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Peter1469
04-15-2014, 05:54 PM
Will Vermont ever get single payer (http://www.bloombergview.com/articles/2014-04-11/vermont-s-single-payer-dream-is-taxpayer-nightmare)- maybe it can't afford it.

IMPress Polly would know more about this topic.


Of the plans that states have hatched for the Affordable Care Act, none has been bolder than that of Vermont, which wants to implement a single-payer health-care system, along the lines of what you might find in Britain or Canada. One government-operated system will cover all 620,000 of Vermont’s citizens. The hope is that such a system will allow Vermont to get costs down closer to Canada’s, as well as improve health by coordinating care and ensuring universal coverage.


Just two small issues need to be resolved before the state gets to all systems go: First, it needs the federal government to grant waivers allowing Vermont to divert Medicaid and other health-care funding into the single-payer system. And second, Vermont needs to find some way to pay for it (http://www.vox.com/2014/4/9/5557696/forget-obamacare-vermont-wants-to-bring-single-payer-to-america):

Now comes the big challenge: paying for it. Act 48 required Vermont to create a single-payer system by 2017. But the state hasn’t drafted a bill that spells out how to raise the approximately $2 billion a year Vermont needs to run the system. The state collects only $2.7 billion in tax revenue each year, so an additional $2 billion is a vexingly large sum to scrape together.

Professor Peabody
04-15-2014, 05:59 PM
I read they'd need to double taxes to make it happen.

Kalkin
04-15-2014, 06:02 PM
I read they'd need to double taxes to make it happen.
That's the historical price of mediocrity.

Green Arrow
04-15-2014, 06:51 PM
They've crafted a good system, it's just payment that is a problem. Getting the Obama admin to let them divert funds from Medicare and such would help, since the single-payer system will make Medicare obsolete in the state, but it's still not enough. They'll need to increase taxes some and find another source of revenue. It would take some budget tinkering. I'm not an expert on Vermont, so I don't know what their budget looks like.

Bob
04-15-2014, 06:57 PM
They've crafted a good system, it's just payment that is a problem. Getting the Obama admin to let them divert funds from Medicare and such would help, since the single-payer system will make Medicare obsolete in the state, but it's still not enough. They'll need to increase taxes some and find another source of revenue. It would take some budget tinkering. I'm not an expert on Vermont, so I don't know what their budget looks like.


Oh god. But do doctors get sued? Do hospitals get sued? Vermont is making a grave error. But we have 1/3 it's population just in my city. My county has far more population than Vermont. We are thick with democrats. They have not proposed that stunt. If my city ever proposed that, I would haul ass out of the state.

Some of you have not properly analyzed single payer.

Bob
04-15-2014, 06:58 PM
They've crafted a good system, it's just payment that is a problem. Getting the Obama admin to let them divert funds from Medicare and such would help, since the single-payer system will make Medicare obsolete in the state, but it's still not enough. They'll need to increase taxes some and find another source of revenue. It would take some budget tinkering. I'm not an expert on Vermont, so I don't know what their budget looks like.

They will tax the shit out of the public. Do you want to move to Vermont?

I would shun that state like I shunned the communists lands I visited.

Newpublius
04-15-2014, 09:20 PM
They've crafted a good system, it's just payment that is a problem. Getting the Obama admin to let them divert funds from Medicare and such would help, since the single-payer system will make Medicare obsolete in the state, but it's still not enough. They'll need to increase taxes some and find another source of revenue. It would take some budget tinkering. I'm not an expert on Vermont, so I don't know what their budget looks like.

They're not looking to do that, VT's single payer system will craft its way around Medicaid and Medicare and that is by design. So if you live in VT they're not going to allow VT employees to pay into VT Medicare and then not be covered by Medicare if they move to FL when they retire. The VT employee will continue to make those payments and be covered by Medicare

patrickt
04-16-2014, 03:53 AM
As if Medicaid and Medicare are financially sound. Get real.

