[OhBeeHave]

Originally Posted by cgregor

The Vermont Workers Center has just released its funding proposal for universal health care in Vermont: RELEASE: Over 100 economists call on Vermont to move forward with universal health care; new financing plan shows a way | Vermont Workers' Center. Let's see what happens.

According to the plan, low- and middle-income families would pay much less in health care costs if Green Mountain Care was implemented. A family with an income of $50,000 per year, for example, would pay 40% less for health care costs on average under Green Mountain Care. The plan proposes taxing wealthier people’s unearned investment income in order to give a bigger break to low- and middle-income families. It also proposes implementing a graduated payroll tax that requires large employers and businesses with highly unequal salary structures to pay more than smaller and more wage-equitable businesses. The payroll tax takes into account the difference between the top 1% of wages and the bottom half of wages in each company, and lowers the tax rate for companies with more equitable wage structures.

The Robin Hoodesque sound of this paragraph makes me question a few things:

Will businesses with 'highly unequal salary structures' choose to remain in Vermont and pay this punitive payroll tax, restructure, or leave the state?

Will wealthy residents and retirees choose to remain in Vermont and pay an increased tax on the unearned investment income, or will they opt to move their residency to a more tax-friendly state?

Of the four economists with direct ties to Vermont, how many of them will depend on this system for health insurance or will they continue receiving benefits from the University of Vermont?

[68vette]

The state can't even get Vermont Health Connect to work. Just a week ago, the Gov. was forced to lay it on the line, if the VHC is not fixed and running, the state will drop it and go with the federal plan. VHC has suffered back-end technological problems and cost overruns since launching in October 2013. The state has spent $126 million in federal dollars on the system, and the cost could be close to $200 million by the end of the year. A waste of $200 million dollars!! Everyone says it's the feds money not the states. Where do you think some of that money came from?

[cgregor]

The State government happens to run the best health-care system in the state: its employee program which not only has reduced premiums for employees three years in a row, but has a denial rate that should make CIGNA and BC/BS blush-- 1.2% (vs. 22% for the former and around 12% for the latter). By the way, CIGNA used to administer the plan, but can't rein in its own costs for the programs it provides to Vermont businesses. What was the big, mean, inefficient state government doing right that CIGNA couldn't get right in the private sector? (BC/BS now administers the state's program.) And, to top it off, state employees apparently are healthier under their plan than most other employees are under their plans. So, we can't say that having government run a health coverage plan is a bad idea.

Vermont Health Connect is working just the way the for-profit insurance companies intend it to: They all stay in business, they are guaranteed 15% profit to cover "administrative costs" (vs. a typical 4-7% for a Vermont business), and the system is complicated enough that it just might crash in two years, allowing the for-profits to once again seize control. And in the course of crashing it will of course have steered $200 million of taxpayers' money into private pockets even as it failed.

Single-payer is a lot simpler to set up-- enrollment is little more than filling out one sheet of paper with one's family's information, with no proof of income necessary and no further paperwork unless one moves out of state and then moves back in again. If entire countries smaller (e.g., Iceland, Malta) and poorer in per capita GDP (16 of them, including France) can afford single payer, Vermont certainly can.

Why should we take a back seat to 36 nations when it comes to being sensible about heath care?

And-- the 2012 Vermont Hospital and Health Insurance Survey indicates that of Vermont Rotarians-- who arguably have the best private health insurance policies in the state-- one out of six nevertheless pays $5,000 or more out of pocket annually, and one out of seven has been contacted within the last year about settling an overdue medical debt. If I were a Rotarian, I'd expect better than that.