Topic: Liberal Fascism
So you don’t like Obamacare? No problem! There’s a quick, simple fix: double down to single payer!
Such is the mantra of lefties like Bob Beckel of FNC’s The Five. It’s not that Obamacare went too far. No, no, it didn’t go far enough—though as they often add, it was “a good first step.” But single payer remains the progressive goal: a healthcare system in which the federal government provides all the coverage and pays all the bills. How this would work remains uncertain. Various schemes have been floated. One idea, beguiling in its simplicity, is “Medicare for All”—an extension of this popular program to cover all Americans.
There are some good reasons, however, to think that single payer wouldn’t actually work out in practice. One is that the very people who tout it are the people who created and supported the policy debacle known as Obamacare. Another is the fact that the United States is a very large country with a highly complex healthcare system—a system that it might prove impossible to run along bureaucratic top-down lines. And then there’s the Vermont Model.
If you get your news from the mainstream media recent events in the Granite State may have escaped your attention. Briefly, the Affordable Care Act includes an opt-out clause for states that adopt a single-payer healthcare system. Though several states are mulling this over, so far only Vermont has made a serious effort to go the single payer route. Enabling legislation was passed in 2011 with significant input from an outside consultant: none other than Professor Jonathan Gruber of “stupid American voters” infamy. The system was scheduled to launch in 2017.
Green Mountain Care, as the plan was dubbed, promised to deliver lavish benefits, far superior to Obamacare. Vermonters would have 94% of their total medical expenses covered. Sounds like a great deal, eh? Well it is—or it would have been except for the little matter of financing the program. Once the numbers were crunched, state officials discovered to their consternation that Green Mountain Care would require a 160% increase in state taxes by 2019. Vermont’s top income tax rate would double from 9% to 18%, saddling top earners with a combined federal-state income tax bill of 56%. But the poor and the middle class wouldn’t have been cheering, for even they faced substantial tax hikes. And that was not all. Vermont businesses faced the prospect of a nearly 12% state payroll tax—this in addition to the preexisting federal payroll tax.
But even this tsunami of new taxes would not have been enough to keep Green Mountain Care out of the red, so it was also proposed to slash payments to doctors and hospitals by 16%, with easily predicable effects on access to and quality of Vermont healthcare.
Equally predictable was the reaction of state officials, who decided that they’d prefer not to ask Vermonters to swallow this bitter pill. Last month Governor Peter Shumlin, a Democrat, unceremoniously shoved Green Mountain Care down the memory hole.
Now some may argue that the Granite State's dalliance with single payer signifies nothing in particular. What doesn’t work on a small scale may well prove feasible when scaled up. Perhaps so. But coming as it does from people who (2) ballyhooed Obamacare and (2) cheered plucky little Vermont’s progressive experiment, this argument may not resonate with very many Americans…
