Shumlin plan to use payroll tax to fund single payer unpalatable to many in business

Gov. Peter Shumlin in January. Photo by Roger Crowley for VTDigger

Gov. Peter Shumlin in January. Photo by Roger Crowley for VTDigger

If Gov. Peter Shumlin pursues a payroll tax to fund a publicly financed health care system, he will meet heavy resistance from one of the state’s most influential business groups.

Betsy Bishop, president of the Vermont Chamber of Commerce, says her organization and its members would not look favorably on a payroll tax.

“When you take away the decision-making process, but leave the payment still in place, it disconnects the employer from the payment,” she said. “What we’re interested in is continuing a system where employers, if they are paying for health care, have some level of control over what they are paying for.”

Last week, Shumlin told Times Argus Editor Steve Pappas that a payroll tax would be one of the vehicles for funding a single-payer, universal health care system in Vermont. Shumlin has been touting single payer for years, but he has provided little detail to date about how the state would pay for the system.

“Clearly, the payroll tax is going to have to play a major role,” he told Pappas.

Shumlin’s Office of Health Care Reform is working on a financing plan to raise an estimated $1.61 billion for the system, and the governor says he will hand the plan to the Legislature in January 2015. The state would not be eligible for a waiver from the Affordable Care Act to implement a single payer plan until 2017.

“Opponents are going to say this will be the biggest tax increase in Vermont history — fair enough,” Shumlin told Pappas. “But it’s going to be the biggest health care premium reduction in American history. We’re just going to swap a health care premium for a publicly financed health care premium.”

Jim Harrison, who runs the Vermont Grocers’ Association, which represents 700 retailers and 250 suppliers, says he is not surprised the administration is considering a payroll tax.

“It is logical a payroll tax would be under consideration because a lot of insurance premiums are paid for by employers,” he said.

Exactly how a payroll tax would affect businesses, however, depends entirely on how it would be leveraged.

“You could have a number of employers that could be dramatically hurt and others who could be substantially helped by such a system,” Harrison said.

Shumlin said the biggest shock would be felt by businesses that don’t currently contribute to their employees’ insurance.

“The question is: How do you ratchet in the folks that are paying nothing slowly enough so that it doesn’t hurt their bottom line?” he said to Pappas.

“We pay about 18 percent of payroll for health care premiums,” Shumlin said about his family business, Putney Student Travel. “You can call it a tax or a premium, but it’s coming out of our bottom line.”

This isn’t the first time a payroll tax has been proposed as the main funding mechanism for a single-payer system. Harvard economist William Hsiao recommended an 11 percent payroll tax on employers and a 4.5 percent payroll tax on employees in 2011. At the time, many employers balked at the idea.

Vermont Businesses for Social Responsibility supports a publicly financed health care system, and the organization’s team has been looking at various funding options for the past couple of years.

Dan Barlow, a lobbyist for the group, says, “There really aren’t that many buckets of money.”

“Taxing junk food is not going to pay for our health care system,” Barlow said. “The payroll system is one of those big buckets you can go to. The income tax is as well.”

David Coates, who chairs the 20-member Governor’s Business Advisory Council, says he prefers the payroll tax to an increase in income taxes.

“It’s one of the funding mechanisms that has to be on the table from my perspective,” he said. “It certainly beats the income tax. You have to look at whether something will be so onerous it will make us anti-competitive and drive people out of the state of Vermont. There are people saying that our income taxes are too high.”

Michael Costa, Shumlin’s health care financing czar, says every option is on the table.

“I think it’s really fair to say that the current system relies heavily on payroll contributions, and we certainly continue to take a hard look at this option,” Costa said. “I wouldn’t be shocked to see the payroll tax as a component of one or more of the plans.”

A plan, however, has not yet been developed, he said.

“A secret plan would make my life easier, and I’m really certain one does not exist,” Costa said. “Why? Because I asked during my job interview. It would make my life a lot easier.”

Betsy Bishop, president Vermont Chamber of Commerce

Betsy Bishop, president Vermont Chamber of Commerce

Shumlin also articulated this sentiment, in his interview with Pappas.

“If we could lift up the veil on this thing, and we had it all planned out, and we could tell you exactly how it was going to work, I wouldn’t be sitting here,” he said. “We would have done it already.”

Rep. Janet Ancel, who chairs the House Ways and Means Committee, said that she is unsure whether her committee will look at tax options this legislative session for single payer. Sen. Tim Ashe, who chairs the Senate Finance Committee, says his committee won’t vote on a financing plan before 2015.

Bishop of the Vermont Chamber said legislators ought to know what the system looks like before they vote on a financing plan for single payer.

“Before we can define what tax this comes from and how much money we can raise from a tax, I think the state needs to be very clear about what the definition of single payer is, and what the benefit package is, and who is eligible for it, and how much we are paying providers,” she said. “If you change any single one of those factors, the overall cost of the system changes.”

Andrew Stein

Comments

  1. Sandra Bettis :

    in single payer, the employer has nothing to do with the health care! i would think employers would love that! it is no money out of their pockets and none of their business!

    • J. Scott Cameron :

      “in single payer, the employer has nothing to do with the health care! I would think employers would love that! it is no money out of their pockets and none of their business!”

      Did you not read the article you just commented on?

      Employers and working people would fund the system for everyone else. Employers could pay a payroll tax of 11% to 18%; employees could pay another 5%. And you would still be faced with high deductibles and co-pays in the plans approved by State.

      Employers would fund the health insurance but have nothing to say about coverage. Employers (like IBM) in ERISA plans would pay both the payroll tax for single payer AND pay for the cost of their own group health insurance.

      Over time, single payer might work or it might not. But to claim that it is free, and that it does not cost employers anything, is sheer ignorance.

      • Sandra Bettis :

        i never claimed it was free – it is paid for by income taxes. in single payer, the employer has nothing to do with it. there are no deductibles or copays with single payer – you would never even see a bill. obviously, this article is not talking about true single payer. i am.

        • Paul Dame :

          With all due respect it doesn’t matter what you or I are talking about, it matters what our governor and legislature are talking about. If they are talking about something different than what you envisioned, you should express your concern and disapproval.

          My fear is that many of the moin more intelligent people I have talked to who support Single Payer in theory often find that once they get the facts by what is actually being proposed, find that they are against it.

          • Sandra Bettis :

            sorry but i find just the opposite. lots of folks don’t really know what single payer is but, when they find out, feel it is win win – which it is. i don’t know anyone who thinks our for profit exclusive present system is working.

  2. Sandra Bettis :

    why is this so difficult? just look at how other countries do it! you add on to our income tax and take away our premiums pd to for profit ins cos – we all win! and we will all save $$$$$$$$$!!!!

    • Jon Culligan :

      Exactly how many ‘other countries’ have you lived in to experience their health care from a native perspective?

  3. Linda Quackenbush :

    Herr Shumlin has to use his Executive Order privilege to nationalize employers payrolls! He’s just showing his Progressive Marxist tendencies to nationalized everything. Next he’ll be knocking on your door demanding accommodations for his gestalt of IRS healthcare compliance regulators… Congratulations Pete for being so business unfriendly…It’s no wonder you have to solicit Communist China for business venture capital…Shameful just shameful…

  4. Walter Carpenter :

    “why is this so difficult?”

    Because it is more about the control than the money.

    “Herr Shumlin has to use his Executive Order privilege to nationalize employers payrolls!”

    How is he going to “nationalize payrolls” any more than they already are?

  5. Dave Bellini :

    The Governor wants employers to pay a large percentage of employees health care cost through payroll taxes.

    Interesting because this same Administration will not provide health insurance to many full time correctional officers. The Administration calls them “temporary workers” but they are full time, full duty, academy trained, correctional officers. They are not anything like a seasonal worker. The Administration refuses to give these full time workers sick days or let them into the state employee’s health plan. Until this charade ends I can’t support or believe there is going to be any type of a fair universal health care system in Vermont.

    How can we believe politicians that say they all Vermonters to have quality health care but DENY it to their own full time employees?

    Actions speak louder than words, look at their actions all you true believers………..

    • Sandra Bettis :

      that is the wonderful thing about single payer – everyone is covered – it doesn’t matter who your employer is or if you are temporary or permanent or unemployed – you pay according to your income – the only fair way for every one – no more premiums, copays, deductibles, etc.

      • Robert Hooper :

        Sandra are you mixing up the term Single Payer, which is a funding mechanism, with the term Universal Coverage, which affords coverage to all citizens in a certain geographic or other area? I am not sure I understand the terms to always walk hand in hand when new systems are created. I am actually not sure the administration is at this point firmly committed to employing either at this time.

        • Sandra Bettis :

          well…single payer is health care run by the govt that covers everyone and universal health care is health care for all run by the govt so….

    • Walter Carpenter :

      “Vermonters to have quality health care but DENY it to their own full time employees? ”

      Dave, as one of those temporary workers, though not in the correctional system, I agree with all you say. I have no retirement, no pensions, nothing, just a weekly check. But this condition has persisted before the shumlin administration and will no doubt continue with whoever occupies the governor’s chair after Shumlin — that is, unless we can change it. I was first a temp. state employee in the Douglas administration. It is a ridiculous situation when retirement, pensions, etc rely on the particular type of employment — that some are granted these benefits and others are not, simply by job status. At least with health care now, there is vhap or catamount, such as this program is, and some measure of coverage. It is crazy.

  6. David Schoales :

    The payroll tax is the most best way to fund universal health care because it is deducted from income and therefore not subject to income tax. It is a win-win for employers offering family health care because it frees employers from paying insurance premiums for members of the employees’ families and spreads the cost of universal health care across more employers.
    I understand Vermont is unique, but that doesn’t mean economics doesn’t apply here. Employers, especially schools and municipalities (which means taxpayers) are burdened with an expensive, wasteful health care system. This has to change and no amount of distortion or fear-mongering will stop it.

