Protesters demand action on single payer, condemn Shumlin’s reversal

A protester burns a medical bill in a demonstration against Gov. Peter Shumlin's decision not to pursue single payer health care in the next legislative session. Photo by John Herrick/VTDigger

Cindy Taylor of Bennington burns a medical bill during a demonstration against Gov. Peter Shumlin’s decision not to pursue single payer health care in the next legislative session. Photo by John Herrick/VTDigger

Protesters from across the state descended on Montpelier Thursday to voice their anger with Gov. Peter Shumlin’s decision to drop his pursuit of single payer health care.

More than 60 people stood in front of the Statehouse chanting slogans and singing protest songs.

“All people, all care, make the rich pay their share,” they shouted, “The system, let’s stop it, our health is not for profit.” And: “Down with Shumlin, up with the people.”

Many shared personal stories of struggles to afford health insurance or medical services, highlighting barriers to care such as high deductibles, copayments and other forms of cost sharing.

Several burned medical bills they said they would never be able to pay off.

Among those was Cindy Taylor, 48, of Bennington, who burned $3,000 in bills from two separate emergency room visits for her daughter that were close to eight years old, she said.

Taylor has had trouble staying covered, and when she is able to enroll in Medicaid for periods of time, it’s difficult to find doctors and dentists willing to accept her as a patient, she said.

Her daughter, now 24, had to drop out of college because of medical debt and is currently uninsured because she can’t afford the premiums on the Vermont Health Connect exchange, Taylor said.

Protesters focused their ire on Shumlin. The governor acknowledged the disappointment of his supporters in remarks Wednesday, but said the economics of single payer wouldn’t allow the program to move forward anytime soon. He called it “the biggest disappointment of my public service so far.”

But protesters were unappeased Thursday, asserting that Shumlin supported single payer while it was politically advantageous, but turned his back on the interests of the working class when he encountered resistance from business leaders.

They marched up to his ceremonial office in the Statehouse to deliver a platter of toast with the message, “Dear Shumlin, your career is toast.”

The protest was organized by the Workers Center, whose director James Haslam, strongly condemned the governor’s reversal on single payer as a betrayal of thousands of his supporters.

A message to the Board

They carried a massive and unflattering cardboard effigy of the governor to Montpelier’s City Center and packed a conference room where the Green Mountain Care Board was holding its weekly meeting.

Protesters demanded that the five board members affirm their commitment to press ahead with universal publicly financed health care, with or without Shumlin’s support.

After some tense moments, the board decided to forego other business and open the meeting for public comment. Many shared their stories with tears in their eyes, and voices that quavered at times.

James Haslam, executive director of the Vermont Workers Center, leaves a platter of toast outside the governor's ceremonial office at the Statehouse on Thursday, A sign directed at Gov. Peter Shumlin reads "Your Career Is Toast.  Photo by John Herrick/VTDigger

James Haslam, executive director of the Vermont Workers Center, leaves a platter of toast outside the governor’s ceremonial office at the Statehouse on Thursday, A sign directed at Gov. Peter Shumlin reads “Your Career Is Toast. Photo by John Herrick/VTDigger

“I make no assumptions of the board up there that they were fortunate enough to have a two-parent household, not live in poverty, not struggle … hopefully that’s what your family looks like, but that’s not what all families look like,” said Shela Linton, of Brattleboro.

“I’m a single parent of two, and like these youth over here I have a 20-year-old who is a sophomore in college. Currently, our health care system that I pay almost $8,000, $9,000 a year, doesn’t afford access to health care for either of us,” she said.

Her insurance doesn’t cover dental care, vision or certain mental health services, she said. The co-pays and deductibles make the insurance unusable in many situations.

“My daughter … has a $1,200 deductible, which means that every time she goes to the doctor it’s out-of-pocket,” Linton said.

Her daughter left college because of student loan debt, and now on top of that she has medical debt that she is unable to pay off, Linton added.

Melissa Davis-Bourque, 35, of St. Johnsbury is a stay-at-home mother of three who had one daughter in tow. She told the board that Shumlin’s reversal felt like a “sucker punch.”

“We do not have the luxury of letting (Shumlin) choose when it’s politically good for him while people are sick and dying, that’s not an option for us,” Bourque said.

