Vermont has the 2nd lowest unemployment rate in the US (Baltimore: 2014, health insurance)
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So is it accurate that the unemployment rate is low? That's what the numbers say.
The reality is that a lot of Vermonters are working more than one McJob to make ends meet. Plnety of junk jobs but nothing you can exist on unless you work for the state.
Shumlin is about to crash and burn with his single payer experiment. The state has no viable way to pay for it and criticism of him and the democratically-controlled state legislature is getting deafening. Plus a number of towns rejected school budgets. I think he finally woke up to the fact that the VT economy is a huge issue to many voters and the one metric he can find that makes VT look good is the unemployment rate.
Vermont actually has a pretty robust economy; it's just that we don't want to share the good news with anybody. The people in this state who think that we can't make the best health care coverage in the US don't know what's possible based on what we have. I looked up the CIA economic data and came up with this:
If Vermont were its own country, its would rank 20th in per capita GDP (PCGDP) with $38,198 (2005). Adjusted for parity of purchasing power (which equalizes currencies’ worth), it puts Vermont right ahead of Belgium and 171 other countries.
Twenty-one of those countries have health care outcomes which, dollar for dollar, are superior to the US (2013 PCGDP, $52,800, ranking 8th in 2013).
Of the 36 countries which have health outcomes superior to the US, only 15 have a higher PCGDP than Vermont. Vermonters per capita are richer than the citizens of France, Belgium, Denmark, the United Kingdom, Andorra, Japan, Finland, San Marino, Israel, Saudi Arabia, New Zealand, Spain, the United Arab Emirates, Oman, Italy, Cyprus, Greece, Portugal, Chile, Argentina, and Colombia.
We have more than triple the PCGDP of Colombia’s $11,100, yet that allegedly violent, narco-ridden state surpasses the US in health care outcomes per dollar spent.
Single-payer is going to be an economic magnet. People who have been holding back from starting their own business-- and young businesses seeking to have the same health care benefits allure that solidly-established companies use to attract the best employees-- will move to Vermont to have a more solid business plan.
We like to complain about taxes, but the vast majority of us know that they are investment in the quality of life. We do, however, have a lot of legislators who act like they're the pimps for a syphilitic *****, trying to drive down her price in order to attract any business at all. They should all be replaced, in my opinion.
You might want to look at those countries' populations. When you have a low population, big spending takes a much higher amount from each person. To the point that it's not possible here.
Businesses don't make their decisions based on if they can provide employees with healthcare, since many don't.
You might want to look at those countries' populations. When you have a low population, big spending takes a much higher amount from each person. To the point that it's not possible here.
Businesses don't make their decisions based on if they can provide employees with healthcare, since many don't.
That's why it was done per capita; it doesn't matter about the size of the population. Saudi Arabia with all its vast oil wealth, is way ahead of Vermont in GDP, but when you take population into account, all of a sudden it's clear that per person Vermont is wealthier. And if we are wealthier than Saudi Arabia per person, we can certainly afford to have health care as good as or better than the Saudis enjoy.
Any business that's lost a good employee to a competitor because of health benefits knows the advantage of having just as good a plan as anybody else.
Vermont actually has a pretty robust economy; it's just that we don't want to share the good news with anybody. The people in this state who think that we can't make the best health care coverage in the US don't know what's possible based on what we have. I looked up the CIA economic data and came up with this:
If Vermont were its own country, its would rank 20th in per capita GDP (PCGDP) with $38,198 (2005). Adjusted for parity of purchasing power (which equalizes currencies’ worth), it puts Vermont right ahead of Belgium and 171 other countries.
Twenty-one of those countries have health care outcomes which, dollar for dollar, are superior to the US (2013 PCGDP, $52,800, ranking 8th in 2013).
Of the 36 countries which have health outcomes superior to the US, only 15 have a higher PCGDP than Vermont. Vermonters per capita are richer than the citizens of France, Belgium, Denmark, the United Kingdom, Andorra, Japan, Finland, San Marino, Israel, Saudi Arabia, New Zealand, Spain, the United Arab Emirates, Oman, Italy, Cyprus, Greece, Portugal, Chile, Argentina, and Colombia.
We have more than triple the PCGDP of Colombia’s $11,100, yet that allegedly violent, narco-ridden state surpasses the US in health care outcomes per dollar spent.
Single-payer is going to be an economic magnet. People who have been holding back from starting their own business-- and young businesses seeking to have the same health care benefits allure that solidly-established companies use to attract the best employees-- will move to Vermont to have a more solid business plan.
We like to complain about taxes, but the vast majority of us know that they are investment in the quality of life. We do, however, have a lot of legislators who act like they're the pimps for a syphilitic *****, trying to drive down her price in order to attract any business at all. They should all be replaced, in my opinion.
There are many issues with Vermont's economy. It's like an onion that you need to peel to see what is underlying. With so many people having to work two jobs, that tells speaks for itself on incomes. I have family in both Italy and the UK. Working two jobs is far from the norm. The other issue is the US and states do not look at unemployment the way it used to or the way it should be looked at. They only look at people actively looking for work in the last 4 weeks. The real unemployment rate should include the U-6. These are people who want full time employment, but can only get marginal employment. If the Fed had included people who could not get full time employment or people who dropped out of the labor force, the unemployment rate would have been over 15%.