Single-payer actually means a few paying and the others just voting their own self-interest.

IMPress Polly
04-16-2014, 07:27 AM
Ohhhh my god! Bloomberg News and the Wall Street Journal -- voices of the financial aristocracy, which includes the health insurance industry -- are against the state replacing the health insurance industry with a free, more efficient, publicly-administered system! Who could have predicted this development? It's time to panic now!! :wink:

Vermont is not indebted the same way that Cyprus is. Yes there will be some struggle over how to pay for such a system, but the bottom line here is that we can hardly afford not to. Even just in administrative costs alone, a state-run health insurance system would save tens of millions of dollars a year. Even from a market-oriented perspective, there are benefits to many businesses. Namely, it would free many businesses up from having to provide health insurance benefits of their own and thus provide cost savings. People may not like higher payroll taxes (which, realistically, is the most likely answer here), but they'll sure the hell like them better than paying for medical insurance!

I agree with the governor though: Canada is not the ideal model to emulate. Britain's system is a better one. They have an almost completely socialized health care system (not just insurance, but also publicly-owned hospitals and so forth) and with it they've managed to keep costs much lower than Canada has and also have shorter waiting lines than we do. That's the ideal situation. But even Canada's system is cheaper and more efficient than ours. You've heard that health care costs account for 11.4% of Canada's economy? Try more like 18% here in the United States! (Previous to this year anyway. The Affordable Care Act will probably lower this some, but not that much.) I have several Canadian friends (including my boyfriend). They complain about long waits too (and understandably so, as they're not essential to a socialized insurance system!), but when asked if they'd prefer switching to our market-based system wherein people have to pay for their own health insurance, that motion is dead on arrival. There exists a pool of demand in America in general and in states like Vermont and Montana in particular for a health care system more like Canada's, if not one that goes further than Canada's. There is no converse demand in Canada for a health care system more like ours. Free health insurance yields longer life expectancy, lower rates of infant mortality, and costs less to administer, and completely socialized health care gets better results still.

People panic much too easily when it comes to health care reform in general. Four months ago, amidst *gasp* temporary web site glitches and junk policy cancellations, the press had all but written Obamacare's obituary, Republicans were proclaiming this their issue of 2014 which would guarantee a retaking of the Senate, and even some of my ideological allies here on this message board were denouncing the policy outright, for example. Today, now that some 10 million people are either enrolled in the exchanges or benefiting from the expansion of Medicaid, an increasing number of polls show the Affordable Care Act in positive territory (i.e. with more support than opposition) for the first time since 2012 and the president's approval rating is returning to normal levels; facts that do not bode well for the prospects of the Senate flipping to Republican control over the issue of Obamacare. Folks, I could've told you this would happen long ago. (In fact, I think I did!) Two weeks ago, former governor of my native Vermont and six-year head of the Democratic Party Howard Dean has proposed that Democrats go on offensive on the health care issue on the grounds that it will be a winning electoral issue for them this year. (http://www.msnbc.com/the-last-word/watch/aca-enrollment-surges-past-7-million-213850179964) (A suggestion he reiterated last night, pointing to a new poll indicating the public now trusts Democrats more than Republicans on health care issues.) You can see why: at this point, repealing the ACA, which is the official position of the Republican Party, would result in 13 million people losing their existing health insurance! (A figure that's not exactly going to shrink over time, but grow.) I have no doubt that the whole process involved with formally implementing the single-payer law here in my state will be just as rife with controversy and undue panic over semantics stoked by rich people with a vested interest in the existing, inferior system. And I have a similar confidence that we'll come out the other side of it all with a superior insurance system that people will like better. And no, I don't expect private doctors and hospitals to ever support the single-payer law regardless because part of such a system's cost-savings would come from reducing payments to doctors and hospitals. People with a tangible investment in the status quo are going to tend to support the status quo. That includes private doctors, hospitals, and certainly the health insurance industry. But the rest of the population might not, especially once they get a taste of the alternative; once they find they don't have to pay anymore.