The protesters who packed the board meeting are only a fraction of those who want Vermont to pursue sweeping health reforms. Many from the Northeast Kingdom could not make it to Montpelier in the middle of the day, Borque added.

A call for patience

Deb Richter, a longtime single payer advocate who regularly attends the Green Mountain Care Board’s meetings, tried to convince protesters that Shumlin is not their enemy.

“He’s the only governor in the country who raised this issue and put it in the forefront,” she said.

She urged them to have patience, and she says she is still optimistic Vermont will be the first state to have public universal health care, but that goal may need to achieved incrementally, as the governor indicated when he made his announcement Wednesday.

“This is like turning the Titanic,” she said, “Frankly, beating up on the governor I do not believe is really going to be helpful.”

Richter called on the protestors to take their message to the Legislature, which she said is now the most fertile ground for making progress on health reform.

“There’s a Legislature that can bring this up also, and I don’t think it would take much arm-twisting for the governor to go along with that,” Richter said.

“If they get 50 calls in every district, believe me they will bring this up,” she added.

Protesters made repeated demands that the board voice support for moving forward with the goals of Act 48 and commit to implementing a public universal health care program in 2017.

Board members said they appreciated the protesters’ frustrations and had heard the message, but were still processing the governor’s announcement and were unsure what they could do as a regulatory body.

“You can honestly yell at all of us, but we just heard this like you did,” said Green Mountain Care Board Chair, Al Gobeille.

“I’m not sure how you get this done, but I think we have to keep trying,” he added.

“Will you take a stand that this should be done?” a protester yelled back.

“I think we’ve all taken a stand, I’ve been working on this for three years. I’m not speaking for anyone else,” he said.

“I don’t have to apologize to anyone in this room … we’re committed to Act 48,” said Con Hogan, a board member and former secretary of the Agency of Human Services, drawing applause from the crowd.

“How much we can do, I don’t know. Al’s got the right answer there,” Con added, “But whatever we can do, we will do.”

The Green Mountain Care Board was created by Act 48 and given regulatory authority over some aspects of health insurance and hospital spending. It was also supposed to vet the governor’s benefit package and financing plan for single payer, and its approval would have been a prerequisite for implementing the program.

But absent a proposal from the governor, it’s unclear what role the board can play other than continuing their regulatory work focused on driving costs out of the system.

Board Member Alan Ramsay, a former family physician who practiced for more than three decades in Vermont, told the protesters their stories echoed those he witnessed while practicing medicine.

“It reminded me once again of the suffering that I saw in my practice for those 32 years because of people that did not have affordable high quality health care. It was not accessible to them,” Ramsay said.

He joined the board to help develop a system that is affordable, high quality and accessible, and affirmed the board’s commitment to those goals, he said.

“We’re at a better place now … than we were three years ago, if not for the very reason that this board understands the faulty nature of the health care system even better than we did when we all took this job,” Ramsay said.

He asked for the public’s trust and support as they continue to work toward the goals of Act 48.

Morgan True

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  • Paul Richards

    It’s the old “bait and switch”. Bet they wish they could take their votes back.

    • Tom Haviland

      Yeah they could have voted for that other candidate with a universal health care plan, right?

      • rosemarie jackowski

        There were 7 candidates on the ballot for governor, plus a write-in option. Voting has consequences.

        • Willem Post

          Rosemarie,

          The only reason Shumlin is ahead of Milne by about 2,000 votes is because of Burlington, a socialist, Bernie Sanders creation gave him a cushion of 6,000 votes.

          Burlington has many household with incomes less than $50,000, that saw their Single-Payer freebee go up in smoke.

          Schulman and cohorts will compensate by having F-35s in a few years to defend us from Russia.

  • OK, so in the first sentence of this article, I realized that more then SIXTY people converged on the capital to vociferously, and indignantly voice their opine, that others should pay Dr’s salaries to provide they with the drugs or treatments prescribed.

    What percentage of VT is sixty people?

    Not the majority I must assume as I know at least a dozen dozen taxpayers that were not their, or “they”, and you can quote me.

    • Moshe Braner

      Paul, did YOU go stand out in the cold and protest against Single Payer while it was still on the governor’s agenda? No, I didn’t think so. For every person who bothered to attend this protest, there are many hundreds who agree with the protestors, but stayed at home or work. Just like every person who comments here represents many who think along the same lines. Except that posting a comment is a lot easier than protesting in the street.