    • Linda Quackenbush :

      We The People are “burdened” by BIG GOVERNMENT… Many states are talking of succession from this big white elephant. Flat tax everyone including the 12 million “new” immigrants and then “call” yourself AMERICAN… Every American needs to “pay” their fair share including politicians who recuse themselves from the very legislation they endorse and force down our throats! Who are these people? Is King George in the house surrounded by all his nobleman? Welcome to SERFDOM America. What goes around comes around….

  7. Ellen Oxfeld :

    The headline of this article (as opposed to the actual contents) might lead you to conclude that the payroll tax is unpalatable for many businesses in Vermont. But actually, once you read the article you can see that the only business group quoted that is unequivocally against the payroll is the Vermont Chamber.

    In fact, of the other business groups quoted, Vermont Businesses for Social Responsiblity is in favor of the payroll idea, as is David Coates, who chairs the Governor’s business advisory council. Finally, the head of the Vermont Grocer’s Association says the payroll is “logical,” and concludes that whether it helps or hurts a particular business will depend on how it is leveraged.

    Thus, this article actually leads me to conclude that the Vermont Chamber does not speak for all Vermont businesses.

    • Karl Riemer :

      “leads me to conclude that the Vermont Chamber does not speak for all Vermont businesses”
      did anything lead you to suspect that it did?
      The state chamber, as opposed to local and regional chambers, is primarily a legislative lobbying and advocacy association. Members include many Vermont businesses but as well Vermont presences of much larger corporations and a host of non-businesses with business interests. It may claim or intend to speak for Vermont businesses but it directly represents a small minority of them.

      • Linda Quackenbush :

        Thank you for clarifying that the Vermont STATE Chamber of Commerce is not the same as the LOCAL Chambers. The lobbying arm of Montpelier’s Chamber is very powerful and works in liaison with the US government and its various departments. They have huge legal resources and deep pockets to persuade politicians & legislation to garner favor and waivers for their particular interests!

  8. Bob Zeliff :

    Betsy Bishop has complained a lot about the cost health care and the negative impact on business. We now have a way to truely control those costs thru VErmonter insuring VErmonts via Single Payer. We are now starting to see the benefit with Green Mountain Care Board result in Fletcher-Allen coming back with a REDUCED budgets. Real results.

    She and the Chanber now complain about the state decoupling buying health insurance from employers. She say “What we’re interested in is continuing a system where employers, if they are paying for health care, have some level of control over what they are paying for.”

    She clearly means she wants to keep the companies in control of what Vermonters health care benefits are. Companies in control, not Doctors or the employees…Companies!

    We all know how well that has worked over the last 20 years. Companies have reduced benefits, have move to High deductible policies, increased co pays, shifted more of the total cost to the employee….this all has helped the companies but the employees are paying more for less coverage.
    Yep that is the control she and the Vermont Chamber of Commerce want to keep. The Vermont chamber does NOT have the best interest of the common Vermonter at heart.

    They want to keep the companies in the driver seat.

    That has worked so well in the past.

  9. Dan Carver :

    So this payroll tax would be applied to companies with 50 employees or less, correct? (Not addressed in the article.) Larger companies that are allowed to keep their current insurance plans, along with schools and government offices, etc. would be exempt from this tax, otherwise they are paying twice for two plans.

    I do realize the vast majority of businesses in Vermont employ less than 10 employees. The article doesn’t state how the tax ill be applied. Will it be similar to social security, where the employee pays half and the employer pays half? Or is this source of funding just from the small employer and the employee pays their monthly premium, which is based on the plan selected and an income sensitivity easement? Still many things unclear about this program. Make it clearer; less smoke and mirrors.

    • Sandra Bettis :

      true single payer would include everyone – no one would get to ‘opt out’ and have private ins – i’m afraid this will cause a problem in vt.

    • Linda Quackenbush :

      Governmental Health Care Reform is a TRAINWRECK…Anything government touches is a failure. Tort Reform, Medicaid/Medicare fraud taskforce & Health Care Plan Competition across state lines was the best way to address Healthcare reform. Shumlin works for the progressive elites whose only interest is to CONTROL the US Free Market system and force “small businesses” out of business. Governmental burden of massive legislation will certainly force many small businesses into insolvency forcing massive unemployment. Forcing more Americans into the government’s “need based” class!

      Remember…China has just surpassed the US GDP and is now the world’s largest manufacturer of the gross domestic products! Also remember, China is Communist country that welcomes our debt and profits on it using inhumane labor camps and dirty coal to produce cheap products using petroleum based plastics all the while selling them back to the US consumer (NAFTA)… They have the upper hand on our Free Market System…Very Dangerous! The US government has transformed into Elite Corporatism which basically controls the governance of the PEOPLE…LOOK at Germany and the EU? The US dollar is very vulnerable right now…

      • Walter Carpenter :

        “Governmental Health Care Reform is a TRAINWRECK… Health Care Plan Competition across state lines was the best way to address Healthcare reform.”

        How so? I have had experience with health insurance and competition across state lines and it is absolute hell. How are you going to regulate an insurer in Illinois, North Dakota, or Texas? If they decided to deny your claim, which they will, what are going to do? They know you are in Vermont and they are thousands of miles away. And what policies are they going to sell? All high deductibles, with all kinds of exceptions? And then you need to deal with something called networks. Not all medical providers will be in the out-of-state insurer’s networks. I’ve been through this before and it is not pretty. Medicare/Medicaid/Va are insurance programs which go across state lines. Despite their imperfections, they are the best.

        Shumlin works for the progressive elites whose only interest is to CONTROL the US Free Market system and force “small businesses” out of business.

        Shumlin is a small biz guy. Why would he put himself out of business? And how many small businesses have been put out of business because of health care costs and how many would be small business people cannot start their own enterprises because of fear of health care costs in the status quo?

        • Linda Quackenbush :

          Shumlin is PRESIDENT of the Progressive Alliance…That’s all I need to know…

          • Karl Riemer :

            Linda, thank you for your brevity. That everyone gets a chance to contribute is wonderful, even when the contribution is predictably uninformative. These comments sections grow long and we all have to scroll through them to find comments containing new insight. This one is as… what’s the word?… let’s say “transcendental” as yours always are, but it’s delightfully succinct.

    • Lee Russ :

      Dan,

      I suspect you’ve fallen victim to the widespread confusion over the federal Affordable care Act and the state’s own universal coverage plan.

      The fed law takes effect in January (most of it, anyway). The intention is to replace the terms of the fed law with Vermont’s own universal coverage plan starting in 2017.

      The exclusion of employers with more than 50 employees is part of the fed law, not the state’s plan. The Digger article is talking about financing the state plan.

      • Dan Carver :

        Lee, thanks for the clarification. It appears Shummy is out to move Vermont to the top of the states unfriendly-to-business list.

        You’ve got small employers that do not offer health insurance who are marginally profitable (i.e. make ends meet) who will get hit hard; hard enough to say, is the money made worth the headaches/hoops.

        You have larger private-sector employers (some multi-state) who offer excellent benefits who will get hit hard by this tax becaue of the size of their payrolls. They do have options to move away from Vermont–you could run Dealer.com from anywhere on the planet. If they do go, then the small businesses will see their customer base dry up.

        Then Shummy will have to devise a plan to tax the state employees enough to pay for their own wages and benefits–that’s when he’ll realize he’s created a no-win situation.

        I should start planning to sell my houe before housing prices drop 20% or more–a la Windham County with the Entergy decision.
        You know, other than the threat of nuclear war, the 1960’s were a lot simpler…Good thing trigger-happy Barry is in charge!

  10. Phyllis North :

    Single payer could be a good idea for national health care. But if Vermont goes it alone and is the only state with single payer, I foresee potential problems. Will our high payroll and other taxes needed to pay for it discourage people or businesses from coming here? Will sick people, especially sick poor or older people, move here to take advantage of our coverage? Will high income people move away when the new taxes are added on to our already high property and income taxes? Unfortunately, we will be compared and are competing with other states. I fear what could happen if money drains away from Vermont and the health care costs here, already high, rise even higher. I think we should be cautious.

    • Lee Russ :

      It’s always good to be cautious. But remember that the Canadian health care system started in a single province When that was successful it was expanded and adopted elsewhere, eventually serving that entire country.

      We certainly do need to get our plan right. That’s why I have little patience for the opponents of our state plan who attack it repeatedly (I’m not talking about you), often with misinformation. The plan was approved by out legislature and governor, and we should all be talking about how to make it as effective as it can be, not how to kill it.

  11. Stan Shapiro :

    A payroll tax is less fair than a consumption tax. If we were to tax processed sugars,starches ,hydrogenated and saturated fats; as well as alcohol monies could be raised where a level of personal accountability would be in place to pay for health care. For those that would argue that this impacts the less fortunate in a disproportionate way; stop the condescension. We should also subsidize healthy locally grown food so that a burden on those that have income limitations is eliminated. Food assistance should be given for those foods specifically. The result will benefit all and lower health care costs.

  12. Scott Mackey :

    I suspect that the sentiment expressed by the Vermont Chamber reflects the fact that employers offering coverage now can modify their benefit packages to reflect what they can afford. However, once a payroll tax is enacted, the legislature assumes control for how much businesses must pay going forward.

    I am not at all surprised that a payroll tax proposal, as yet undefined, would generate different reactions from the Vermont business community. A payroll tax would have a very different impact on businesses depending upon the type of business they are in and whether they offer insurance now.

    Low wage employers who provide some type of health insurance now would probably be much better off. Low wage employers who offer no insurance would have to start paying.

    Many businesses with average wages near the median income that provide insurance now would probably be only slightly better or worse off.

    The tricky part of a payroll tax is what to do about firms with highly compensated employees and owners. Lawyers, doctors, highly compensated business owners, and successful entrepreneurs could face an enormous payroll tax liability under a payroll tax unless it has a wage cap like the Social Security payroll tax.

