Big ol’ lead airliner

Crossposted on The Vermont Political Observer.

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.

After the jump: the grim details.

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.

This hurts.

6 thoughts on “Big ol’ lead airliner

  1. I came to believe him to be a duplicitous huckster rather early in his administration.

    The Governor couldn’t have more successfully torpedoed the future of single payer efforts if he had been operating directly on behalf of the insurance industry.

    The model seems to be “Lead a horse to water…then overpower and drown it.”

    I can’t imagine what this betrayal will do to his relations with fellow Democrats, especially after his presence on the ballot suppressed voter turnout leading to losses at the statehouse.

  2. Executive malpractice in the !st degree.

    Shitcan him before he continues to ruin our state due to epic failures resulting from abject incompetence. Keeping everyone in the dark re Shummycare & what was really going on with state budget is an outrage to say the least.

    – Remove blinders alert –  

    Aside from being a wolf in sheep clothing who has mauled & ravaged VT — not our guy & never was, an R in D skin as clearly since Emperor Shummy has no clothes.

    A complete fraud & huge hoax. Unbelievable!  

  3. Lawrence Miller, Robin Lunge, Michael Costa respond at length in the VtDigger.com comment section

    The decision to not move forward with a public financing system for health care in Vermont was an incredibly difficult one and it was not taken lightly. The charge that we essentially cooked the books for political purposes, is both absurd and insulting. There are many difficult tradeoffs in designing a new health care system that affect the lives of almost all Vermonters. It is neither fair nor borne out by serious scrutiny of our plan and the documents we released with it to say otherwise.[added emphasis]

    http://vtdigger.org/2015/01/07

  4. I posted over at VT Digger, but it deserves to be repeated: A 5.3% income tax adder would finance the $1.6 billion. That would be $2791 for a household earning median income ($52k). Not bad, really, compared even to the Bronze plan premium under the present system. Yes, millionaires would scream.

    The thing that nobody seems to acknowledge is that we are paying through the nose right now. The single payer numbers are presented in the abstract, as if they were to be added onto the present costs instead of replacing them.

    I want to see a comparison of what we are paying in premiums to private insurance companies now vs. what we would pay into an equivalent single payer system.

    I looked up some numbers on the Kaiser Family Foundation site (http://kff.org/state-category/health-costs-budgets/). The average employer based single employee cost in Vermont was $5,580 in 2012. It was $4,800 for individuals.

    It looks as if the 87% plan would beat that by a mile.

    Apples to apples, people.

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