Saturday, June 6, 2015

Message to Vermont: Single-Payer Medicine Not in America’s DNA

In Vermont, Frustration Mounts over Health Law

Abby Goodnough, title of June 4 New York Times article

Vermont, America’s most socialistic state and its 625,000 residents, must be frustrated. In December 2014, Vermont’s Democrat government, Peter Shumlin, said Vermont was scuttling plans for a state-run single-payer system. While doing so, the governor declared, “ It was the biggest disappointment in my political life.”

Shumlin had little choice. A Vermont single-payer system would require a 11.5% increase in payroll taxes, a 9.5% hike in sliding scale income taxes, and an overall tax rise of state income taxes from $2.7 billion to $5.2 billion.
This, in a state that had already spent $200 million in developing its state-run health exchange, mostly in funds from the federal government.

Now, Vermont, one of 14 states with state government health exchanges, might have to carry on as one of the few states with estate-run exchanges.

Why the frustration? Maintaining a state exchange is expensive. Besides, Vermont has already instituted ObamaCare changes - prohibiting insurers from charging more for pre-existing condition, running one of the nation’s most generous Medicaid programs, helping low-income people in private plans, and proposing a plan to pay providers based on outcomes rather than fee-for-service. Other than a philosophical kinship with the health law, Vermont had little to gain from either its expansion or its demise.

Now, if the Supreme Court strikes down federal subsidies for health exchanges, Vermont faces the prospect ObamaCare may die an untimely death, and with it the dream of a single payer system, in which government covers all medical costs rather than letting private insurers do it.

Not that Vermont has given up on its dream. One of its senators, Bernie Saunders, is running for president as a socialist; and the other Patrick Leahy, is a far-left Democrat and a staunch ObamaCare fan..
Vermont must now confront another reality: full-bore socialized single-payer medicine is not in centrist America’s DNA.

Not when America’s free market capitalism leads the world in economic growth, even with a progressive Obama agenda and paltry GDP growth of 2% under Obama over the last 6 ½ years.

Not when Europe’s centralized social welfare programs are dragging its member nations down into an economic quagmire, and its members are experimenting with privatized solutions to satisfy its members.

Not when ObamaCare has failed to live up to its promises of keeping your doctor and health plan and lowering costs.
Not when insurers have announced premium increases of 10% to 50%, including 26% in Vermont, to compensate for the delusional dream of expanding access and benefits while reducing costs.

Not when deductibles average $6000 for ObamaCare silver plans and $10,000 for bronze plans.

Not when the American public disfavors ObamaCare, often by margins of 10% or more, in multiple national polls over the last 6 ½ years.

Not when the health law drives doctors out of private practices and precipitates growing physician shortages.

Not when ObamaCare mandates demand that health plans over all essential benefits whether you need those benefits or not.

Not when the young and healthy must pay dramatically more to subsidize the old and sick.

Not when small businesses avoid and evade health law penalties by placing more employees on part-time rather than full time work.

Not when meta-data defines quality rather than clinical judgement.

Not when doctors must spend more time collecting patient data for data-hungry government systems rather than spending time with patients.

Not when the opposition party controls 30 of governorships and legislatures of states resisting ObamaCare with many holding back on Medicaid expansions.

Not when progressive government, political, and academic elites define what is “politically correct” rather than what is commonsensical to the majority of Americans.

To be perfect fair, or fairly perfect, for social fairness and quasi-socialism is the Obama doctrine, to quote Winston Churchill, “socialism’s main virtue is the equal distribution of miseries, “ while capitalism’s main fault, is the unequal distribution of blessings.”

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