    The populists out there will say, “Great, they can afford it. Stick it to the rich.” True enough. However, these wealthy individuals are the ones currently paying the high state income taxes that support state services. They are also contributing to charities, paying the full freight on school property taxes, investing in Vermont and creating jobs. They also tend to be mobile and their businesses in many instances are easily relocated. I know it is popular to dismiss the argument that the rich will leave Vermont for tax reasons, but the impact of a new payroll tax must be considered since the economic cost to Vermont of losing these businesses and individuals is very high.

    One other political issue with the payroll tax is the “trust funder” problem — the folks with huge trust funds who live off the interest and do not have any wage earnings. It may be a small number of people, but it creates an enormous perception problem when small business owners are paying a big payroll tax while these trust funders pay nothing.

    At the end of the day, the trick is going to be creating a funding mechanism that does not reward low wage employers and penalize high wage employers.

    • Craig Powers :

      Great post, Scott. I agree 100%.

    • Moshe Braner :

      Not only would the “trust funders” not pay anything, if the system would be based solely on a payroll tax – they would get something for nothing: free health care. Clearly there must be an income tax component!

      • Dave Williams :

        Moshe, The income tax component can still be avoided or minimized by trust funders. Some trust funders live off savings and other assets that are not counted as income. So these people with millions of dollars worth of assets can minimize their income that is subjected to income tax so they can qualify for property tax prebates, government subsidized health care, and other “income sensitive” benefits. How to prevent wealthy trust funders from taking advantage of the tax system based mainly on payroll and income taxes is a very important question. Some may say that this isn’t a big problem in Vermont, but how do we know that. I’d also say that we should not allow even one trust funder to scam the system and live off the backs of hard working taxpayers. The fairness issue of a tax system based primarily on payroll and income taxes is of real concern here.

        People getting paid “under the table” are also scamming the system based on these taxes, as “under the table” earnings are not subjected to taxes, and are not included when one applies for “income sensitive” benefits.

        • Sandra Bettis :

          unfortunately, there are always going to be people who scam the system – no matter what system we have.

          • Phyllis North :

            Dave – Interesting point about “under the table” economy not paying payroll or income taxes. I know if I want my house painted or a new roof I can get a better price by paying cash under the table. Those people are getting a break now and will get even more of a break if health care is paid for by payroll and income. That’s why I would prefer a consumption tax component. However, then we are at a further disadvantage to the internet and New Hampshire. We leads me again to think that this will be difficult to do as a single small state. Single payer would be better implemented at the national level.

    • Linda Quackenbush :

      Great comment Scott!

      Vermont’s Single Payer HC is setting up an unfriendly business atmosphere by sanctioning VT payrolls to pay for it. This will ultimately alienate start ups and out of state businesses from doing business here in Vermont. Not to mention employees are very wary too of GMC. They will be forced to pay premiums for health care that they may not necessarily want! Accountability, Costs, Budgeting was never implemented with Government sponsored insurance. Again the government shrieks themselves of responsibility and leave the burden to the taxpayers! They only take the money and distribute it by waiver and/or favor! Sounds like an organized syndicate…

      • Bob Zeliff :

        It is the traditional business community presumption that change is necessarily unfriendly to business. If you read the Shumlin statement it is clear that the pay roll tax (aka insurance premiums) is only a component of the method for payment os Vermont self insuring Vermonter, Single Payer.

        I would think a start would welcome Vermont Single Pay. Good insurance would be available to their employees with out the attention units wasted on money wasted on providing and the administration of health benefits. In fact this seem a distinct competitive advantage for Vermont.

        The rest of you comment is essentially baseless diatribe.

        • Dan Carver :

          Hi Bob,

          Please reveiw and restate the middle paragraph of your post. It does not make sense. Thank you.

          • Bob Zeliff :

            Thanks Dan…

            Here is that paragraph corrected

            “I would think a Start-Up” would welcome Vermont’s Single Payer Health plan.
            Thru it, good insurance would be available to their employees with out the unproductive diversion of the Start Up’s money and management attention to providing and administering health coverage. In fact this seems to be a distinct competitive advantage that Vermont will provide to new Start Ups…or to any business.

      • Sandra Bettis :

        health care they may not want? everyone needs health care and, under single payer, the funding is equitable.

  13. Tony Redington :

    San Francisco instituted universal healthcare for its residents in 2004 using a payroll tax on employers with an exemption based on a full-time equivalent employees for smaller businesses. Any employer spending less than $X per hour (this varies over time, my recollection is it started out about $2 an hour) per employee pays a tax to the City–which so happens to also be San Francisco County with Public Health facilities and University of San Francisco Hospital–all public institutions–providing the bulk of health services. San Francisco also is about the population of Vermont. Again, residents of San Francisco only and all state and federal (Medicare, Medicaid, etc.) worked into the system. Thousands of older Chinese and others who never got health care got it for the first time–residency, not citizenship is the test. Not a big deal really.

    Now several years old, it is all there to see and view the reports and evaluations.

    • Linda Quackenbush :

      Tony,
      California is insolvent… It’s being propped up by bedroom politics! Empty governance…

  14. Ralph Colin :

    Phyllis North’s comment above is spot on.

    The governor and all those who have backed his payroll proposal/solution in this column are all too ready to accept its “simplicity” and its superficial equanimity. So great; let’s do it! Someone else – the small businessman -will carry the biggest load. Terrific! I won’t have to pay for it and it’s all free!

    Oh, but wait; how’s it going to work? Is it really as practical as they want us to believe? Yeah, and it may just put a whole lot of those entrepreneurs out of business or they may be forced to move out of the state if they are still able to do so. So who’s going to be left to provide all the jobs that the governor says he’s so anxious to create? I mean he’s losing over 400 jobs at IBM; 35 at General Dynamics; more than 300 next year when he has put Vermont Yankee away and eventually a total of 650 there plus possibly close to a thousand more jobs in companies which have been supporting VY indirectly. And now he proposes to put the SMALL businesses on the precipice by imposing an 18% payroll tax on them – and remember that that includes those mom and pop businesses which even now can’t afford to offer health care insurance to their few employees!

    Yeah. It sure is simple. Except that when you want to go to your local “green” grocer, your local convenience store to buy a newspaper or fill your car’s tank with gas or the local jewelry store to buy a gift for your spouse, that store may NO LONGER BE THERE because the 18% payroll tax closed it down. And by the way, if there’s a SHARED payroll tax to which the employee also has to contribute, that employee may be you. That is, if the store is still there and you still have a job!

    So maybe you should think a little about this before you jump in on the governor’s proposal because maybe it isn’t looking so free anymore as you thought it was . There ain’t no free lunch; haven’t you learned that yet? Everybody’s gotta pay, one way or another and this scheme isn’t going to be cheap. If it’s going to cost $1.6 BILLION just to get it off the ground, what makes you think that that the costs are going to be reduced in the ensuing years? Do you really think you’ll be getting all the health care you want at no cost? That bridge in New York is still available if you want to buy it too.

    So are you still convinced that “single-payer” is such a great deal and that the other guy is going to have to pay for it? Maybe private health insurance isn’t looking so bad after all. Betcha you’ll be paying a whole lot more for Shumlincare in the long run than you ever thought you’d be paying for your family’s insurance. And by the way, by the time we all figure out what a ponzi scheme this all is and what it’s really costing us, the “perp” will be long gone either to Washington DC or more likely to his vacation home in Canada or one of the islands in the Caribbean where he likes to go to get away from it all.

    It’s not as simple as you thought, is it?

    • Sandra Bettis :

      single payer is not free – it is paid for from income taxes – and it will be much cheaper than ins thru a for profit co (which includes bcbs) and everyone will be covered. one of the reasons it is so much cheaper is that the paperwork is lessened by the fact that there is no billing.

    • Lee Russ :

      What in the world is your point?

      You’ve made a ton of assumptions, apparently gotten a key piece of info wrong (Shumlin didn’t say he wants an 18% payroll tax, he said that’s what his company pays now in health care premiums), and completely ignored the fact that this type of system has been proven to actually WORK in many other places on the planet.

      • Karl Riemer :

        Lee, good of you to try, but authors of diatribes have a vested interest in ignoring confounding facts. Starting with a conclusion, working backward through the argument to presume the premise, makes unsupportive evidence invisible, supportive evidence unnecessary.

    • Dan Carver :

      Ralph,

      For another twist, when I think of how, reportedly, 30,000 Vermonters do not have insurance, yet, not too long ago, taxes could have paid for them to be under Catamount for under $5,000 per year, which equates to $150 MM total per year. A far less costly and disruptive proposal than a cost of $1.6 B and putting everyone in a state of chaos as to what the future holds.

      In the current state of affairs, would any smart business person start a new business here knowing this is a high-wage, labor-biased, geographically remote state which may add a new 18% tax on payroll? Although health care is a national issue, there are states that are very pro-job creation, whose actions match their rhetoric.

      • Lee Russ :

        Again, Shumlin didn’t say he wants an 18% payroll tax, he said that’s what his company pays now in health care premiums.

        And putting all the uninsured under Catamount would not have solved the plethora of other problems that are addressed by the universal coverage plan that Vermont has approved.

        And the “cost” of the universal coverage plan is not $1.6 billion in any meaningful sense. That “cost” has to reduced by the current “cost” of everybody health insurance premiums–those premiums will cease to exist when the universal plan kicks in.

        • Walter Carpenter :

          That “cost” has to reduced by the current “cost” of everybody health insurance premiums–those premiums will cease to exist when the universal plan kicks in.”

          Yep. Premiums will more or less cease to exist as will deductibles. Imagine not having to pay a $3,000, $5,000 or whatever deductible before you can use the insurance, never mind the $400 or so premium every month.

      • Sandra Bettis :

        i find it hard to believe that bcbs would have insured 30,000 vermonters for 5,000….the prices i heard from catamount were unaffordable….

      • Sandra Bettis :

        i’m sorry – i read that wrong – you meant 5000 per person – that’s only 416 per month per person – oh yeh, i know lots of folks who can afford that….

