There’s an absolutely devastating piece on VTDigger this morning. If you haven’t read it, go. Now.
For those who didn’t immediately take my advice, the story outlines the role Governor Shumlin played in holding a pillow over single payer health care’s face until it stopped breathing. Or, as the headline says, “Shumlin built ‘lead airplane’ for single payer.”
If the story is true, here’s basically what happened. At some point, the governor decided that he couldn’t win on single payer. Then, rather than face the music directly, he larded his single payer proposal with assumptions that added to its cost and suppressed its revenues. As the story says, “he cast the program in the most negative light possible.”
And then he walked away.
How did he do it?
Well, first of all, he presented only one plan, when he’d promised a menu of options.
Aside from that, his plan offered top-shelf coverage, paying for 94% of clients’ health care costs — a 94 Actuarial Value. He could have gone with a lower figure; “Act 48, Vermont’s single payer law, directed the administration to shoot for a plan that covered 87 percent of costs.”
So he ignored the law. Not much new there.
The 94 AV added $300 million a year to single payer’s cost.
He also chose to add out-of-state residents who work in Vermont, which added another $200 million. And he called for the elimination of Vermont’s provider tax, which cut $160 million in revenue.
He also chose to assume the new system would yield no administrative savings — which had been one of his big selling points for single payer.
You can see where this is going. Shumlin projected a first-year cost of $2.6 billion, but he could have brought in a perfectly acceptable plan for well under $2 billion.
And he knew it. And he chose not to tell us.
The massive report released by the administration at year’s end included not one, but 15 plans. But Shumlin chose to present only one.
Among the 15 different models in the document dump is Financing Concept 12, which uses an 87 percent actuarial value and would require $1.6 billion in state revenue for the first year.
It excludes out-of-state workers and does not offer supplemental coverage to federal employees or people with employer sponsored coverage, all of which is contained in the plan Shumlin chose.
It’s hard to read that and feel anything other than betrayal.
Maybe there were perfectly sound reasons for Shumlin’s choices, but he didn’t give them and he didn’t provide any options. Instead, he “buried” them in his pre-holiday document dump.
So, Vermont misses a chance at single payer. Even worse, the entire idea of single payer has been significantly set back, perhaps by decades. Because now we have a liberal governor, a strong advocate of single payer, concluding that it’s not practical.