Costs derail Vermont’s dream of a single-payer health plan

[seabeyond]

For decades, liberal activists yearned for a European-style, single-payer health system that they argued would lead to more affordable, efficient, and comprehensive medical coverage for all citizens. When Vermont four years ago enacted a landmark bill to establish the nation’s first single-payer health care system, they saw their long-sought dream about to be fulfilled.

But reality hit last month. Governor Peter Shumlin released a financial report that showed the cost of the program would nearly double the size of the state’s budget in the first year alone and require large tax increases for residents and businesses. Shumlin, a Democrat and long-time single-payer advocate, said he would not seek funding for the law, effectively tabling the program called Green Mountain Care.

“In my judgment, now is not the time to ask our Legislature to take the step of passing a financing plan for Green Mountain Care,’’ Shumlin said.

The decision not only stunned and angered supporters in Vermont, but also signaled that the dream of universal, government-funded health care in the United States may be near its end. Vermont’s experience, analysts said, shows how difficult — and costly — it can be to shift from a system long-dominated by private health insurance, and that the future of universal health care lies within the private market.

In short, if a liberal state electing a Socialist (US Senator Bernie Sanders) to Congress can’t or won’t put a single-payer system into place, then who will?

https://www.bostonglobe.com/business/2015/01/25/costs-derail-vermont-single-payer-health-plan/VTAEZFGpWvTen0QFahW0pO/story.html

[litlbilly]

1. Democratic Socialist. Get it right. The only way to do it is the entire country at the same time.

It's coming so you may as well get used to the idea. This kind of OP is just getting old. Not gonna help Hillary one bit.

[Beartracks]

34. My thoughts, too. Vermont is simply to small.

The transition period is bound to be costly as pent up demand for healthcare is unleashed into the marketplace, and a country could absorb that much more easily than a tiny little state.

==========================

[litlbilly]

38. Not only that, but with big pharma and insurance, it's impossible to do in the current climate.

[Beacool]

62. It's coming? Really?

In which decade?

[BooScout]

66. ...

[img][/img]

[randys1]

2. It can be done, nationally, and it HAS to be otherwise I would hope tens of milions

of Americans would go on a general strike

[dreamnightwind]

15. +1

[Recursion]

75. Canada does it by province (nt)

[jkbRN]

3. If you keep smashing on single payer--HRC will lose even more of the progressive movement

[Agschmid]

10. If you base your decision... Or if progressives base their decision...

On what one random anonymous poster is saying on the internet you were already "lost" to begin with.

Single payer is a good thing, universal healthcare is a good thing. There are legitimate questions about how/if it would work, and how/if it would come to fruition to ignore those questions is to set ourselves up for failure.

[enid602]

26. platform

Single payer is not part of our candidate's platform. It is for bernie to defend. He can start by giving the figures to the public.

[Agony]

4. Funding public programs at the state level is in no way comparable to federally funding programs

It is our government, if we decide to create a publicly funded health care system there is nothing stopping us but irrationality and fear.

[litlbilly]

12. Exactly, and if there's no control over the drug companies or insurance companies, it wont work.

They did it one province at a time in Canada but those were different times back then. The huge companies weren't quite as greedy as they are now. The only way to do it is with Bernie's plan. Fixes it from top to bottom.

[Ferd Berfel]

5. NOt enough people in the state to support it

BUT there ARE enough people in THIS NATION to support it.

[ChiciB1]

33. EXACTLY TRUE! Doctors In State Agree!

Numbers too small!

[senz]

52. Precisely. The population of VT is too small for it.

However, we know full well it works beautifully on a large scale. Just ask our friends to the north.

[Ferd Berfel]

74. Yep!

Feel the Bern

Then FEED THE BERN and send him another $25

[Goblinmonger]

6. How can Europe possibly afford it?

It would never work there, would it?

[Ron Green]

7. Vermont residents can't afford what they've got now,

and neither can the rest of us.

18% of GDP - that's unaffordable.

This stuff is not hard to understand, it's just hard to do with cowards and bought politicians in place.

One risk pool. No profit-taking insurance. Resources where they belong. That's how it's done.

[Hiraeth]

25. ^^^ yes ^^^

[ChiciB1]

36. WRONG! n/t

[Ron Green]

44. Explain how it's wrong, please.

Betcha can't!

[cosmicone]

8. The startup costs are impossible to fund

Single Payer would cost trillions of dollars before any benefits and savings are realized.