  15. Dave Stevens :

    Does anybody recall the Governor pledging not to raise broad based taxes? The governor’s anti tax stance is reminiscent to that of George H.W. Bush’s “read my lips” speech. Bush senior lost the 2nd time around, lets hope the Governor follows suit.

    • Sandra Bettis :

      there are lots of things that we pay for that are not called ‘taxes’ such as car registrations etc. personally, i would rather pay a little more in taxes and get rid of the payment that i make to the for profit ins co every month. and, know that EVERYONE has health care.

  16. David Dempsey :

    The way we pay for health care insurance is far less important than how much health care costs. The way health care insurance is funded doesn’t change the amount that health care providers charge. The work that the Green Mountain Care Board is doing to bring health care costs down is the key to saving money. 30 years ago, insurance premium increases each year were more in line with inflation, and businesses and individuals could afford good, low deductible plans. The rapid rise in health care costs has made those plans unaffordable for businesses and individuals, while health care costs continue to rise. No matter how it is funded, those who can afford health insurance will always pay for those who can’t. Currently, through higher premiums which cover the unpaid bills of the under or unisure . Single payer will also be fundedby those that can afford it, such as businesses and/or employees, maybe through a payroll deduction, as suggested, to pay for people who can’t afford to contribute to the single payer fund. Until costs are controlled, we can only decide who pays and how much, not the amount needed.

  17. Shumlin has been selling single payer as a way to get the cost of healthcare off the backs of employers. That’s what’s supposed to give Vermont a competitive business environment. But, replacing a premium with a tax does not do that. It replaces a bad burden with a worse burden.

    Why worse? For small businesses that cannot currently afford to pay for their employees’ health insurance costs, they will have a new – perhaps unbearable – financial burden with the new payroll tax. For ERISA employers, they will be saddled with brand new tax on top of their current insurance costs that essentially makes them pay twice for insurance (though it’s possible they are ultimately exempt, the financial analysis indicates they cannot be exempt to make the numbers work realistically for those left in a single payer system. It’s also possible that they could drop their ERISA coverage for the state plan, but if it’s worse than their current plan or more expensive their employees will be unfairly punished). For those non-ERISA employers who do provide health insurance, it’ll be a mixed bag of benefit or punishment. Some may do ok, at least in the short term, particularly low-wage employers. Some will be punished, perhaps to the point of destruction. But, consider this fact for this category of employee: they will be trading a flexible cost over which they have some control for a TAX – over which they have no control. In fact, if they don’t pay the tax, they could face criminal penalties. That’s hardly a position any rational business person would put him/herself into. So much for single payer attracting businesses to Vermont.

    Shumlin has scaled back his promises significantly from half a billion dollars in savings to simply hoping that the tax increases under government monopoly single payer will grow more slowly than premium increases under current government regulations and mandates on private insurers. But this hope doesn’t hold much water given the fact that the same government that will plan and execute single payer will spend over $427 million over five years to create the Vermont Health Connect exchange, a “Travelocity-like” website for a whopping TWO, count ‘em, two!, companies providing eligible health insurance policies. Plus $18 million a year to manage the site. This same government is now launching a $6 million advertising campaign to promote this website. That’s more than SEVENTEEN TIMES the amount Shumlin spent on his entire 2012 election campaign. So, if the expectation was to get rid of all the administrative waste and profit-driven advertising and spend the money on helping sick people… not so much.

    What we are more likely to see after 2017, if single payer becomes the law of the land, is a situation in which the cost of the government monopoly system rises even faster than costs under the current government regulated/mandated system. More people will have access to healthcare, driving up overall demand and, therefore, cost. It will be “free” increasing individual demand and, therefore, cost. Businesses will have no mechanisms for applying breaks to the system, and politicians who will then be in charge of the system, looking always to the majority of voters, will have very little incentive to deny services or cut costs. We’ve already seen the activist pushing to expand dental care! Expand vision care! Etc. Fewer doctors will want to participate in a system where they have to treat more patients for less money (we’re already seeing them leave Vermont or retire in anticipation of single payer) driving down supply and, therefore increasing the costs for service…. The businesses that can’t keep up with all these rising costs will become tax criminals. Ingenious.

    Has anybody noticed that since government decided it would be a good idea to help those on the fringes who couldn’t afford health insurance and health care afford these things, we’ve steadily reached a point where NOBODY (or almost nobody) can afford these things. As Ronald Reagan said, government isn’t the solution. Government is the problem.

    • Sandra Bettis :

      if we were talking about true single payer, the businesses would not be involved. costs would go down and health would go up – just ask anyone in any country but ours.

      • Sandra, under a “true” single payer system as you describe, where does the money come from? I appreciate your passion for this ideal, but I don’t think you have any idea about how this must be implemented. You say businesses are not involved, so is the money going to come from an income tax? That would involve businesses and employees on a personal level. A sales tax (on what?) That would involved businesses regarding what they sell, where and to whom. You can’t retool 20% of the state economy and double the size of the state government without involving everybody — businesses, families, the education system, everything — profoundly.

        This is a massive, bureaucratic, expensive, highly politicized government program. It’s not Tinkerbell, and simply clapping and believing that single payer will work in Vermont or the United States or anywhere will not make it so.

        • Sandra Bettis :

          single payer is financed with our income taxes – how is that a burden on business? i never said anything about a sales tax – it is financed with our income taxes alone – the only equitable way to do it. and, as far as proving it works, well, just look at any other industrialized country except ours.

          • Sandra, Vermont currently has some of the highest marginal income tax rates in the country. With those already high rates, we are projected to raise about $625 million in 2013, and this is a good year. In order to raise an additional $1.6 to $3 BILLION in new revenue to fund single payer, you’re talking about multiplying our current income tax burden by at least a factor of four. That’s insane.

            You can’t possibly believe that an employer making $100,000 a year (like, for just one example, a doctor running a private practice) looking at a this kind of hit to his or her personal income tax isn’t going to seriously consider getting the hell out of Dodge. And you can’t tell me that a potential employee (like, again for example, a doctor or nurse) deciding whether or not to take the job in Vermont or New Hampshire where the income tax rate is ZERO, is going to look favorably on the Green Mountain State under these circumstances.

            But, you’ll say, that employee or employer will have free health care! Not if no wealth producers hang around to pay for it, and not if no doctors hang around to administer the services.

            Having a marginal tax rate that is stratospherically higher than any other state in the union will impact employment from both sides profoundly. You can’t think it wont.

          • Sandra Bettis :

            yes, i believe that vt will be an excellent place to live in 2017 – we will no longer be paying exorbitant ins premiums! we will not have to worry about copays, deductibles etc. why do you think the europeans live longer than we do??

          • Linda Quackenbush :

            What rights do the physicians have in the development and implementation of Green Mountain Care? They’re employers to… I envision private practices making very little concessions for Green Mountain Care! The hippocratic oath was thrown out the window along with Shumlin’s ethical business practices. Good luck trying to find a credible doctor…

    • Nick Wilson :

      Your entire argument rests on a series of assumptions that have little basis in reality.

      Every nation that has implemented a “government monopoly” on healthcare, either through direct government programs or regulations has seen lower costs and better results.

      Your belief that this will not happen in Vermont is based on what exactly?

  18. It is not just the payroll tax, but a whole list of all sorts of rules and regulations that will be associated with it.

    There will be people on a state payrolls or outside contractors to manage it all.

    A less costly way, with less government control, would be:

    To require ALL employers to offer a list of standardized plans from which an employee chooses.

    ALL employees HAVE to choose a plan. Single people might choose plan a, married people plan b, etc.

    Each plan has its own premium which is paid 50% by the employee and 50% by the employer.

    Each plan would have deductibles, such as 10%, 20%, 30%, 40%, etc.

    People with some savings might choose a greater deductible and pay a lesser premium, than people without such savings.

    • Sandra Bettis :

      lots of holes in this system – for instance, walmart offers ins but the employees making minimum wage can’t afford it. and, what do you do about folks who don’t have an employer?

      • Sandra,
        Instead of trying to be so ” comprehensive”, it is best to start with something that is doable right away, AND covers about 80% of Vermont’s population. Most of the rest is still covered by Medicaid and Medicare.

        Wal-Mart, etc. would be required to offer the standard plans, etc., and pay 50% of their cost to ALL its employees, not just its part-timers.

        After my plan has shown itself to be less costly, AND less vexing for employees, AND more fair to employees (instead of some being well insured and others having little or no insurance), THEN add other folks.

        THERE IS NO EMERGENCY.

        • Sandra,
          Public employees would also be offered the same standard plans as offered to non-public employees, and pay the same 50% of the premium, instead of the 1950s gold-plated, fee-for-service plans with minimal premium payments and minimal co-pays.

          This will not go down well, but in the interest of fairness to all Vermonters and tax payers, it must be done; some holy cows much be sacrificed, for the good of all.

          • Sandra Bettis :

            in single payer, there is no choice of a plan. we’ll all have the same plan – the way it should be – no haves and no have nots. again, there are no premiums and there are no copays. we will all be paying according to our income which is very much unlike the current system and also the system that will be in place til (hallelujah) 2017.

        • Sandra Bettis :

          THERE IS NO EMERGENCY???? tell that to the 45 million people in the usa w/o health ins!!!!!!!!!!

          • Dave Bellini :

            Sandra do you think a single payer system is a good idea?

  19. Walter Carpenter :

    ” A less costly way, with less government control, would be.”

    William, how is this plan you have outlined going to get costs under control? You still have the same problems which have made our health care so costly while still leaving so many either uninsured or underinsured.

    • Walt,
      The co-pays will drive costs down. Providers will negotiate the co-pay amount, as they are already doing.

      I am merely repeating a plan that has been in effect for some years in the Netherlands.

      It followed a complicated single-payer plan that few understood, did not work, was inefficient and drove up costs. Why should Vermont repeat such ineffectiveness.