Peter1469
04-16-2014, 09:31 AM
Thanks for the Vermont view. I really hope you guys get this program off the ground- it is what America was meant to be. Most governance at the state level.

Green Arrow
04-16-2014, 10:51 AM
Ohhhh my god! Bloomberg News and the Wall Street Journal -- voices of the financial aristocracy, which includes the health insurance industry -- are against the state replacing the health insurance industry with a free, more efficient, publicly-administered system! Who could have predicted this development? It's time to panic now!! :wink:

Vermont is not indebted the same way that Cyprus is. Yes there will be some struggle over how to pay for such a system, but the bottom line here is that we can hardly afford not to. Even just in administrative costs alone, a state-run health insurance system would save tens of millions of dollars a year. Even from a market-oriented perspective, there are benefits to many businesses. Namely, it would free many businesses up from having to provide health insurance benefits of their own and thus provide cost savings. People may not like higher payroll taxes (which, realistically, is the most likely answer here), but they'll sure the hell like them better than paying for medical insurance!

I agree with the governor though: Canada is not the ideal model to emulate. Britain's system is a better one. They have an almost completely socialized health care system (not just insurance, but also publicly-owned hospitals and so forth) and with it they've managed to keep costs much lower than Canada has and also have shorter waiting lines than we do. That's the ideal situation. But even Canada's system is cheaper and more efficient than ours. You've heard that health care costs account for 11.4% of Canada's economy? Try more like 18% here in the United States! (Previous to this year anyway. The Affordable Care Act will probably lower this some, but not that much.) I have several Canadian friends (including my boyfriend). They complain about long waits too (and understandably so, as they're not essential to a socialized insurance system!), but when asked if they'd prefer switching to our market-based system wherein people have to pay for their own health insurance, that motion is dead on arrival. There exists a pool of demand in America in general and in states like Vermont and Montana in particular for a health care system more like Canada's, if not one that goes further than Canada's. There is no converse demand in Canada for a health care system more like ours. Free health insurance yields longer life expectancy, lower rates of infant mortality, and costs less to administer, and completely socialized health care gets better results still.

People panic much too easily when it comes to health care reform in general. Four months ago, amidst *gasp* temporary web site glitches and junk policy cancellations, the press had all but written Obamacare's obituary, Republicans were proclaiming this their issue of 2014 which would guarantee a retaking of the Senate, and even some of my ideological allies here on this message board were denouncing the policy outright, for example. Today, now that some 10 million people are either enrolled in the exchanges or benefiting from the expansion of Medicaid, an increasing number of polls show the Affordable Care Act in positive territory (i.e. with more support than opposition) for the first time since 2012 and the president's approval rating is returning to normal levels; facts that do not bode well for the prospects of the Senate flipping to Republican control over the issue of Obamacare. Folks, I could've told you this would happen long ago. (In fact, I think I did!) Two weeks ago, former governor of my native Vermont and six-year head of the Democratic Party Howard Dean has proposed that Democrats go on offensive on the health care issue on the grounds that it will be a winning electoral issue for them this year. (http://www.msnbc.com/the-last-word/watch/aca-enrollment-surges-past-7-million-213850179964) (A suggestion he reiterated last night, pointing to a new poll indicating the public now trusts Democrats more than Republicans on health care issues.) You can see why: at this point, repealing the ACA, which is the official position of the Republican Party, would result in 13 million people losing their existing health insurance! (A figure that's not exactly going to shrink over time, but grow.) I have no doubt that the whole process involved with formally implementing the single-payer law here in my state will be just as rife with controversy and undue panic over semantics stoked by rich people with a vested interest in the existing, inferior system. And I have a similar confidence that we'll come out the other side of it all with a superior insurance system that people will like better. And no, I don't expect private doctors and hospitals to ever support the single-payer law regardless because part of such a system's cost-savings would come from reducing payments to doctors and hospitals. People with a tangible investment in the status quo are going to tend to support the status quo. That includes private doctors, hospitals, and certainly the health insurance industry. But the rest of the population might not, especially once they get a taste of the alternative; once they find they don't have to pay anymore.