Where will the working capital come from?

Increase in taxes is out of question -- will be filibustered in the Senate even if House goes democratic.

Borrowing the funds is also out of question because the current deficits couldn't handle the interest payments on the debt.

That leaves wishful thinking and magic -- which abound.

[dreamnightwind]

17. You're simply wrong about the startup costs and the trillions

[cosmicone]

49. Got data?

Spreadsheets? Projections?

I think not. It is easy to say someone is wrong out of sheer faith.

[dreamnightwind]

61. You made the claims, back 'em up yourself

[cosmicone]

68. I made a commonsense claim

However, like in the rest of the bernie world, hard data is never provided. Just slogans, platitudes and 'feel good" promises.
Data? Nil

[dreamnightwind]

77. You stated the following as if it were fact

"The startup costs are impossible to fund

Single Payer would cost trillions of dollars before any benefits and savings are realized."

How about you stop making up false claims trying to disparage Sanders? There are better ways to support your candidate, or better yet, support a better candidate.

[quickesst]

42. It's really not that hard to understand...

.... why he won't release any details of his plan. I'ts the elephant in the room you just alluded to.

[guillaumeb]

9. Canada went from a privatized, insurance based system to single payer

based on province. And it started in the Conservative dominated west. In Saskatchewan, of all places.

Canadian healthcare spending is 1/2 what the US spends for better results.

[DFW]

24. Let me guess.....

An average overnight stay in a hospital doesn't cost $18000 in Canada? (that's what they billed my daughter in NYC last November).

[guillaumeb]

78. Correct.

Pricing of services is handled by each Province. Doctors make less also. But the results? Canada ranks 9, the US ranks 37 according to the WHO.

[RandySF]

11. This is why only the federal government can pull this off.

[DURHAM D]

13. But, his plan is for the states to run it.

That can not work in red states. Medicaid is already being screwed with in red states and doctors, dentists and care facilities are turning away Medicaid patients.

[RandySF]

18. No, I didn't think the redder states will put the effort into running it well.

[restorefreedom]

37. wrong. it will be federal, medicare for all. nt

[DURHAM D]

41. Medicaid is a federal program run by the states.

Bernie's plan calls for his federal program to be run by the states. eom

[restorefreedom]

64. bernie's plan will not allow states to opt out or screw up like in medicaid

this is based on his 2013 bill. i am certain his new plan will be at least this comprehensive or more so. he said the plan will be out before iowa, so we will all be able to see for ourselves

" Sanders’ plan requires states to set up the specifics of their health care system, though they must meet federal standards for various administrative details. For example, states must identify a single agency to manage the program. If a state does not set up a system, or if they refuse to meet the federal standards, the federal government will step in and run that state’s program.

Clinton’s comments seem to be based on how many Republican governors have reacted to the Affordable Care Act, a.k.a. Obamacare, deciding not to accept an expansion of Medicaid, the government insurance program for low-income individuals.

The Sanders’ campaign said the provision that allows the federal government to step in and run state programs would prevent governors who oppose the law from refusing to provide health coverage for their residents or offering subpar programs.

The bill also states that every U.S. resident "is entitled to benefits for health care services" and would require auto-enrollment at birth or at the point when someone becomes a legal resident."

http://www.politifact.com/truth-o-meter/statements/2016/jan/14/chelsea-clinton/chelsea-clinton-mischaracterizes-bernie-sanders-he/

[dsc]

65. and how won't he let them

Remember the ACA at first required states to expand Medicaid or else lose a significant chunk of the funding they get for the Medicaid they already had. SCOTUS said you can't do that. They said that the feds couldn't force the states to do it. So how, pray tell, does he get around that?

[restorefreedom]

67. we will find out soon enough

his plan will be released before iowa, the campaign said.

but know this: bernie has been fighting for this for 40 years. no way he is going to allow some knuckle dragging, scum sucking winger to leave people out in the cold. count on it.

p.s. the aca is nothing like medicare for all. it was a "first step" which leaves insurance companies raking it in and all of us holding the bag. it is apples and oranges compared to a true sp plan

[dsc]

69. the medicaid expansion was the exact same thing

[restorefreedom]

71. he will not leave m for a in the hands of rw govs. not gonna happen. nt

[dsc]

72. He has repeatedly stated

and the bill he and his supporters have repeatedly pointed to, says in clear, unambiguous language that the states would be tasked with running this program. So again, how does he make the states do this?