      Not all people have the same health, and not all people need the same insurance. One shoe fits all ultimately fits no one.

      • Sandra Bettis :

        one shoe doesn’t fit all – but, with health care, you cannot predict your shoe size next yr. single payer is not at all complicated – there are no copays, there are no premiums, there are no bills.

  20. Dave Bellini :

    THE EXCHANGE: Under the federally mandated exchange Vermont is one of the most expensive states(highest?) to buy health insurance. The state prohibited insurance outside its exchange.

    AS TO “SINGLE PAYER” 2017 AND BEYOND: The only certain thing is that no one wants to define what a universal plan could be and how it will work. It will not be a true “single payer” that much is assured. It might be a large self-insured group plan run by the state. Who’s in and who’s out is TBD. Who pays how much is TBD.

    As a state employee already in a large self-insured plan with low premium increases and good coverage, I’m certain that a new model will cost more, provide less and won’t be run nearly as well. The GMCB rejected the state employee plan as a model. That is an ominous warning. Rejecting a design that is working, predictable and transparent should worry Vermonters. If the state employee’s health plan was chosen, the costs of recreating this on a larger scale would already have been published. It’s too clean and simple. The state wants to keep the debate about what COULD Be going for a few more years. We’re paying a ton of money to people who are working on something that doesn’t exist yet.

    • Sandra Bettis :

      while i agree that the state employees plan is a good plan for state employees, it is not single payer/universal health care or anything close to it. and, as far as premiums go, i am 99.9% sure that the tax will be far less than the premium.

    • Sandra Bettis :

      the reason it will be so much cheaper is you take out the profit motive and the administrative costs (billing etc) – how can that not be cheaper.

      • Dan Carver :

        Sandra,
        When you say, “take out the profit motive” remember our primary health insurance provider is a non-profit.

        If you replace profit with greed, then you must include hospitals – adminstrators and employees who look to be paid more for the same level of work, doctors – whose billing fee schedules are not at the lowest levels possible, lawyers – who, similar to patent trolls, pray upon patients concerns and pocket 33% of an award (and drive up doctors fees for malpractice insurance), and patients – who want the latest and greatest technology and/or drugs to solve symptoms caused by their lack of focus and action to improve their OWN health (and not pay for the services).

        The US does not have the worst health care delivery system; we have the worst health consciuos citizens. It is a fact, we are the most obese “advanced” nation in Earth’s recorded history. (Clue: Doctors do not make you sit on a couch, or force feed you Pop-Tarts.)

        Almost forgot – beaurocrats – as an example, we’ve created a 5-person board whose annual wages are a combined $500,000 plus an undisclosed benefits package–I’ll wager the board will not cost less in the future.

        Prior to the discussion of new payment plans, let’s implement the elimination of excessive system costs first: eliminate malpractice suits, create the statewide fee-for-services schedule, implement a low-cost, yet fair, pay scale for all of the health care providers/workers in Vermont.
        Basically, if the goal is to drive down cost and provide quality service, let’s start with defining “quality service” and the cost to delvier the services. There is already plenty of money flowing into the system to pay for this future more cost-efficient system. Once we’ve lowered costs, then we can get into a new model to pay for it; probably much cheaper and easier to swallow.

        • Nick Wilson :

          “eliminate malpractice suits”

          That is a truly horrific suggestion. No profession on earth should have practitioners who are immune from malpractice law suits when they act incompetently. Further, Texas has pushed the most draconian tort reform (not elimination) in the US, which failed to lower costs or improve quality.

          “create the statewide fee-for-services schedule”

          No one is going to look for bargain basement care when they are seriously ill or in need of emergency care.

          “implement a low-cost, yet fair, pay scale for all of the health care providers/workers in Vermont.”

          Not a bad idea.

          Overall, your plan has been demonstrated to be ineffective at lowering costs or improving quality.

        • Sandra Bettis :

          as i (and others) have said several times before, bcbs might call itself non profit but, when you give your ceo a 6 million dollar bonus, that is a misnomer.

        • Sandra Bettis :

          the usa might not have the worst record in the world but it certainly has the worst record of the industrialized countries. we are more like a ‘4th world’ when it comes to health care.

  21. Dan Luneau :

    After reading this article and all the commentary I am more convinced now than ever that any state cannot go down this path alone. I am strongly in favor of creating a program that would replace the mess that we are in now but, in my opinion, it just is not feasible for Vermont, or any state, to get this done successfully on its own. Too many pitfalls, too many moving parts, not enough money.
    Our business has always provided health care benefits including paid sick leave. We feel it is our responsibility to do so. That said, nowhere in anything I have read up to now convinces me that the alternatives being spoken of will lessen the financial burden we have now.

    • Linda Quackenbush :

      Absolutely agree… We The People are NOW “wards” of the STATE… As taxpayers we are working for the King on the hill and all his elite noblemen! Welcome to SERFDOM…

    • Lee Russ :

      Dan,

      I really hope you look into the issue independently before reaching that decision. If you relied on the postings here to any great extent, you’ve been misled by people who are philosophically hostile to the idea of a universal, publicly funded system, and who do not worry about being accurate, thorough, or even honest in their complaints.

      Keep in mind that the universal care plan set to take effect in 2017 will be funded in part by the funds paid for Medicare-eligible people, and that the amount that the state and its residents now pay for health care is enormous and expected to grow considerably. While the cost of funding the 2017 plan sounds very large, the people who oppose it never talk about the fact that 2009 total spending on health care was $4.7 billion in Vermont, and expected to reach $10 billion by 2019:
      http://www.leg.state.vt.us/jfo/healthcare/November%20Report%20-%20Final.pdf

      The uncertainty about the details of our state’s universal coverage plan is not unusual given that this is 2013 and the plan is not being implemented until 2017.

      Again, investigate this for yourself.

  22. Lance Hagen :

    I find it interesting that there are so many people making assumptions, both pro and con, on a ‘single payer’ plan that we have yet to see any published details.

    That being said, the report from UMass was not very comforting. It states that the yearly operations will require $1.6 billion. This figure also assumes the state can squeeze another $300 million from the feds. If not, the annual bill is $1.9 billion. It also assumes the healthcare service providers are willing to accept payment rates that are 5% above Medicare rates versus what is being claimed to cover the cost of such service, being 30% above Medicare.

    All this only results in a cost reduction in healthcare spending with single-payer versus present system is only 0.60% in the first year and 1.5% over 3 years. To achieve this they had to assume that administration costs could be reduced from 12% to 7% %, which is very unlikely if the state has to hire someone like BCBS to administer the plan.

    I have stated this before, but a study the numbers in the report from UMass (tables 7 and 8) shows if you evenly distribute the $1.6B to $1.9B over the number of people covered under GMC single-payer plan, for a family of 4, this amounts to a tax of $13,600 to $18,800 per year. Now, since ~30% of the Vermont population was previously uninsured or on Medicaid and is unlikely they can afford such a high tax. So assuming that these people will cover 10% of the yearly cost and the remaining 90% of cost is covered by the 70% of the remaining population, the amounts to an annual tax, for a family of 4, of $21,800 to $34,500.

    I just don’t find these figures very comforting.

    • Craig Powers :

      A typical family premium is around $15,000 annually. There is no way that a majority of families will pay $21K to 34K in taxes to support health care for all. You might as well not go to work anymore and keep yourself broke to obtain increased gov’t benefits.

      If Lance’s figures are accurate, this is one scary scenerio for every VT’r who makes an average living.

      • Chris Lewis :

        Perhaps Shumlin is trying to make us all broke so he can go on a real estate shopping spree.

  23. Lance Hagen :

    As a side note, I heard from a friend at UMass that the healthcare report, provided to the state of Vermont, had a section that described options for raising the yearly $1.6 billion. And that these options were so distressful, that the Shumlin Administration decided not to release the section to the public. Now the governor says he will hand the plan to the Legislature in January 2015 (after the 2014 elections).

    I have a feeling this ain’t going to be pretty.

  24. Cynthia Beaudette :

    I find it interesting that in this whole conversation the trees seem to get more attention than the forest. Everyone should know by now, that it was government policy, for the most part, that has caused the high price of health care, particularly in Vermont. I don’t have any faith in the entity which created the problem to solve the problem now. But this solution is not one that should or needs or is even appropriate to be adopted by a FREE capitalistic society. “Government” health care is a Marxist solution….of and by the State…..not of We the People.
    Not very long ago, before State mandated Community Rating and Guaranteed Issue, we had 45 very competitive Insurance companies, and affordable insurance, that most Vermonters enjoyed. Despite Sandra’s aversion of a company making a profit (how absurd, would she work for nothing?!)they all left the State creating a powerful insurance monopoly in this state to pick the pockets of all Vermonters, driving premiums to the point where most could no longer afford insurance at all. Without the competition driving the prices down, premiums went sky high in a few short years. So, here we are, on a path of socialism/ Marxism, again, with the State taking over the monopoly as per Karl Marx.
    I am concerned with a loss of Freedom.
    No Board in a FREE nation gets to tell doctors what they will be paid for their services, just as no board should tell a hairdresser how much to charge for a hair cut, or a plumber to unclog a toilet or an auto mechanic how much to charge for an oil change. How dare they! No government entity in a FREE nation gets to pit the doctor against the patient by saying here’s what you get paid for your little pod of patients, and at the end of the year, if you have money left, it’s yours. The more you deny care Doctor, the more you get in the end for yourself.
    If I am willing to pay for a better insurance, no State in a Free country should have the right to tell me I can’t buy it because it is not on their Exchange. And regardless of what the (progressive) Supreme Court says, no government in a FREE nation has a right to tell me what to buy or charge me a penalty if I refuse. In a FREE nation, Behavior Modification via taxation is not Freedom! And once this seeps into the government’s way of doing business, you will have no choice about what you eat, when you see a doctor for this test and that test, the amount of muscle mass you will maintain and the length of time you and you children will exercise or whatever the common wisdom is of the day…..YOU WILL COMPLY …….or pay a hefty price.
    This week a customer of mine came in to my store. She was short of breath and her lips were cyanotic. She said she had to leave her house because she was upset. She has lymphoma with tumors on her lungs. She may be in remission. She may not. Once a year, to find out the status of her cancer, so as to determine her treatment, she has her Oncologist’s order to have PET SCAN. She turned 65 this year and now, her medical doctor’s office refuses to even ask (so they say)Medicare for approval for the Pet Scan. How FREE are you when you need a test and you have to beg? Her primary doctor says she will be denied. She does not care if the government denies the cost, because if she is denied, her supplemental insurance will cover the cost…..but they want to see the denial in writing. Her doctor refuses to request permission because it is a long application to the government and they don’t want to waste their time.
    This is what we will be getting. Story after story (I already have heard a slew of them) of government rules and regulations made for the masses. Not for the individual, which is what this nation has always been about.
    And since I am the last to comment, I’d like to say here that Health Care is NOT a Right. Why? Because NOTHING can be a Right if it has to be provided by another. If a Right has to be provided by another, then, you have taken away the provider’s rights of freedom. Food can not be a Right. A farmer can not be forced to provide you with food.