The issue with comparing Vermont to countries is like comparing apples to oranges. Vermont is not a country. The other issue is you are dealing with data that is about a decade old. Vermont is a very different state economically than it was 10 years ago. In fact if you look at the federal data on GDP, Vermont is dead last in the country. It only looks good on paper because of our population size. California is probably the only state that could compare to wolrd economies because of GDP compared to the world. If your argument had any validity, LA county with a larger GDP and average personal income of over $71,000 could make the same argument. Again, it's apples and oranges. I think you need look at the state data that the state shares freely. The taxes in the state are getting to be oppressive on the citizens of this state. Only 30% of Vermonters make an income high enough to not have any state assistance on their taxes (again, this recent data released by the state). That is not a good number. It doesn't matter if you think taxes are fine or not as they stand. What matters is what the majority of the citizens in the state think. I think the many town meeting days around the state spoke for themselves.
There are many issues with a single payer system you are not looking at. I'm not an expert, but healthcare is my profession. I have a little bit of insight on how it works. I have a colleague who works for OneCareVermont which is a statewide ACO. They are keeping an open mind on how this will work, but from a conversation we had this past week, Vermont has obstacles. How a single payer system succeeds is by providing better primary care and keeping people out of hospitals. Problem one: I'm not sure if you are aware of this, but primary care physicians are the lowest paid physicians. At present, we do not have enough primary care doctors in the state to take care of people that are currently being seen. We are also talking about adding more people to the system on top of that. Do you think a physician with hundreds of thousands of dollars in debt is going to come to Vermont and take a job that has capped fees that will be paid? It's obviously not a position which you can start with a higher income, because that defeats the purpose. It's much more affordable to practice in a non-single payer system. Problem two is in an interview this past week. Shap Smith, who is an ally of the Governor stated the governor is running out of time. The Governor has not said how he is going to fund this plan. Shap is only giving him a few months before the legislature has to shut this plan down. Health care in the US is far from great. The ACA would have been much better if the system was modified instead of radically changed. The majority of citizen had/have health care that they are happy with. Leave them out of it and develop a plan to get the remainder of people insured. There are many cost savings to be had by moving from fee for service to pay for performance. The US can't compare itself to most other parts of the world when it comes to health care. We are not a healthy society. Thailand has great health care, but as a society they are much more healthy, thus care is cheaper to provide. Unfortunately in the US it's easier for a family to run to McDonald's to get a meal than it is to sit down as a family unit with a home cooked meal. Again, these are societal issues. I was in Denmark this past year and if you wanted to eat junk food, you had to really want it because it was much more expensive than traditional cooked food.
I used the 2005 figure, $38,198, because it was the first to pop up. However, Wikipedia gives a 2013 GSP which, divided by 623,000 citizens, yields $40,831, which puts Vermont even higher on the CIA health ranking data.
Texas has the world's twelfth-largest economy. it also has the most health insurance companies operating there, more than any other state in the Union, and compared to Vermont at present it has worse health outcomes in every category except breast cancer (I have no idea why). Iceland is half the size of Vermont, also has government-run health care and better outcomes for lower expenditures than the US. So size is not a limiting factor in providing better health care.
As for health care for all Vermonters, the first thing to realize is: The state already has all the facilities and equipment to handle 90-95% of all health care issues; the personnel are there as well. The problem has been in the uneven allocation of those services. We've had 4 gp's in my town quit in the last few years not because they weren't getting paid enough, but they couldn't stand the meddling in their practices. They hated having the system management constantly carping about having a patient in too many times or in the hospital too long; they got nailed for talking with patients about how much a procedure was going to cost; they hated not being able to treat couples with the same ailment in the same way if they had different insurers, and they were appalled to realize the only way their patient could afford treatment would be to get a divorce.
And doctors in general, given a choice between making the big bucks and being allowed to practice according to their best judgment, will choose the latter. I can't answer for surgeons.
So, here's what happens when you have a single payer plan: The plan administrator (the "single payer") does not make more money either by withholding payments or prescribing unnecessary tests, and if the CEO gets paid exorbitantly, the state finds a different company to administer it. This is completely opposite to how insurance companies have operated. Big savings!
Next: Hospitals, aware of what their revenue will be for the year (thanks to global budgeting), no longer feel pressured to advertise or to buy complex but unnecessary technology to lure new patients. Nor do they pressure their medical staff to prescribe more procedures than needed and to limit themselves to an average visit of seven minutes per patient (my kid's doctor once said, "My job is to generate $120 an hour"). More savings.
Doctors no longer get calls saying, "You've had Patient X in the hospital for four days now. She was supposed to be out two days ago." Billing departments vanish: Baltimore and Toronto each have 900-bed hospitals. Baltimore employs 300 people for billing; Toronto, three. More savings, although it is quite likely more care providing staff will be hired.
Nobody puts off a lump in their breast for two or three months, much less two or three years. They know it will only cost a nominal sum at the emergency room and if it needs to be treated, it is affordable, quite unlike today. Life savings.
Nobody loses their job because they're too sick to work and then loses their health insurance because they can't pay for it.
People who are paying big bucks for adequate policies-- premiums, co-pays, rescissions, etc.-- find out they're paying less in taxes for the same or better coverage. (However, the DINK's-- double income, no kids-- usually will find they now pay more). More savings. While the savings will be small per household, it will be in the range of half a billion per year-- but it won't stop people from complaining about taxes!
So, with a universal health care plan, general practitioners will be very happy, hospitals will appreciate the certainty, and people will be unafraid to watch their health.
Now, as for paying for it-- do you think the Vermont legislature would ever vote to obligate itself to an amount twice the state budget? it doesn't have to with single payer, but it did do it once upon a time...
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