      Count me as one who voted for Shumlin, over and over, only because he promised single payer.

      • I voted too Moshe, as a minority of actual voters did also.

        Too bad so many voters could care less about voting.

        Maybe that was why Shumlin gave up on this, he didn’t want to inspire more voters.

  • Kathy Nelson

    I pay no heed to the “Vermont Workers Center” whatsoever. They are amongst those responsible for putting Shumlin in office. Let them reap what they have sown. So many millions of dollars wasted that could have gone to creating more jobs and providing services for Vermont citizens……

  • Glenn Thompson

    Looks like we won’t need to wait until Jan for the fireworks and entertainment to begin. It begins now!

    Not sure what burning up medical bills is going to accomplish? They’ll just send out another one!

    From the article!

    “Taylor has had trouble staying covered, and when she is able to enroll in Medicaid for periods of time, it’s difficult to find doctors and dentists willing to accept her as a patient, she said.”

    Why would that change under Single Payer…..unless of course Single Payer would force medical care providers to accept everyone?

    Perhaps the question should be put to medical care providers…..WHY?

    Perhaps this article will help explain it!

    http://www.medicaldaily.com/more-doctors-rejecting-new-medicaid-patients-program-expands-posing-threat-shortage-264091

    I’m only going to conclude (and for good reasons) the more government embeds itself into our healthcare system….the worst it will get!

  • Paul Richards

    Let’s try this again; I bet they feel like they were deceived (another word for suckered or sucker punched). We are all adults here, let’s call it what is is.

  • Nick Spencer

    I respect the passion of the 60 people protesting for single payer today, but have greater respect for the 60,000 who were working today and would have born the brunt of seeing 20 percent of their income taken to pay for it.

  • James Berg

    why cant people understand that we cant tax people and business anymore in one of the most taxed states in the country? I’m broke and so is everyone else…except for those who can stand in front of the statehouse and protest…I cant afford that. If people want it so bad where are there ideas?

    • Rob Coates

      They did have an idea…it was single payer. We are not getting it because the Governor is unwilling to do the heavy lifting to get it done. I don’t totally blame him, he is after all, a politician who almost got voted out of office.

      Vermonters paid over $4.5 B for their healthcare treatment in 2009 (http://kff.org/other/state-indicator/health-spending-per-capita/). All of a sudden a $2B program is way too expensive.

      • Kathy Callaghan

        No one from the administration has yet explained why if, as they said, we pay over $2.5b on health care already, we can ‘t afford single payer. I think they have to answer that question for the public because Michael Costa has been making that statement for at least a year.

      • Joyce Wilson

        Rob, Here is the 2013 link to the per capita for Vermont as your link was the 2009. It went up $288 per person from 2009 to 2013 for Vermont. The per capita in the US went up $1,471 from 2009 to 2013.

        Vermont is over the national average, but it has a very high percentage of both Medicare and Medicaid patients that consume more health care. Vermont is the second oldest state so a much higher percentage on Medicare. Utah is the youngest state and look at their per capita health care spending. It is much lower. There is no doubt about it that older patients consume more health care. The rapid graying of Vermont is a problem. Notice nursing homes are including in the per capita figures so in the second oldest state then a higher percentage in nursing homes.

        Also Vermont had almost 30% on Medicaid with the last Medicaid expansion.

        http://kff.org/other/state-indicator/per-capita-state-spending/

        • Wendy Wilton

          Really excellent information, Joyce. More people need to understand this.

          • Willem Post

            These seniors do not get a freebee being on Medicare.

            Here are some numbers for an upper income retired couple.

            A 2-person household, both retired, over 70 years old, with a GROSS household income of $200,000, a taxable income of $160,000, which is high because of few deductions at that age.

            – Existing annual STATE income taxes about $11,500 in 2014, per tax return.

            – Existing Medicare premium $104.50 per month per person, doubled to $209.00 because of “high income”, $5,016 in 2015; covers 80% of medical bills, but excludes drug cost coverage, which would have required an additional premium.

            – Existing AARP Supplementary premium (for the 20% not paid by Medicare) of $213.16 per month for 2 people, $2,557.92 in 2015.

            – Existing real estate taxes (school + municipal) $10,500 in 2014 (Town of Hartford), due to increase by about 5% in 2015, as they did last year!!