[restorefreedom]

73. we will find out.

speculating based on. 3 yr old bill will not give us any further information. we can only guess at this point about the mechanics.

but i do not believe for a second he would leave something this importsnt to rw yahoos who will screw the people.

we shall have to stay tuned.......

[geek tragedy]

14. Single payer isn't going to happen under either candidate.

Sanders favors it, but Congress would have to pass it.

Yes, that Congress.

[Rosa Luxemburg]

16. If this country didn't waste trillions on futile wars and pipelines

then it would have some money left for healthcare. It should not be left up to states to fund exclusively.

[Autumn]

19. .

same old same old

[hrmjustin]

20. It is a noble goal but it will never get through congress.

[artislife]

45. They say the same sentence for a lot of things and they are wrong.

Marriage equality, anyone?!`The will of the people is no small thing.

[hrmjustin]

47. Marriage Equality never passed the congress.

We got that through the courts.

[artislife]

50. Well wasn't it a pipe dream?

Didn't conventional wisdom say it would never happen?

Or is it fine that somethings are worth fighting for while other things aren't?

[hrmjustin]

51. Yes it was worth fighting for.

But Sanders needs to be realistic about his chances of getting his things through.

I am not sure if he will be willing to compromise.

[senz]

53. So too is health security worth fighting for.

Bernie is very realistic; he has spent the past 25 years in the U.S. legislature. He knows how things are done, he gets along fine with others and understands the art of compromise.

Y'all might need to find another line of attack.

[hrmjustin]

55. Why haven't they endorsed him?

If he is the best why haven't they endosed him?

And Hillary has been in DC for just as long and has more experience.

Hillary is the most qualified.

[senz]

57. Establishment elites don't endorse people like Bernie.

He doesn't play the money game. He doesn't make backroom deals. He doesn't cultivate the 1%. Until recently, he was probably viewed as relatively powerless by the power players. What he has now is people power. The ones you admire don't respect people power -- until the numbers get too big to ignore.

"Being in DC" means NOTHING. Doing the work does matter.

Hillary has held ONE elected position and she got there by carpet-bagging and playing on her famous husband's name. While in that position she cast some terrible votes.

Her second stint, which was handed to her in a spirit that many believed to be "keep your friends close and your enemies closer," was not a success. She has nothing to show for it -- just a mess in Libya and many millions of dollars for her family foundation and her family itself from approving $165 billion worth of commercial arms sales to 20 nations whose governments had given money to the Clinton Foundation.

Not admirable.

[hrmjustin]

58. Hillary is well liked here in NY and that is why she won.

We have a history of electing people not from this state. She won in a lanslide both times and served us well. Hillary was chosen for SOS because she is highly capable and highly intelligent.

You want to go the republican route and trash her that is your choice.

[senz]

60. Certainly she's well-liked on Wall Street.

But her dismal, life-destroying blunders remain. No pretty image, no dressed-up back story can change that. She is what she is. She does what she does. She is responsible for what she does. To acknowledge her deeds, and to reject them, is not "trashing Hillary." It's holding her responsible. That is not "Republican."

To many of us, your candidate is a DINO whose loyalties reside squarely with the wealthiest 1% of this nation and with the neocons who want to further American hegemony over the globe. To us, THAT is Republican.

[artislife]

56. Right senz. This timidness from the Dems is mind blowing.

I mean, why don't they just join the party of NO?

Everything that is man made was first an idea.That is what we call inspiration, then we build, create it. We take an idea and make it real.

[senz]

59. Some are not interested in making America livable for its people.

And actually, Bernie's ideas aren't as "out there," as they're trying to make them sound. We're the only industrialized country that doesn't have some form of universal health care. They're making it sound like the United States of America can't "afford" single payer.

But if Hillary were for it (which she said she was until recently) they'd be trumpeting it all over the place.

They care more about her personal ambition than they do about the well-being of the American people.

[Paulie]

21. Two differences between states and federal

The printing press and scale.

[beam me up scottie]

22. Wow, why didn't someone post this before???

[Hiraeth]

28. a year old hot slice of news smelling past ripe, nigh on rotten

wonder how many times it has already here

[beam me up scottie]

30. Maybe this time will be the one that makes us realize we're not gonna get that pony!

We'll abandon all hope, throw up our hands and fall in line.

I don't think they get that we support Bernie because he doesn't give up.

Trying and failing is better than never trying at all.