    • Sandra Bettis :

      uh…marxism/socialism/govt is the people – corporations/ins cos are not people…..i think you are blaming the wrong ‘people’.

    • Sandra Bettis :

      you obviously don’t understand ‘non profit’ (such as govt) – the workers still get paid. in ‘for profit’, the ceo’s make billions. which would you prefer?

      actually, in every free country but the usa, they have single payer health care. you think that regular workers should get told what they are paid but drs are somehow immune to that?

      and why should you have better ins than the next person? are you better than them????

      • Jon Corrigan :

        Why do you think the IRS is going to play such a key role in implementing the ACA? With electronic health records available to many federal and state organizations at the push of a key, it’ll be quite easy to determine who’s a ‘net asset’ or ‘net liability’. I predict you’ll be able to answer your own final question in short order.

        • Sandra Bettis :

          well, with single payer (what i am advocating for), it will not matter who is an asset and who is a liablility – we will all have the same health care – as it should be. 2017 can’t come soon enough.

          • Jon Corrigan :

            Sure we will – everybody’s equal (except Congress Critters, federal employees, state employees, union members, etc.). Pardon me if I don’t hold my breath waiting for utopia.

          • Sandra Bettis :

            in single payer, we will all have the same plan – govt employee or not – no haves and no have nots.

      • Linda Quackenbush :

        Unfortunately Sandra the US government no longer works for the American people. Crony capitalism is the new US governmental corporation of legislation and regulation. They regulate us with massive legislation and regulation of healthcare. Yet they excuse themselves and their crony capitalists from the same health care by the way of governmental cronyism in the form of waiver and favors.

        The US government has the power to put the American people out of business! So far they have become quite successful at designing legislation that banishes free market choice! Nationalized Healthcare is controlling the American people by implementing massive “one stop” legislation and regulation that gets rid of local control, local choices and public due process. As Americans we are relinquishing our rights little by little every day to a self-serving government and that’s very dangerous to our American FREEDOM…

        • Sandra Bettis :

          i guess you are saying that we should have no govt regulation on health care? that worked really well with wall st….i’m sure the ins cos will feel bad for us and do right by us….just like they have in the past…

    • Sandra Bettis :

      there are plenty of horror stories from people who have ins also.

    • Sandra Bettis :

      and, there is a big difference between govt non profit (where the workers get pd and the directors don’t get millions and there is truly no profit) and cos like bcbs who call themselves non profit but, as we found out last yr in the press, are not.

  25. Linda Quackenbush :

    One important piece of information…Doctors have been “forced” to subscribe to this massive government controlled insurance called Green Mountain Care. Many doctors are retaliating and not taking any more “new” patients and/or enlisting long waits for new patients. Lets face it, Doctors got the shaft and were never involved in the decision making process that directly involves their livelihood. Anything the government does is a complete failure…

    • Sandra Bettis :

      i wish it was govt controlled health care instead of ins co controlled health care. those poor drs…they must be starving….

      • Peter Bosco :

        I wonder why you feel you have the right to another person’s talents and services on your terms, that you are so disparaging to physicians with your “poor drs” comment. This is just the start. Food, shelter, clothing, automobiles, plumbing, education, literature, entertainment, cell phones, internet access, etc, can all be labeled as “rights”, but that does not mean they are. Forcing physicians to participate in this system is coercion by legislation. Single payer healthcare is just the beginning.

        • Sandra Bettis :

          someone else gets to determine what i am worth when i get paid. i’ve never heard of a poor dr, have you? you don’t think education is a right either? i guess you don’t believe in public schools then. personally, i feel we are way behind other countries in our rights and we are paying for it by going downhill every day.

          • Peter Bosco :

            Physicians typically are 30+ years old before they make any real income. And the training is intense and time-consuming. So they give up 10 years of income and time that folks in most professions don’t. They are trusted with the most important resource, the lives and health of ourselves and our loved ones. The laws of supply and demand dictate that they are valuable.
            As for education, I believe education is the great equalizer, and we should introduce competition into education via a voucher system. We are either number 1 or 2 ON THE PLANET in what we spend per capita for public education, and we are getting a substandard product. Thank you for proving my point. Government can’t get education right, which should be a lot more straightforward than healthcare.
            You are correct regarding our rights and freedom. The more government, the more regulation there is, the less freedom and rights people have. The answer is smaller government, more free-market competition, and no more government subsidies to ANY industry, which selects winners and losers based on political patronage and party affiliation.

          • Sandra Bettis :

            you really think that capitalism is working well? you must be one of the 1% because i can tell you that, for the rest of us, it isn’t. maybe, if we supported education (with our pocketbooks)in this country, we wouldn’t be so far behind – not sure how you see that as the fault of the govt – unless it’s because our priorities seem to be the pentagon over education. as far as govt regs go, did you think that deregulation worked well for wall st???

          • Peter Bosco :

            Ms. Bettis, we spend more per capita on education than any other developed nation in the world, and still do poorly comparatively. You must be a teacher, thinking more money is needed. A publicly funded voucher system, giving parents the CHOICE to take their child out of a failing school and move them to a better one would fix this right up, but the government monopoly and teacher’s unions can’t have that! As for your 1% comment, nice try. Clearly you can’t argue the facts, so you resort to name calling and wealth envy. Come up with some real arguments.

      • Cynthia Beaudette :

        Government is a necessary evil which always seeks more and more power until We the People have no freedom. The Founders contorted for months for a way to prevent this from happening by creating three branches of government: checks and balances so a monopoly or oligarchy could not be created. Government exists for one reason Sandra: To protect your Rights. Government can not create Rights. The Rights they are sworn to protect, are Natures Rights or God given rights. Rights you are born into. That is the only function of government. To ask that government do more, or in your case demand, is sheer folly. To insist that other countries provide free health care at no cost is sheer ignorance. The cost of socialism and entitlement spending has been enormous. All EU countries are broke. In Greece, they have confiscated the people’s bank accounts. We are in a global recession as a result of global governments spending more than they take in. The house of cards they have created could collapse at any moment and most economists foretell it will. The United States is on the verge of becoming a third world nation as a result of losing the dollar as the world’s currency. The Fed decided yesterday to keep printing phony money (85 billion a month) and gold went up $60 dollars an ounce in one day. The middle class picks up this tab. The 18% payroll tax, we are talking about, will have to increase by 2% a year just to keep up with the government mandated inflation rate to the FED. In ten short years, the payroll tax will have to be 38% just to keep up with inflation. Add 15% for FICA and the government, who is promising us Utopia, will be removing 53% of your paycheck before you get to spend a dime. It isn’t the insurance industry who is evil because they want to provide a service and expect a payment for such, it is government which under the pretense of benevolence, is creating a monopoly and using their new found power, to take away your freedom. Never in the history of mankind has socialism ever lasted and it usually never ends pretty. In the words of M Thatcher, Socialism can not work because eventually you run out of other peoples’ money.

      • Sandra Bettis :

        i have heard just the opposite of va health care. i had a child on va health care – she cost us $1.

  26. Cynthia Beaudette :

    ”People willing to trade their FREEDOM for temporary security deserve neither and will lose both.”

    Ben Franklin

  27. Peter Bosco :

    There is no free beer. You get what you pay for. I suspect as this system develops, fewer physicians will come to Vermont, and health care will be increasingly provided by less-trained practitioners. Good luck with that.

  28. Cynthia Beaudette :

    38% of Vermont specialists have quit medicine or left the State of VT in anticipation of what’s coming. 24% of primary care physicians have as well. VT physicians’ salaries are already considerably less than other states. A new study released today reported that 80% of all physicians nation wide are considering a change out of medicine. I heard today (can’t say that it is fact) that 95% of dental students in dental schools today are from foreign countries. They will not becoming to VT to replenish the aging dentist population. They are only interested in practicing in cities. Conceivably, Vermonters could be paying a sky high price for health care with no one to deliver it.
    I am curious as to what happens to the State plan if Obama Care is defunded?

    • Nick Wilson :

      First, please link to something that proves both your stats and the reason for them (and I mean any of them).

      Second, “I am curious as to what happens to the State plan if Obama Care is defunded?”

      Well, it will probably get fast tracked, since the waiver we must wait for will no longer be necessary.

  29. Walter Carpenter :

    “I suspect as this system develops, fewer physicians will come to Vermont, and health care will be increasingly provided by less-trained practitioners. ”

    Perhaps the opposite will be true. More physicians will come to Vt to do what they are actually trained to do rather than struggle with insurance companies.

    • Peter Bosco :

      Physicians are not trained to work in a system constrained by rules and regulations dictated to them by a government bureaucrat for substandard pay. So I’m not sure why any would come to VT. Would you?

