Single Payer or … Bust

By Alice Dubenetsky

Vermont is about to cross the Finish Line in the race to implement the most closely cherished tenet of liberal ideology. A “single payer” health delivery system will soon be imposed upon every man, woman and child in what used to be one of the most fiercely independent, self-reliant states in the country.

As the Affordable Care Act (Obamacare) rolls out nationwide, and as the Vermont experience almost exactly mirrors the problems associated with the federal program, we can rest assured, we are told, that the best is yet to come for this lucky little state. Green Mountain Care, aka Socialized Medicine For All, is slated to take hold of Vermont in 2017.

Vermont Health Connect, the state insurance exchange program implemented under the Affordable Care Act of 2010, experienced the same “glitchy” roll-out as the probably because Vermont unwisely hired the same firm, CGI of Canada, to design the website, in spite of the company’s sorry history in Canada.

Even today, as we move into January, people who believed they had enrolled in an insurance plan are finding that they may not have coverage, or at least proof of coverage, when they arrive at their doctor’s office or hospital. Recently nearly a dozen patients seeking treatment services at Fletcher Allen Health Care did not appear in the system as insured. The hospital said it would wait up to three weeks to bill those people, but there will probably be more to come. And people with a high deductible plan will still find themselves paying out of pocket.

Vermont Arrived Early

Expensive premiums and high deductibles are less shocking to Vermonters than to consumers in other states. In 1992 the Vermont legislature, under Governor Howard Dean, passed Act 160, a law that mandated guaranteed issue (no one can be turned down, regardless of health and pre-existing conditions) and community rating (insurance rates can’t be based upon factors such as age or health factors). This had the predicable effect of chasing from the state low-cost insurers who offered affordable plans. Concurrently, Act 160 also helped bail out the floundering Vermont Blue Cross/Blue Shield from a fiscal crisis caused by years of mismanagement. The overall effect to was to wreak havoc on Vermont’s insurance markets as, one-by-one, insurers who had provided reliable, low-cost, comprehensive health insurance to individuals and small business left the state. Vermonters were left with Medicaid if they qualified, or expensive, high deductible plans if they didn’t. The result: more uninsured Vermonters.

Prior to the ACA, people in most other states were able to choose from a variety of plans, with a variety of options, deductibles and premiums. Many Americans at least had a real choice, based on their circumstances and finances. Was the system perfect? No, not by along shot, but people were able to choose coverage based on their personal circumstances. The ACA (Obmacare) deliberately, and deceptively, priced these plans out of the market, forcing individuals, under threat of penalty, into higher cost plans that cover whatever the government deems “essential services” – whether or not the individual needs them or wants them. After witnessing the hue and cry over this governmental over-reach, the Obama Administration, in a display of transparent political stratagem, delayed the mandate for small businesses until after the 2014 elections. Saddling Americans with higher premiums for services they don’t want or need is the only way to satisfy Obamacare’s thinly disguised goal of wealth redistribution that was built into the law.

And So, Vermont Goes One Step Further

The Vermont legislature is not content with mere government interference in the insurance market. In 2011 the Democrat dominated legislature, in partnership with Governor Peter Shumlin passed H.202. With the stroke of a pen they established the nations first and only “single-payer” health care system. It is also the country’s only – as yet -unfunded single payer system. (The only proposed funding mechanisms to date are too distasteful to fully explain to Vermont taxpayers.)

Vermont, alone among the 50 states, is now going to intrude in every possible way into actual health care delivery. The state, with its mandates and rules and doctrines will insert itself between doctors and patients at every phase of a person’s life and most personal affairs – via their health care. But there are still a few problems on the rocky road to liberal utopia. The Governor, incredibly, believes that a single payer system will be an advantage to Vermont’s economy. This apparently will be achieved by saddling the Vermont business community with the largest tax increase in state history.

Darcie Johnston and Robert S. Emmons, M.D. of Vermonters for Health Care Freedom summed up the tax issue nicely in a recent commentary published by the American Association of Physicians and Surgeons:

“The governor clearly sees single payer as a boon to Vermont’s economy (“a real jobs creator for us”) with technology that will create a ‘smarter and more affordable health care system.’ Many thoughtful Vermonters, however, do not share his views.

“Businesses will flee Vermont, owing to $2 billion in new taxes in 2017. The size of state government will be nearly doubled. Vermont will become the most heavily taxed state in America—as its health system deteriorates. The only new jobs may be for state employees to adjudicate all the healthcare claims for the government.

“Gov. Shumlin agrees that the tax increase will be the largest in history. But he claims it will be offset by a decrease in premiums. He calls the 18% of revenue that a small business spends on health benefits equivalent to a payroll tax, but he acknowledges that this will not be enough. He states that for single payer to succeed, Vermont has to “find a way to ensure that you contain costs and that we don’t continue to see our costs go up.”1 Note that a 5% difference in the cost forecast would diminish Vermont’s fund balance by an additional $300 million.”

Vermont’s recent track record on containing costs has been abysmal. The Vermont legislature has shown no political will to contain costs, relying on federal funding to continue to prop up profligate spending habits. And still a state with a tiny population of 630,000 souls is expected to support an enormous, intrusive, arbitrary health care system, even though federal funding is notoriously unreliable and could be withdrawn at any time. Living within our means isn’t a principal the Democrats (or for that matter Republicans) are comfortable with because it doesn’t buy votes.

To borrow a phrase from that old revolutionary group ‘s manifesto, that seems particularly appropriate today, “You don’t need a weatherman to know which way the wind blows,”

An ill wind is blowing in Montpelier and there is little time left to stop it before it wreaks fiscal, social and personal havoc on every single person in our state.

3 thoughts on “Single Payer or … Bust

  1. Alice, 18% of revenue ? Are you sure of that ? Not 18% of net income ? The former would make many small businesses unprofitable.

  2. It’s a sad state of affairs – one that is causing many people to leave this beautiful, but politically corrupt state. The fiscal mismanagement in Montpelier will eventually go down in history as it should, but by then it will be too late.

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