[Hiraeth]

31. If at first you don't succeed try, try and try again !!

[Thinkingabout]

23. Our healthcare is probably the highest in the world.

On international health insurance policies they discourage using the health care in the US because of the cost. If you want to k ow why other countries can afford single payer look at the average cost per person and compare it to the US. We have the highest prescription cost in the world.

[questionseverything]

29. that is why single payer has to start with cost controls

[notadmblnd]

27. The article is year old. Do you mean to tell us that the citizens of Vermont have no health care?

[ChiciB1]

32. The Real Reason About Costs Is That Vermont Is Too Small

and the state does not have enough citizens to implement it as it should be implemented. A DOCTOR FROM VERMONT was on Thom Hartmann 's Show tonight said THIS IS THE REASON. Then he said Bernie's plan is the nest way to go. The doctor sat in the middle of the 2 man panel.

CHECK IT OUT at Bernie's website!

[Kalidurga]

35. You prefer people die from lack of medical care I get it.

You can be honest about it. I really prefer the let him die crowds to so called liberals that belly ache about how to pay for people to get medical treatment if they can't afford it. This is a despicable line of reasoning from Democrats that should know better. Why don't you try pushing for fewer nukes or fewer military bases in other countries shut a few of those things down and we can pay for everyone to see a doctor for easily treated illnesses.

[napi21]

39. Yes it's costs, but not only in VT. It's a problem in the USA only.

My granddaughter & her husband are both doctors in Germany. They make very good salaries, but NOT compared to the salaries in the USA. That's a problem I see no answer to. We CAN'T tell our doctors they have to take a huge pay cut! And we can't provide single payer health care and still ay them what they're currently earning.

Yes I'm aware that ALL Docs don't make several hundred thousand a year, but most that have been practicing for a number of years do, not to even mention Specialists. I also understand that in the USA it's very expensive to get a Doctor pf Medicine degree, and those huge loans have to be paid off! It cost my GD $1,000 per year to get her doctorate; her husband as well. They don't HAVE the horrible loans to pay off!

I simply don't see how we could ever get single payer.

[artislife]

46. I remember reading about a program

that would pay a doctor's loans if they came to areas in the US that needed more doctors. SoDak comes to mind as one of the states that has horrible access to healthcare.

[napi21]

54. I can't speak to every country and how much college & doctorates cost. I only know

that my GD went to college in Romania. She went to med school in Romania as well. The four years of college was at no cost to her. The med school was $1,000 per year, and her parents paid that for her. She met a fellow while in med school and got married after her fiancee' graduated from the same school. After she graduated, they both moved to Germany. He accepted a job at one hospital there, and she finished her internship at a different hosp. in the same area of Germany. The pay in Germany is much higher than it is in Romania.

Maybe there is a cost in countries like India, Korea, etc. I just don't know.

[99Forever]

40. Comparing a row boat to oceanliner.

Yeah, that'll yield irrefutable data.


More lameass Single Payer bashing from Camp Weathervane. Sad and pathetic.

[R B Garr]

43. If he wants to brag up mayor of a 45,000

population town, then can't get his vision implemented in his own tiny state of Vermont, obviously there's something wrong. Nothing wrong with pointing out the obvious, hence the words from the article: "But reality hit last month".

[Doctor_J]

48. The federal grant was too small, deliberately.

The federal government wanted to make sure it would fail, lest it catch on and lead to their insurance industry johns losing their welfare.

No matter how many times you tell this lie, there is absolutely no way that single payer can cost more than for profit healthcare. Anyone with a sixth grade education can work that out.

[GoneFishin]

70. And the lack of any attempt to phase it in over time rather than instantaneously is telling, and

it indicates to me that they chose not to pursue it for some reason not made public.

[Beacool]

63. It ain't going to happen.

I have lived in countries that have socialized medicine, in general it's a good thing, but the mindset of Europeans is different than that of Americans. I think that there was a better chance of passing a single payer healthcare bill in the 60s. If anything, the country has become more conservative and polarized since the Vietnam era. Like Dole and McCain said, they wouldn't have gotten elected if they ran nowadays. Orrin Hatch and Ted Kennedy were good friends off the Senate floor. That kind of camaraderie and civility no longer exists with the new bunch of Congress critters.

Just observe the lack of civility right here on this site and we're debating about two candidates of the same party.

[ViseGrip]

76. It's time for people to watch NH with their own state house bill, doctors all over are supporting