            – NEW MEDICAL INCOME SURTAX, 9.5% of $200,000 = $19,000 per year, or 9.5% of $160,000 taxable income = $15,200 per year!! Just what elderly, retired couples, such as your parents, need on top of everything else!

            NOTE: Shumlin reports a gross income of about $1,000,000 per year. He will not pay 9.5% ($95,000/yr) of that, but just the cap of $27,500. Or, he may have a taxable income of $900,000, but not pay $85,500 of that, but just the cap of $27,500. Look who is looking out for the seriously rich!

            Retired people, who already have expensive (compared to the City of Rutland) Medicare and AARP, should not have to participate in, or be impacted by, Single-Payer.

        • Willem Post

          Joyce ,

          Here are some numbers from a Vermont website, as well as some other comments to put Single-Payer in perspective.

          This was also published on VTDigger under Commentary, but it was much shorter and did not include the latest information. This the latest, more complete version.

          All,

          The numbers in the below article are revised for a MEDICAL PAYROLL TAX of 11.5% (the leaked number was 8%), and a MEDICAL INCOME SURTAX of 9.5% (the leaked number was 9%), capped at an astounding $27,500/yr., based on the Governor’s Single-Payer concession speech, which was about 4 years overdue.

          This agonizing, 4-yr folly, based on (now admitted) euphoric estimates regarding federal subsidies, and based on (now admitted) euphoric estimates of cost saving reductions from BAU conditions, would require raising a more realistic $2.6 billion (the leaked number was $2+ billion) in taxes on an economy with near-zero REAL growth since 2008, and that has not recovered from the Great Recession, and that has many already-struggling, long-suffering, households and businesses with DECLINING real household incomes and dismal profits since about 2000.

          No wonder tax collections are below optimistic expectations. People surrounding the governor are high on the same Kool-Aid. A housecleaning is long overdue.

          No wonder Democrats waited until after the elections to release the Single-Payer bombshell onto VT’s already-struggling households and businesses. A Republican governor would have been elected and even more Democrats would have lost their seats to Republicans.

          Montpelier folks are on a socialist, Single-Payer healthcare, ego-trip, led by the governor, to solve the “healthcare problem”, just as they came up with the state centralizing the financing of public education to solve the “education problem”, which led to much higher taxes than predicted, but did not materially improve educational and societal outcomes!!

          Politicians declared it a success anyway. With Republicans controlling the US House and Senate, no additional subsidies can be expected to financially support Single-Payer in “pioneering” Vermont.

          http://vtdigger.wpengine.com/2014/12/04/single-payer-financing-likely-start-8-percent-payroll-tax/

          Solving the “healthcare problem” apparently involves imposing two NEW taxes totaling $2.6 billion/yr, FOR STARTERS!! That number would likely follow the same course as centralized school financing, as more and more “needs”, such as toddler daycare/education, are added.

          1) MEDICAL PAYROLL TAX to raise about $1.3 billion:

          This tax will be in addition to the present payroll taxes, such as the FICA taxes, etc.

          This NEW tax would be 11.5% of Vermont’s $11.7 billion payroll to raise $1.3 billion per year, FOR STARTERS. VT’s total payroll is much greater, about $16 to $18 billion (depending on the counting), but it looks like the difference, $4.3-6.3 billion, is exempt for various, more or less nefarious, reasons. Legislators should look into the $4.3-6.3 billion exemption.

          Single-Payer would likely have co-pays and may cover only a part, say 80%, of medical expenses. If so, the other 20% would likely need to be covered with supplementary insurance!!

          The tax is supposed to replace present healthcare premiums paid by employees and employers.

          – Will employers pay 11.5%?
          – Will the 11.5% be divided 5.75% employee and 5.75% employer?
          – Will all employers, large and small, be required to enroll and contribute to Single-Payer?
          – Will all government employees, policemen, firemen, education, medical personnel, etc., be enrolled in Single-Payer, or will they keep their expensive, fee–for-service plans?

          2) MEDICAL INCOME SURTAX to raise about $1.3 billion:

          This NEW tax will apply to households with annual incomes greater than $50,000, about 45% of all Vermont households. The tax is imposed to adhere to the principle of “ability to pay”, says Shumlin,

          The tax RATE will start at a not-yet-determined percentage for households with incomes greater than $50,000, and the rate will be capped at 9.5%. That means about 55% of all Vermont households will pay the tax.

