So this was the good news I came home to after going to see the final part of the Hobbit trilogy. (Excellent movie, by the way. Good action, loved Billy Connoly as Dain Ironfoot, and my god but Galadriel is revealed as a truly bad-ass elf lady.)
Governor Shumlin revealed that the plan to pay for Vermont’s single payer system would involve taxes that are, to use Shumlin’s word, enormous. Apparently the plan would have called for an 11.5% payroll tax (think your social security taxes, which are only 6.2%, paid by both employee and employer for a total of 12.4%) as well as an increase in income taxes ranging from 0 to 9.5% (the highest rate currently is 8.95%, so the tax rate on the highest earners would more than double). Even with such taxes the plan was apparently unsustainable in and of itself, apart from the destruction it would wreak on the economy. According to Michael Costa, who presented details of what the plan would have been:
So in year one, the system, works, with a surplus of $168 million. However you see by year four, since health care expenditures exceed revenue growth. The system, finds itself in deficit.
All I can say to that is, “Well thank you Captain Obvious.” Anyone with half a brain should have been able to see, without spending tens of millions of dollars, that essentially doubling the amount of taxes taken by the state would kill the economy. Especially as the state is already facing a $100 million shortfall in next year’s budget without Green Mountain Care.
Single Payer is Dead For Now, But Will it Stay That Way?
While Shumlin has said that it “is not the right time to ask our Legislature to take the step of passing a financial plan for Green Mountain Health Care,” I have no confidence that this will be the end of it, or another similar plan, as there is very little principled opposition to socialized health care in the state. Those who have opposed Green Mountain Care have mostly done so on pragmatic grounds, the fact that it costs too much, but I have rarely seen any arguments that such a plan is simply not a proper function of government.
What exactly is universal health care?
The WHO provides a good definition to start with:
Universal coverage (UC), or universal health coverage (UHC), is defined as ensuring that all people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
A little wordy, so let’s try to boil it down a bit. I would trim it down to something like: “All people should have all the health services they need of sufficient quality to be effective, without having to worry about the cost.”
That is better, but still leaves a lot to be desired in terms of a definition. After all, what does “need” mean and who gets to decide that? The same with “sufficient quality.” Both of these questions I think lead to the government deciding those issues, but I want to focus on the last part, “without having to worry about cost.”
How will it be possible to provide everyone in the United States the “quality” care they “need” without having to worry about the cost? There are just two ways. 1) Everyone who can afford to pay for their own health care are compelled to do so, but at rates high enough to offset the cost of those who cannot afford to (this is essentially what the individual mandate of Obamacare attempts to do), or 2) everyone pays higher taxes and the government pays health care providers directly (as Medicare, Medicaid, or other single payer system would do.)
Those who support the idea of a single payer, from Governor Shumlin on down, have not given up on the idea. During the press conference announcing the dropping of the current plan Shumlin said, “This is the greatest disappointment of my political life so far, that we can’t advance this ball as quickly as we had wished, but we shall persevere.” Dr. Deb Richter, another supporter of the plan said, “We’re going to need a slower phase-in of this. And I think trying for the whole thing all at once was what made it impossible, or made it more difficult to do.” In reaction to the governor’s announcement, State Senator Jane Kitchel, a Democrat, said that single payer is just one option for funding universal health care and refuses to abandon hope for it. So they have obviously not given up on the idea, they simply have realized they cannot achieve it as quickly as they had hoped, but they will keep trying.
Who is there opposing such plans? Any opposition, from either side, has been largely (entirely?) based on the cost rather than principles. This is not surprising from the Democrats, but even the Republicans, the party that is supposed to support limited government, largely oppose the system based on its cost. For example, according to WCAX television, earlier this year Lieutenant Governor Phil Scott said he cannot support the single payer law because of the lack of details about what it will cost and what the benefits will be.
For a Republican, a member of the party that is supposed to be about individual rights and limited government, how much more do you need to know about a plan other than it intends to take over roughly one sixth of the state’s economy,violating the rights of thousands of individuals in the process?
Further reinforcing the idea that his opposition to the plan was not based on the principle of limited government, in a statement he released in response to Shumlin’s announcement he said, in part:
As I’ve said continually over the last two years, if the Governor’s single-payer plan places another burden on already overtaxed Vermonters, we simply cannot afford it.
Even Senator Joe Benning, who has taken me to task in the past for stating that Republicans in Vermont are largely Democrat Lites and is quoted in today’s paper as saying “I told you so,” apparently does not oppose the plan on the principles of limited government and individual rights. In an opinion piece that appeared last year he wrote:
“I share in the wish for a system that is disconnected from employment, provides universal coverage, and is less expensively paid for through a streamlined approach, only I’d do it with a national plan.”
Once you see the words “universal coverage” (see the sidebar) you can be certain that what is intended is either the government will force everyone to buy insurance (e.g., the individual mandate in Obamacare) or tax everyone, well the “rich” anyway, enough to allow the government to pay for everyone’s insurance (as in the abandoned, for now at least, single payer plan). Or some combination of the two. Apparently Senator Benning has no issues with the idea of government controlling health care, but would prefer such control be at a national level rather than a state one. Hardly what one could call principled, rights respecting, opposition.
This morning’s paper had more reactions to the governor’s announcement and not one had a single word of whether such plans are a proper function of government, they are not, but rather focused on cost. As a couple of examples, newly elected Scott Beck is reported as saying, “As envisioned, it was completely unaffordable and completely unworkable.” while Rep. Dick Lawrence’s reaction was similar, “I’m glad [Shumlin] realized he can’t take voters for more than we are capable of paying.” So if a plan was envisioned differently, in a way that wouldn’t crush the tax payers and the economy, then they could support a program that oversteps the proper scope of government, the protection of individual rights, and indeed violates those rights?
Lastly, Scott Milne, who still has a chance, however slim, to become our next Governor, also did not articulate clear, principled, opposition to government-run health care. According to Seven Days, a weekly Vermont newspaper, “unlike most Republican candidates outside Vermont, Milne says he has no beef with the Affordable Care Act, commonly referred to as ‘Obamacare'” and as to Vermont’s proposed single payer system, he says:
“I think we should put a price tag on it and let that drive the debate.”
So rather than make the debate about the proper role and scope of government, Milne sees it as just a matter of cost and would support single payer if a case could be made that we could afford it. Again, hardly what one could call principled, limited government, opposition.
We will always have the specter of single payer hanging over us until we have politicians who are willing to say, and believe, in essence, “Yes, health care is a tremendous value, but it is not the role of government to provide it. The government’s sole role is to protect the rights of each individual equally, not to take by force from some to give to others to meet some perceived need. One cannot protect the individual rights of some by violating the rights of others. To do so merely opens the door for groups competing to see who will be sacrificed to whom. The way to achieve affordable health care is, in part, for the government to stop mandating what coverage must be provided and to allow for insurance companies from all corners of the country to compete to provide the best coverage at the best price. The government’s only role in this process is to protect the individuals from cases of fraud, i.e., to protect their rights.”
And, even more importantly, a population who supports them.