IMO, Norway is a better model to use than Canada or Britain.

Gerrard Winstanley
04-16-2014, 10:55 AM
IMO, Norway is a better model to use than Canada or Britain.
Norway is also funding itself out of the big oil pocket, an unreliable asset.

Green Arrow
04-16-2014, 11:18 AM
Norway is also funding itself out of the big oil pocket, an unreliable asset.

I'm sure they have a contingency plan in place for that.

Professor Peabody
04-16-2014, 09:40 PM
Please double the taxes in Vermont, but let me know in advance. I want an adult beverage and a bowl of popcorn so I can sit back and enjoy the results.

Gerrard Winstanley
04-17-2014, 10:30 AM
I'm sure they have a contingency plan in place for that.
Yeah, go the way of every other European state.

http://cdn.theatlantic.com/static/infocus/athens021312/a24_38820801.jpg

lynn
04-17-2014, 01:10 PM
Vermont actually has a good shot at a single payer system since half their population already is on Medicaid, Medicare, CHP, Tri-care. If they eliminated the insurance companies entirely and they convinced the employers that are self-insured that covers over 200,000 employees in that state to let the state take it over, they can make it work.

Of course this depends on the state not being corrupt and is fair to its citizens, not allow wallstreet to be any part of their system to start might work.

Peter1469
04-17-2014, 02:59 PM
You are the go to member on this issue. Check out the OP - it mentions the costs and mentions the current tax revenues and tax expenditures in Vermont. Does the OP get the cost incorrect?


Vermont actually has a good shot at a single payer system since half their population already is on Medicaid, Medicare, CHP, Tri-care. If they eliminated the insurance companies entirely and they convinced the employers that are self-insured that covers over 200,000 employees in that state to let the state take it over, they can make it work.

Of course this depends on the state not being corrupt and is fair to its citizens, not allow wallstreet to be any part of their system to start might work.

patrickt
04-17-2014, 05:44 PM
I wonder who the single payer in Vermont will be. He's in for a surprise when he gets the bill.

Norway? Population around 5,000,000. New York City? Population around 8,337,000. I think that alone makes it difficult to follow their pattern. A friend of mine from Norway also has a very high opinion of the honesty of their politicians that he says is shared by most Norwegians. That's as different with the U.S. as the population.

Kalkin
04-17-2014, 05:58 PM
Please double the taxes in Vermont, but let me know in advance. I want an adult beverage and a bowl of popcorn so I can sit back and enjoy the results.
When taxes are doubled on the productive so the non-productive can have free healthcare, the productive move, leaving the non-productive with no tax base to support them. Detroit is experiencing a similar dilemma.

Newpublius
04-17-2014, 07:34 PM
When taxes are doubled on the productive so the non-productive can have free healthcare, the productive move, leaving the non-productive with no tax base to support them. Detroit is experiencing a similar dilemma.

well, when one's mantra is that supply side doesn't work, ie. lower taxes don't encourage economic activity, why would they think higher taxes would discourage it? Liberal economics is about ignoring the impact of costs on individual's decision making because it conflict with their vision of utopia.

Kalkin
04-17-2014, 07:48 PM
well, when one's mantra is that supply side doesn't work, ie. lower taxes don't encourage economic activity, why would they think higher taxes would discourage it? Liberal economics is about ignoring the impact of costs on individual's decision making because it conflict with their vision of utopia.
Hence the reason liberal economics require the enslavement of the productive. It takes a village.... with a cage around it.

patrickt
04-17-2014, 08:35 PM
When taxes are doubled on the productive so the non-productive can have free healthcare, the productive move, leaving the non-productive with no tax base to support them. Detroit is experiencing a similar dilemma.

And Detroit just got $100,000,000 from Glorious Leader.