U.S. CitiesCity-Data Forum Index
Go Back   City-Data Forum > U.S. Forums > Vermont
 [Register]
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
View detailed profile (Advanced) or search
site with Google Custom Search

Search Forums  (Advanced)
Reply Start New Thread
 
Old 05-07-2014, 08:11 AM
 
809 posts, read 673,158 times
Reputation: 1332

Advertisements

Quote:
Originally Posted by Oriz View Post
As I recall saying in a different thread about this, I think no single system in any country should be taken as an example. What I think should be done, is some serious research - closely examine each system that already exists, the pros and cons, and figure out a system that will work best here. No need to re invent the wheel when it's already all out there for you.
Vermont's been doing that, Oriz. Nine working groups involved 300 participants so far, and Michael Costa has been leading the data gathering effort. Not that the private sector's been totally supportive: a federal court recently ruled that insurers' disbursements are proprietary information, so Costa's job in determining likely costs is just that much harder. Most of the whining, whimpering and complaining you hear about it comes from people who need to see it defeated-- and they rely on flinging fear, uncertainty and doubt
('f u d') to divert us from the facts.

As I've written before, it is now known that Vermont can afford it: if we were a country, we'd have a per capita GDP higher than 21 of the 36 countries whose health care systems do better than the US-- about triple that of Colombia, the country most widely known for "la violence" that has plagued it since the Fifties and the culture of narco-terrorism. That alone should put to shame the opponents of affordable, accessible and universal health care to cover all of us, even when we get laid off.
Reply With Quote Quick reply to this message

 
Old 05-07-2014, 10:46 AM
 
Location: Winter Springs, FL
1,789 posts, read 4,057,972 times
Reputation: 925
Quote:
Originally Posted by cgregor View Post
Vermont's been doing that, Oriz. Nine working groups involved 300 participants so far, and Michael Costa has been leading the data gathering effort. Not that the private sector's been totally supportive: a federal court recently ruled that insurers' disbursements are proprietary information, so Costa's job in determining likely costs is just that much harder. Most of the whining, whimpering and complaining you hear about it comes from people who need to see it defeated-- and they rely on flinging fear, uncertainty and doubt
('f u d') to divert us from the facts.

As I've written before, it is now known that Vermont can afford it: if we were a country, we'd have a per capita GDP higher than 21 of the 36 countries whose health care systems do better than the US-- about triple that of Colombia, the country most widely known for "la violence" that has plagued it since the Fifties and the culture of narco-terrorism. That alone should put to shame the opponents of affordable, accessible and universal health care to cover all of us, even when we get laid off.
I am not apposed to a single payer system, but I have reservations about how successful it will be. The central dilemma facing the Shumlin designers are the 1-50 employee businesses. There are roughly 16,500 small (1-50 employees) companies in Vermont and only about 7,500 now provide health insurance. That leaves 9,000 such companies that now pay nothing for health insurance, and many of them are "very small margin operations." They can't offer insurance because they can't afford to and they will not be able to afford the proposed payroll tax. It's easy to sit on the sidelines and say this is a wonderfull idea when it doesn't effect your bottom line. The other issue is all of the big companies like IBM and GE. The ERISA issue, where the federal requirement that the state can’t interfere with a company that self-insures its employees. The Governor told those companies he will not interfere with them. That's a huge number of people who will not pay into the system. These are some of the reasons things like the Vermont GDP mean nothing. Many of the large companies are responsible for the Vermont GDP. Look at the GDP of those 16,500 companies and see if they can fund the system. Then we will know if it can be pulled off and that is only if everyone in the state recieved their health care in state.

Regarding the small businesses, if they are faced with an employer tax of any significant magnitude, then it could threaten the survival of many of them. They now pay a little bit in effect for health insurance as part of the same mechanism that finances unemployment insurance, but that revenue stream wouldn’t get Shumlin anywhere near the $1.6-2 billion he needs.

So the problem remains, and neither the program designers nor the Legislature are anywhere near a solution.

Then how does the state control health care costs for the tens of thousands of Vermont patients that use New Hampshire, Mass. and New York hospitals? Vermont can't control those costs. There are many issues with the plan everyone needs to look at.
Reply With Quote Quick reply to this message
 
Old 05-07-2014, 04:34 PM
 
809 posts, read 673,158 times
Reputation: 1332
Good point on the financing, 68vette!

It should not, in my opinion, be a payroll tax. It should be broader-based than that. The big problem with the legislature-- almost any state legislature, for that matter-- is a willful blindness toward the inequities of taxation. Households which earn $25,000-$45,000 have the highest total tax load in Vermont, while the top quintile and top 1% pay the lowest load. Reversing the tax hikes of the 1989-2003 era (hiked in inverse proportion to the household earnings) would have meant back then an extra $9 million a year in revenues. The highest earners in the state get the biggest downward adjustment from federally computed adjusted gross income--7%-- which if I remember correctly is another $9 million.

Everybody complains that property taxes are too high, but one of the reasons they're high is the huge amount of property that is recognized only in courts of law but not by the public-- the assets which are mostly owned by the top 5% and on which they pay nothing unless they sell (in which case they pay only capital gains of 10% in Vermont. One dollar in capital gains taxes represents $95 worth of legally-recognized property-- be it equities, royalties, patents, options, etc.-- which was sold.

Property was originally taxed because landowners used it to generate income. Nowadays, two-thirds of the average millionaire's income is from capital gains (Andrew Hacker's book, "Money: Who Makes How Much and Why," p. 84). I estimate some $32 billion in equities in Vermont that is untaxed. And don't let me get into estate taxes…

Finally, companies ought not have the privilege to gut a town by playing with its industries as though they were just poker chips. Textron and the Goldman Industrial Group ripped the economic heart out of Springfield. They should have been made to pay handsomely for the privilege of rape. Unilever steamrollered the Ben and Jerry's investors who scraped up $326 million; the fallout cost Springfield even more jobs. Cowboy capitalism should be taxed.

Your concerns about how funds are spent will of course be answered one way or another when the financing is announced next January. "Fee for service" is ripe for fraud. Great Britain is one of the few "global budgeting" operations, which can be a problem in the opposite direction-- under-prescribing rather than over-prescribing for profit.
Reply With Quote Quick reply to this message
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.

Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.


Reply
Please update this thread with any new information or opinions. This open thread is still read by thousands of people, so we encourage all additional points of view.

Quick Reply
Message:


Options
X
Data:
Loading data...
Based on 2000-2016 data
Loading data...

123
Hide US histogram

Over $104,000 in prizes was already given out to active posters on our forum and additional giveaways are planned!

Go Back   City-Data Forum > U.S. Forums > Vermont
Similar Threads
Follow City-Data.com founder on our Forum or

All times are GMT -6.

2005-2019, Advameg, Inc. · Please obey Forum Rules · Terms of Use and Privacy Policy · Bug Bounty

City-Data.com - Archive 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35 - Top