      • Nick Wilson :

        “Physicians are not trained to work in a system constrained by rules and regulations dictated to them by a government bureaucrat”.

        No, every doctor currently practicing is made aware of the rules and regulations on their field as legislated by the government.

        States also create new healthcare laws all the time.

        As far as how many doctors will come to VT, that remains to be seen.

        What we know so far is your underlying concept for why you think they won’t come is incorrect.

        • Peter Bosco :

          You are engaging in magical thinking, typical of the liberal mentality. Your stating my conclusion is incorrect does not make it so. This is not a change in regulation. This is a hostile takeover of medical care for an entire region, run by bureaucrats, who will dictate what tests physicians can order and how much they can make. Do you really think highly trained, intelligent professionals want to work in such a system? Time will tell which one of us is correct.

          • Sandra Bettis :

            you don’t think that ins cos haven’t been dictating which tests we can have for yrs??????????

          • Peter Bosco :

            Insurance companies have tried to dictate such things, but the balancing force of government is there to limit what they can do. Once government controls it all, who is going to provide the balance?

          • Sandra Bettis :

            when an ins co turns down your claim, the govt gets involved? i have never ever seen or heard of that happening….i think you are misinformed….

          • Peter Bosco :

            Ms. Bettis, obviously this concept escapes you. Government gets involved by regulating insurance companies and preventing overt fraud and abuse. When you have 2 entities at odds, the consumer is protected. Who will regulate the regulators when they are one and the same?

          • Sandra Bettis :

            well, if the govt was regulating the ins cos, they’ve been doing a crappy job. i see no evidence that they have been. as far as the govt providing health care, in my opinion, they would do a lot better job than a for profit ins co. and, as i think i’ve mentioned before, it seems to work well in the rest of the industrialized world…

          • Peter Bosco :

            You’re finally right about something!!! “Government does a crappy job.” Yes, all you have to do is look at the Post Office, Medicare, The Department of Energy, the Department of Education, Medicaid, the VA system etc….. Why do you think they could get this right?

          • Sandra Bettis :

            the only depts that i would find fault with are the ones who oversee wall st and the military (not va, but the pentagon). the reason i think that they would do a better job than the ins cos is because you are taking away the profit motive.

          • Peter Bosco :

            The only true motivator is profit. Why do you think they don’t wait in line for toilet paper in Russia anymore? Why do you think Fed Ex and UPS aren’t in debt, but the post office is? Why do private schools turn out better educated students than public? Because if they don’t, they go out of business!

          • Sandra Bettis :

            the govt is truly non profit (not like bcbs who says they are then pays their ceo a 6 million bonus). when there is a profit in the pic, people come last. look at the disasters on wall st. look at any ins co or corporation. the po is in the red because they were forced to fund their retirement system way into the future – the only place that has been forced to do that – why? so that private cos like fed ex and ups could take over. look at the privatization of prisons – that is a fiasco. and, if we privatize our schools, only the rich will be educated – is that what you want?

          • Peter Bosco :

            If the government is “nonprofit” as you say, then why does everyone who goes into politics, Republican, Democrat, and otherwise, somehow leave office much wealthier when they went in. Ideally, government is nonprofit. Reality is that the government is run by people, with their own selfish agendas and motivations, that often have nothing to do with public service. Your error is in seeing government as this idealistic entity, not an organization run by people with their faults and deficiencies and selfish wants and needs. These people are more about control and their own self-advancement. Every agency created by government takes on a life of its own, with ever increasing costs, budgets, and overpaid administrators.

          • Nick Wilson :

            No, I am replying to the comments you have made.

            “Your stating my conclusion is incorrect does not make it so.”

            No, the irrefutable facts I have cited prove the logic you used to arrive at your conclusions is faulty.

            “This is a hostile takeover of medical care for an entire region, run by bureaucrats, who will dictate what tests physicians can order and how much they can make.”

            This is, at best, a blatantly disingenuous description of single payer.

            And for the record, every country that has enacted government run healthcare has seen greater efficiency, lower costs and better results.

            Your problem is that the facts don’t conform to your ideology, and you simply refuse to accept these realities because you believe things should not be so.

            A typical problem among conservatives.

          • Lee Russ :

            I have what you consider a liberal mentality and magical thinking is not something I like or even respect. I see even more examples of magical thinking from conservatives, who hold the abstract concept of “the market” in such esteem that you would think it was a deity.

            Most of the examples you have cited as showing the superiority of the profit motive (post office vs UPS, public schools vs private schools, etc) don’t, in fact demonstrate the superiority of the profit motive at all. They demonstrate that it is easier and more lucrative to serve only a portion of the public than it is to serve all the public,

            In other words, cherry picking works for the cherry picker, it means deprivation for those of us who are not cherries.

            Your concerns about doctors avoiding Vermont reflects one unproven theory. I know doctors who think that single payer is the only way to go, but they don’t run around the state screaming that opinion at the top of their lungs. Those doctors who are philosophically opposed to publicly financed healthcare, on the other hand, make as much noise as they can.

            In another comment you stated that “The rates will be 5% above Medicare.” Please supply a reference for that if it is, in fact, a fact. If it is not a fact, please acknowledge that so as not to mislead people about what is fact and what is opinion.

          • Peter Bosco :

            Regarding my source, that number is quoted in Vermontfreedomhealthcare.org. Unfortunately they do not cite their source, so I do not know the origins of the number. Regarding your claim that UPS and Federal Express skim the cream, last time I checked, the post office charges for its services, and their rates have been going up dramatically compared to other services. Also, regarding education, United States plays more per capita to educate its students in the public system than any other developed nation. Those that choose to send their children to private school still have to pay taxes to fund the public education system. I have talked to many people Who have experienced healthcare in single-payer systems in other countries, and most of them feel that American healthcare is better. I have a friend in England, was very liberal, who talk about how wonderful England single payer system is. Then he went on to say How wonderful his sister she made was in England, and how she had a private room and everything. Then he divulged that she had supplemental insurance that got her more expedient cash then people who did not have a supplemental plan that they paid out-of-pocket for. He acknowledged that those who don’t get supplemental plan have to wait much longer and those were willing to pay extra for expedited care. (Those who want to criticize my grammar, please note that this is using voice recognition software, as I have grown tired of trying to type on my iPad)

          • Sandra Bettis :

            that website that you mention is financed by the koch bros.

          • Peter Bosco :

            If it’s financed the Koch brothers, than I know it is at least more reliable than Soros’ MSNBC. We all have our political bogeymen, don’t we?

          • Lee Russ :

            Peter,

            You’re still citing examples that demonstrate the results of cherry picking. The post office financial “problems” for example are two-fold:
            (1) they deliver letters to everyone, everywhere, at less than the cost of doing so, which used to be subsidized by the profit made on package delivery; that gave us all a “postal system.” Now UPS and FedEx undercut the profitable package delivery, leaving less profitable mail to the post office.
            (2) the congress passed a law requiring the post office to fully fund the pensions going well into the future. The money they set aside to comply with that law is deducted from their revenue to produce the ballyhooed “losses.”
            Public schools are geared to educating everyone; private schools pick off some of the better students, none of the worse.

            Cherry picking simply does not indicate that “the profit motive” is always the way to go.

          • Peter Bosco :

            Lee, the post office is poorly run, and their ridiculous pension system is part of the problem. No private industry has a pension system as out of control as those in the public sector. I know of people who worked in public jobs, that retire on a full pension in their 40s because they have 25 years in their government job. They then work under the table as landscapers and carpenters while collecting their pensions while taxpayers pay them. If the government takes over health care, do physicians become public employees, and after 25 years get to retire on 80% of their income. The problem isn’t that private industry siphons off profit, it’s that government agencies are poorly run and have an unrealistic pension system that is unaffordable. Government run industry doesn’t have to run a tight ship, they raise taxes or create deficit spending to cover their mismanagement. Until we fix the problems with the way government works, it won’t get fixed. Adding health care to the list of government run systems will only make it worse and the cost of government more expensive.

          • Sandra Bettis :

            wow – 80% – i wish!

          • Sandra Bettis :

            the taxpayers pay the pensions? i als always thought the employees earned earned them.

          • Peter Bosco :

            “the taxpayers pay the pensions? i als always thought the employees earned earned them”

            In addition to being unable to type coherently, or use proper grammar, punctuation, or capitalization, you obviously are unable to comprehend the mathematics of the Ponzi scheme behind government pensions. I’d apologize for being critical of your verbal skills, but given you chose to mock me for their vs they’re, one would expect at least an attempt at proper grammar from the criticizer.

          • Sandra Bettis :

            sorry about my typing – with the new website, i am afraid i am typing blindly.

          • Sandra Bettis :

            actually, it’s 30 yrs. compare the cost of a private school to a public school. compare the cost of a private prison to a public one. what happens when you add a profit motive?

      • Sandra Bettis :

        i guess they’ll be just like the rest of us then.

        • Todd Taylor :

          Doubtful, Sandra. Professionals tend to migrate to where the jobs are plentiful and taxes are reasonable, while moochers tend to drift to where the most freebies are. Moochers can’t long survive on the good will of other moochers, once all the professionals have departed the sinking ship.

          • Sandra Bettis :

            i tend to see more professionals than moochers in vt – maybe it’s the climate.

          • Nick Wilson :

            “Professionals tend to migrate to where the jobs are plentiful and taxes are reasonable”

            Again, I’m sure your ideology tells you this is so. The facts, however, are against you.

            If you actually bother to look at the stats, their is absolutely no correlation between tax rates and availability of professionals.

            If this were so, Mississippi would be the capital of the country for professionals.

            “moochers tend to drift to where the most freebies are.”

            Again, try looking up actual stats regarding the number of people on welfare by state. Red states that have stated their main goal is to impose the greatest hardships on the poor are not succeeding in driving them out to more enlightened states.

            I know it is difficult for you to look at the situation objectively, but you might give it a shot.

