Just in time for Christmas, Vermont’s Loudest Economist has left a flaming bag of conventional-wisdom poo on our doorsteps. (At least he didn’t try to come down the chimney.)
He’s scribbled out a column entitled “Explaining Demise of Single-Payer.” Which, of course, does virtually nothing to explain the demise of single-payer. I mean, this is Art Woolf we’re talking about here.
The good professor spends most of his time on a shallow meander down Memory Lane, explaining that despite the efforts of the last three Vermont Governors, our percentage of uninsured Vermonters has remained basically the same.
Of course, Woolf’s entire argument falls apart right there, because his beloved statistics end at 2013 — before the Affordable Care Act had gotten off the launchpad. So he’s telling us that Shumlin has failed to reduce the uninsured population, even though Shumlin’s reforms hadn’t begun to work.
Woolf goes on to the only useful part of his “analysis.” In recent years there have been efforts to expand Medicaid eligibility, and they have worked. However, there’s been a corresponding decline in coverage through employers, so it all washes out.
Us liberals would blame this on a worldwide, concerted effort to drive down wages and benefits — the race to the bottom, as revealed in the stagnation of buying power for all but the very top earners, the persistent crappening of benefits such as employer-provided health insurance (and the steady cost-shifting to employees by way of worker contributions, high deductibles and copays) and the virtual disappearance of defined-benefit pension plans.
Woolf, good capitalist lackey that he is, blames the loss of employer health insurance on the expansion of Medicaid.
What apparently has happened during the past 15 to 20 years is that some employers who formerly provide insurance to their workers no longer provide that benefit. Most likely, it’s because their employees can get a better coverage plan at no or low cost from the state.
“What apparently has happened,” my ass. Woolf might be justified in making that evidence-free assumption, if not for all the other evidence that employers are squeezing their workers and transferring responsibility for their well-being to the government. (See: all the Walmart employees on some form of public assistance. I guess Woolf would blame that on welfare, not on a greedy corporation.)
The toxicity of Woolf’s presentation becomes clearer in th;e ensuing paragraph:
Their employers can therefore afford to pay their workers higher wages instead of providing health insurance benefits. This is one of the unintended consequences of government policies that are all-too-often overlooked by policymakers.
Well, sure, they CAN afford to pay higher wages. But they DON’T. And Woolf knows damn well that they don’t. He must be aware that working Americans’ wages have been stagnant for decades.
And he must be deliberately excluding that fact from his presentation so he can preserve his dubious conclusion: government largesse is to blame for private-sector miserliness. If not for Medicaid expansion, he is effectively saying, working Americans would still be getting health insurance from their employers.
Working Americans can only respond with a bitter laugh.
He also blames Medicaid for the rising cost of health care: because Medicaid offers low reimbursement rates to providers, they have to charge more to private insurance carriers. Which is true, but again, it leaves employers out of the equation.
Finally, in the last paragraph of Woolf’s column, we get to “Explaining the Demise of Single-Payer.” Sort of:
The state’s Medicaid expansion now provides a backstop for lower- and middle-income Vermonters who might lose their private health insurance. This means the third goal, the fear of becoming uninsured, might have lessened over time for many Vermonters.
Perhaps that’s one reason why there wasn’t greater support for single-payer in Vermont, and why there wasn’t more opposition to the governor’s recent announcement.
Oh, so we should blame the demise of single-payer on the patchwork success of Medicaid? Nothing else at play here, Art?
To be fair, Woolf doesn’t necessarily write the headlines, so maybe he’s not responsible for the vast overpromise of this one. But he is responsible for the incomplete, one-sided “logic” that resides beneath.
Art Woolf’s weekly words of wisdom usually come to us on Thursdays. This one was published on Wednesday. Perhaps tomorrow, on Christmas Day, Woolf will favor us with his reasoned defense of Ebenezer Scrooge, and how the government’s generous provision of prisons and workhouses helped drive down wages in Victorian England.