this intensive network of urgent care facilities?

So there’s my RandyCare Top Ten. As I said at the top, now I understand why Randy released this “plan” very quietly, and why he wants people to stop paying attention to it. It’s a bloody disgrace.