          Remember, this new tax is in addition to any income taxes these households already pay, PLUS, for employees on a payroll, in addition to the above new Medical Payroll Tax!!!!

          Retirees, not on any payroll, will not pay the Medical Payroll Tax, but will be required to pay the Medical Income Surtax, if their household income is greater than $50,000.

          VERMONT HEALTH CARE EXPENSES VERSUS STATE TAXES IN 2013

          Private Insurance…………….2,186.4
          Out-of-pocket…………………….846.4
          Medicare & Medicaid………..2659.2
          Other Government……………..238.9
          Total………………………………5,930.8

          Personal Income Tax………624.6
          Sales and Use……………….349.2
          Rooms and Meals………….132.2
          Corporate……………………….94.1
          Purchase and Use……………83.7

          http://hcr.vermont.gov/sites/hcr/files/2013/Financing%20Plans%20PPT%20w%202017%201-25%20Final.pdf

          COST SHIFTING

          The costs of Medicare and Medicaid Underpayments (as judged by the providers), Free Care (as estimated by the providers), Bad Debt (the amount unrecovered after collection efforts) are ultimately shifted to the premiums charged by private insurers. The addition to private insurance premiums due to cost shifting may be as much as 15% to 20%, and may become greater as more people enroll in Medicare and Medicaid.

          http://gmcboard.vermont.gov/sites/gmcboard/files/CostShift2013.pdf
          http://www.azchamber.com/assets/files/Lewin%20Group.pdf

          FAMILY INSURED BY THE CITY OF RUTLAND

          The family consists of 4 people, 2 adults of which one is employed by the City, 2 children of which one is in college and covered by the City, and one, 26, with separate coverage through the Affordable Care Act, ACA.

          – The premium cost of a high deductible, $5,000, family plan is $22,161 for 3 people. NOTE: Competitive bidding is limited, as BC/BS, and MVP are the only other insurers in the state. Vermont’s “business-friendliness” chased all the health care competitors out of this state over the last 20 years!

          – Employee pays: 16% of $22,161 = $3,546 for 3 people. The rest of the premium 22,161 – 3,546 = $18,615 is paid by the City. Next year the employee will pay 18% of the premium.

          – Employee voluntarily contributes, a tax-exempt, $800/yr to a Flexible Spending Arrangement, FSA, to pay out-of-pocket medical and dental costs, including co-payments and deductibles, but NOT to pay premiums. Some employers contribute to FSAs.

          – Total family cost is 3,546 + 800 (if all is spent) = $4,346 for 3 people.

          The $5,000 deductible comes into play as follows:

          – If a family member has an operation costing, say $15,000, the deductible payments would be $1,250 by the employee and $3,750 by the City, the rest 15,000 – 5000 = $10,000 by the insurance company.
          https://www.healthcare.gov/flexible-spending-accounts/

          ELDERLY COUPLE IMPACT, IF SHUMLIN’S PLAN WERE IMPLEMENTED

          A 2-person household, both retired, over 70 years old, with a GROSS household income of $200,000, a taxable income of $160,000, which is high because of few deductions at that age.

          – Existing annual STATE income taxes about $11,500 in 2014, per tax return.

          – Existing Medicare premium $104.50 per month per person, doubled to $209.00 because of “high income”, $5,016 in 2015; covers 80% of medical bills, but excludes drug cost coverage, which would have required an additional premium.

          – Existing AARP Supplementary premium (for the 20% not paid by Medicare) of $213.16 per month for 2 people, $2,557.92 in 2015.

          – Existing real estate taxes (school + municipal) $10,500 in 2014 (Town of Hartford), due to increase by about 5% in 2015, as they did last year!!

          – NEW MEDICAL INCOME SURTAX, 9.5% of $200,000 = $19,000 per year, or 9.5% of $160,000 taxable income = $15,200 per year!! Just what elderly retired couples, such as your parents, need on top of everything else!

          NOTE: Shumlin reports a gross income of about $1,000,000 per year. He will not pay 9.5% ($95,000/yr) of that, but just the cap of $27,500. Or, he may have a taxable income of $900,000, but not pay $85,500 of that, but just the cap of $27,500. Look who is looking out for the seriously rich!

          Retired people, who already have expensive (compared to the City of Rutland) Medicare and AARP, should not have to participate in or be impacted by Single-Payer.