      • Walter Carpenter :

        “Physicians are not trained to work in a system constrained by rules and regulations dictated to them by a government bureaucrat for substandard pay.”

        Who says the pay will be substandard? And, for one, at least it will be standardized to a far greater degree than now where the same procedure might have a dozen different rates depending on the insurance the patient might have. And if they do not have insurance they pay the most of all.

        • Peter Bosco :

          The rates will be 5% above Medicare, which reimburses 30% less than private insurance. Vermont has high taxes and a high cost of living. So, comparatively low income + comparatively high expenses = difficulty attracting talent. It’s simple math, really.

  30. Tony Elliot :

    In my area we are losing doctors and what I have been hearing is they don’t like the idea of a government run monopoly. A retiring dentist told me he could not get someone to take over his dental practice for the same reason.

  31. I’m sure it is just a coincidence that my dermatologist in St. Johnsbury just sent me a letter yesterday saying he is moving his practice to Littleton, NH. Yup, probably just a coincidence.

    • Sandra Bettis :

      or maybe he belongs to the gop (greedy old party).

      • Peter Bosco :

        Or maybe he just wants to be fairly compensated for his education, training, knowledge, skills, compassion and services? Because despite what you say, Ms. Bettis, no one is giving away anything that they worked for. Your socialist politicians aren’t giving away anything of their own. Their redistributing everyone else’s services and wealth while they laugh all the way to the bank.

        • Sandra Bettis :

          all of us would like to be paid what (we think) we are worth. (did you mean they’re?)

          • Peter Bosco :

            It is clear that you can’t win the argument based on sound reason and logic, so you’re mocking my grammar instead. If you analyzed your own writing, you would realize that you shouldn’t throw stones. However, I overlook your grammatical deficiencies, because this is a forum for ideas and debate, not an English class. But thank you for pointing out my occasional error in spelling, since you clearly are unable to argue against sound logic and reality.

        • Linda Quackenbush :

          You hit the nail on the head…Career politicians are self serving hypocrites that protect the interests of not only their Party but their jobs and their pocketbooks. Most business people don’t align with Obama’s ideologies because he personally attacks viable successful businesses by enacting massive expensive “unread” legislation that is fiscally irresponsible and corrupt. Successful businesses that oppose Obama and his bully pit gets assaulted personally or he goes after their livelihoods by garnering a massive TAX/Obamacare not only from employers but from their employees. Obamanomics rewards Failure and punishes SUCCESS…

          Obama and his Progressive machine is setting US up for “Top down, Bottom up” economics failure. Obama’s and his Progressive machine are passing unsustainable, unfunded, nonviable massive legislation in Healthcare, Education/Common Core & Renewable energy/Cap & Trade. This massive expensive expansive federally mandated legislation will ultimately bankrupt US as a nation. Throw a another WAR into the mix and you have total devastation of US dollar and Free Market system. Cloward & Piven will ultimately squash and force the Middle Class into “2” classes…The elite Rich & Poor. Then we have a Real & Present danger of an “elite” crony multinational US Government CONTROLLING its people by forcing its citizens into governmental welfare programs that are CONTROLLED by the US Government and China. Remember, Communist China is now #1 leader in the manufacture of gross domestic product (GDP) surpassing the US. China is using its poor citizens as slave laborers who manufacture and assemble US products for US multinational companies who sell it back to US (NAFTA)! The US government, Multinational corporations, Elitists and China have become business partners using its poor citizens as its biggest money making commodity! Shame…Shame on them!

      • Craig Powers :

        Sandra:

        This is a very unnecessary and repugnant reply to Sen. Benning. Do each side a favor and try to keep your discourse civil.

        • Sandra Bettis :

          dear craig, i will try. :) it’s really hard not to be sarcastic tho when a person cites one example and sees it as a trend….

    • Lee Russ :

      Senator Benning: Assume for the sake of argument that Vermont’s healthcare reform is why your dermatologist is moving to NH. What does that tell you? Is your dermatologist speak for all doctors, or most doctors, or any doctor other than himself?

      I know doctors in Vermont who are thrilled with our healthcare reforms. There is evidence that some doctors outside Vermont would be attracted to the state by a sensible and comprehensive healthcare system.

      A single anecdote doesn’t really help the debate at all and can easily serve to distort it.

    • John Greenberg :

      Senator Benning: My cardiologist re-opened his Brattleboro office after having one only in Keene. Coinicidence? Meaningful?

      Drawing inferences about hundreds of people from one example is a pretty risky endeavor, don’t you think?

  32. Cynthia Beaudette :

    All Discussions
    My Discussions
    Add
    .

    A Peek at Our Future, Thanks to Democrats: Tales of British Health Care
    Posted by Myrnalynn Bennett on September 26, 2013 at 3:20pm in Tea Party Nation Forum
    Send Message View Discussions
    .

    On July 7, 2010 Barack Obama appointed Dr. Donald Berwick to administer the Centers for Medicare and Medicaid Services. He has since resigned. This is what he said of the British health care system, the NHS:

    “I am romantic about the NHS; I love it. All I need to do to rediscover the romance is to look at health care in my own country.”

    From the Daily Mail:

    “Hospitals are paid millions to hit targets for the number of patients who die on the Liverpool Care Pathway, the Mail can reveal. The incentives have been paid to hospitals that ensure a set percentage of patients who die on their wards have been put on the controversial regime. In some cases, hospitals have been set targets that between a third and two thirds of all the deaths should be on the LCP, which critics say is a way of hastening the deaths of terminally ill patients. At least £30million in extra money from taxpayers is estimated to have been handed to hospitals over the past three years to achieve these goals. Critics of the method warned last night that financial incentives for hospitals could influence the work of doctors.”

    “An elderly woman died alone after doctors failed to tell relatives they were ending her life on the controversial Liverpool Care Pathway. Olive Goom, 85, passed away with no one by her side after medics neglected to consult with her family about her treatment at Chelsea and Westminster Hospital. …As Miss Goom lay dying alone, staff reassured relatives on the phone just hours before her death that there was no urgent need to visit – even though doctors had already removed tubes providing vital food and fluids. Her family discovered that she had died only when her niece went to visit her and found she was already being prepared for the mortuary. They said last night that they will never be able to stop feeling guilty that no one was there in her final hours. The Mail has been contacted by several families who claim that relatives were put on the Liverpool Care Pathway – the controversial system designed to ease the suffering of the dying in their final hours – without any consultation. Some said they found out that their relatives were on the pathway only after they happened to read their medical notes; and by that time it was too late.”

    From the Independent:

    “Hip replacements, cataract surgery and tonsil removal are among operations now being rationed in a bid to save the NHS money. Two-thirds of health trusts in England are rationing treatments for “non-urgent” conditions as part of the drive to reduce costs in the NHS by £20bn over the next four years. One in three primary-care trusts (PCTs) has expanded the list of procedures it will restrict funding to in the past 12 months. …According to responses from the 111 trusts to freedom-of-information requests, 64 per cent of them have now introduced rationing policies for non-urgent treatments and those of limited clinical value. Of those PCTs that have not introduced restrictions, a third are working with GPs to reduce referrals or have put in place peer-review systems to assess referrals. In the last year, 35 per cent of PCTs have added procedures to lists of treatments they no longer fund because they deem them to be non-urgent or of limited clinical value. ..Bill Walters, 75, from Berkshire, recently had to wait 30 weeks for a hip operation instead of the standard 18.”

    From the Telegraph:

    “Women in labour have been forced to wait while epidural equipment was borrowed from other hospitals, while other patients have been denied chest drains and radiology supplies, according to doctors at South London Healthcare Trust. Minutes of a meeting between medical staff and the trust’s chief executive say “cash flow” problems at the trust which has a £50 million deficit, mean vital equipment is regularly not ordered. A separate letter sent to managers of the trust, one of the largest in the country, says consultants have been misled into carrying out operations when it was not safe to go ahead because of bed shortages. …Doctors told managers “again and again” that consultants were unable to know that equipment was missing until the last item had been used, when their patient was already lying on the table, according to the minutes of June 16 meeting.”

    From the BBC:

    “The NHS is failing to treat elderly patients in England with care, dignity and respect, an official report says. The Health Service Ombudsman came to the conclusion after carrying out an in-depth review of 10 cases. The ombudsman, which deals with serious complaints against the NHS, said the patients – aged over 65 – suffered unnecessary pain, neglect and distress. Charities said the findings were “sickening”, while the government admitted improvement was needed. …Several themes became clear from the ombudsman’s analysis. Half the people featured did not consume adequate food or water during their time in hospital. Some were left in soiled or dirty clothes. …In another case, a cancer patient wanted to be discharged to die at home. When his daughter arrived to collect him, she found him sitting behind a closed curtain in distress. He had been left for several hours in pain and desperate to go to the toilet. He was unable to ask for help because he was so dehydrated that he could not speak or swallow.”

    If you don’t want this in your future, now is the time to call your senator.

    Please see main article: “Nightmare on Constitution Avenue: The Real Intent of ObamaCare”

  33. Ellie Belansky :

    I am retired from UVM and they cover my healthcare. I would like to move to North Carolina because I cannot afford to live in Vermont any more. My husband is a Disabled American Veteran. My question is as follows. If Vermont enacts a Single Payer System, will I still be covered with my UVM health plan?

    • sandra bettis :

      don’t move to nc – they are cutting benefits as we speak!!!

      • ellie belansky :

        who is cutting benefits, is it UVM? what happens if we are on medicare and have J-CARV as a supplement?

  34. sandra bettis :

    ellie – nc stands for north carolina. also – what happens if you are on medicare and have a supplement? you will save money as you will no longer need a supplement.

  35. ellie belansky :

    Sandra, My husband is going on medicare this June. What happens if I relocate to North Carolina. I have 4 years left until I reach 65. Will UVM still cover my supplement? Thanks, Ellie

    • sandra bettis :

      i have no idea -you’d have to ask uvm – but i can’t imagine that they wouldn’t if they have in the past.

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