Tag Archives: Green Mountain Care Board

Single-payer price tag: the dollars matter less than what they bought

Another fine “Fair Game” column by Seven Days politimeister Paul Heintz, most of which is an attempt to put a price tag on Gov. Shumlin’s failed pursuit of single-payer health care.

The takeaway number: $2 million. But that comes with some major cutouts; if you changed the ground rules, you could come up with a much higher number.

Heintz sought that number for ten weeks before the administration finally came up with it. And after all that time, all they did was add up two numbers: $597,000 to ten consultants, and $1.33 million spent on the governor’s Office of Health Care Reform.

However… the consultants and the OHCR weren’t the only people who put in time on single-payer. Work was also done by staffers in “10 offices, departments and agencies.” There was lobbying and flackery on behalf of single-payer. And many millions were spent on the Green Mountain Care Board and other entities that might not have existed, or been nearly so expensive, if not for their work on single-payer.

So, $2 million. Or a lot more, your choice.

The big question, though: was that too much? And the answer is, it depends.

If it was spent well and wisely, then $2 million or even $20 million would be a perfectly reasonable investment in research on a huge policy initiative. If it was spent poorly, then $2 million or $2,000 would be a waste.

So it depends. If you oppose single-payer, it’s an outrage. If you favor single-payer and believe the governor did his best, it’s reasonable.

And if, like me and many other single-payer supporters, you have your doubts regarding the administration’s performance, then that $2 million figure will make you a bit more queasy about the whole enterprise.



Talk about a waste of money…

Governor Shumlin appears to have his knickers in a knot over Vermont Information Technology Leaders’ decision to buy ad time during the Super Bowl.

Bear in mind we’re not talking about a Budweiser-level national buy; VITL bought one spot on channel 5 at a cost of $13,000. A waste of money? Arguably, perhaps; but VITL is trying to raise its public profile, and that 13K was part of a $195,000 marketing campaign.

Shumlin told the Vermont Press Bureau’s Neal Goswami that he was “disappointed” by VITL’s move. Well, he put it more grandly: “Many Vermonters joined me in being disappointed that state and federal funds were being used for an advertising buy during the Super Bowl.”

Yeah, “many Vermonters.” Why, just the other day I heard the folks at Coffee Corner’s front table griping about that waste of $13,000.


And then Shumlin got to the real meat of his objection.

“This should highlight the need for the Green Mountain Care Board to regulate VITL’s expenditures,” Shumlin said Sunday.

Aha, the penny drops. VITL is currently an independent nonprofit organization that “helps health care providers adopt and use IT systems.” Shumlin wants GMCB to have authority over VITL spending. And now he’s publicly scolding VITL for its horrifically wasteful use of… ahem… $13,000.

Smells like a power play to me.

Now, I’d love to have an extra 13 large. It’s nothing to sniff at. But as part of a sizable organization’s marketing campaign? Certainly not worth the Governor’s attention. Let’s say, hypothetically, that GMCB already had the authority. Would it be micromanaging VITL’s budget to that extent? I don’t think so.

Besides, if you want to talk about wasting money, let’s look at the taxpayers’ $2.5 million donation to GlobalFoundries, as ordered by our provident Governor.

GlobalFoundries, you may recall, “bought” IBM’s computer chip operations, including the facility in Essex Junction, for a whopping negative $1.5 billion. Last month, Shumlin announced he intends to hand over $2.5 million in state incentives to GlobalFoundries. That’ll clean out the Vermont Enterprise Fund, which was created last year at Shumlin’s behest. It’s supposed to help encourage large employers to remain or relocate in Vermont, and spending it is a gubernatorial prerogative.

As VTDigger’s Carolyn Shapiro reported, it’s unclear “how the money will be used and what conditions, if any, GlobalFoundries will have to meet.”

If any. Snort.

The Governor said the money “will help the state build a relationship” with its new corporate occupant.

Think of it as a $2.5 million corsage for a prom date.

Because when you’re talking about a giant corporation that does business in billions, $2.5 million is nothing but a gesture. Will it do anything to keep GlobalFoundries in Vermont or get them to expand? No. Corporate decisions will be made with global concerns in mind. On that scale, $2.5 million is a rounding error.

The Governor might as well have taken that money, in bags of small bills, to GlobalFoundries’ front gate and set fire to it, in hopes that the sweet, sweet smoke would appease the corporate gods.

The fundamental problem is, Vermont can’t move the numbers significantly enough to affect decisions at that level. We will always be at the mercy of large employers, and we’ll be playing with a short stack against bigger states (and countries) that can offer much bigger incentives. We’d be better off taking that $2.5 million and investing it in something that might actually make a difference — say, in a revolving loan fund for startup businesses.

Or here’s an idea: A revolving loan fund for students pursuing two-year degrees in technology fields. Why, just the other day one of IBM’s top executives said that GlobalFoundries “is struggling to fill positions because they can’t find enough workers with a two-year technical degree.”

You want to keep them in Vermont and simultaneously grow opportunities for Vermonters? Access to education is much more relevant to GlobalFoundries than a burnt offering at their front gate.

Just spitballing. My point is that there have got to be better, more effective, business-friendly ways to spend that $2.5 million. And that’s a lot bigger waste than VITL’s $13,000 Super Bowl ad.

So, maybe health care reform is working?

For those of us who practice compassionate liberalism (which is actually a thing, unlike compassionate conservatism), the primary reason for health care reform is to ensure that everyone can access the services they need. But reform isn’t going to work unless it meets another goal: containing the costs of health care, which were out of control under the old system.

And here’s some good news on the green-eyeshade front, courtesy of VPR:

Vermont’s 14 hospitals have submitted budgets for the fiscal year starting Oct. 1 that increase by just 2.6 percent over the current year’s budgets, the smallest annual increase for the Vermont health care delivery system in four decades.

… The 2.6 percent inflation figure follows on the heels of a 2.7 percent jump in the current year. Taken together, the performance of the hospital system should be considered a positive augury in the coming debate over Gov. Peter Shumlin’s single-payer reform initiative.

Kudos to VPR’s Hamilton Davis for slipping “positive augury” into his script. Few radio reporters would dare so much.

Anyway, yeah, two consecutive years of low cost increases for Vermont hospitals. In fact, as Davis reports, those increases are roughly one-third the rate of increase since the year 2000. And this year’s figures came in under the Green Mountain Care Board’s target of 3 percent. GMCB chair Al Gobeille pronounced himself “very pleased” with the submissions.

It’s still early days in health care reform, but something is obviously working. And this is a “positive augury” because state law requires the government to demonstrate an ability to control costs in order for Governor Shumlin’s single-payer health plan to go forward. So far, so good.