          LIKELY RESULTS OF SINGLE-PAYER

          – Higher-income, TAX-PAYING households, such as 2-person households with 2 retirees, will likely escape to less-socialist, “less-tax-happy” states, or, even worse, not come to retire in VT.

          – Lower-income households, which will pay little in taxes, will likely move into VT from other states to cash in on Single-Payer. Vermont, the welfare magnet, just as Norway is in Europe, except Norway is very rich.

          – Many businesses will reduce their operations in Vermont, move out of Vermont, or not move into Vermont.

          SINGLE-PAYER REPLACING PREMIUMS AND OUT-OF-POCKET EXPENSES?

          The argument is made Single-Payer will replace the $3+billion in premiums and out of pocket expenses. See below table.

          Private Insurance………….…..2,186.4
          Out-of-pocket………….………….846.4
          Medicare & Medicaid….….….2659.2
          Other Government………….…..238.9
          Total……………………..……..…5,930.8

          The above proposed NEW taxes will replace premiums, but only partially. Medicaid and Medicaid will not be “replaced”, because it is likely not a political option. Businesses that do not offer, or offer minimal health care insurance will not be required to offer it under Single-Payer, because it is likely not a political option.

          As above noted, more than $1.3 billion in NEW MEDICAL INCOME SURTAXES would be imposed on households with incomes of $50,000 or more, and that tax will be capped at about 9.5% for higher income households, FOR STARTERS.

          Households with income less than $50,000, about 45% of all Vermont households, about 280,000 people, including most of the 47,000 Vermonters without insurance, will find Single-Payer highly attractive, because THEIR care will be partially subsidized by the higher-income households.

          FEDERAL WAIVER AND FANTASY COST SAVINGS

          To launch fully in 2017, Green Mountain Care would have to gain approval from the federal government to use federal health finances to fund the state program. Also, before Green Mountain Care is allowed to launch, state law requires Vermont to define the benefits in the program, provide a three-year budget that costs less than current health care expenditures, and to acquire the federal waiver. As of December 2014, Vermont had yet to craft a bill that would address the $2.6 billion in extra spending necessary to fund the Single-Payer system.

          Vermont needs the federal government to grant waivers allowing Vermont to DIVERT Medicaid and other federal health-care funding into the Single-Payer system.

          People drawing up proposed budgets for their pet ideas tend to be too optimistic. They surmise fabulous cost savings from using the government’s monopoly buying power to bargain prices down with providers. But Vermont is already the beneficiary of significant monopoly buying power: One insurer, BC/BS, has 74 percent of the state’s small-group business, so don’t count on fabulous savings due to squeezing out costs. The large-group business is even more concentrated.

          Nor can you get much administrative saving at the provider level, because they still have to deal with out-of-state insurers. And the much-touted fabulous savings from preventative care have mostly turned out not to exist.

          So this is going to be expensive. In fact, so expensive that it is doubtful Vermont will actually go forward with it.

          http://en.wikipedia.org/wiki/Vermont_health_care_reform
          http://www.bloombergview.com/articles/2014-04-11/vermont-s-single-payer-dream-is-taxpayer-nightmare

          UNIVERSAL-COVERAGE COUNTRIES HAVE LOWER PER CAPITA COSTS

          The lower per capita cost in “universal-coverage” countries is almost entirely due to providers (doctors and hospitals, drug companies, etc.) not being able to charge willy-nilly/gouge the public, as they are allowed to do in the US. Most doctors are EMPLOYEES of the hospitals, not quasi-small business people having a “private practice”, as in the US.

          Example: Identical drugs are sold in Europe at 1/2 to 1/3 the US cost. How do I know this? I lived in several countries for over 26 years.

          Example: I fell, broke my left wrist, needed a plate and seven screws, did not stay in the hospital, total cost as billed by the hospital and doctors was $24,000. Medicare and AARP paid all the costs minus a discount, per provider contracts.

          Example: On a walking tour in Germany, a person fell on a cobble stone street. She broke her left wrist, needed a plate and six screws, stayed 2 DAYS in the hospital, total cost 3,500 euro = $4,900. She paid with her credit card.

          What Shumlin proposed under Single-Payer will do practically NOTHING to reduce provider charges. For them, Single-Payer will largely be BAU.

          For the state, Green Mountain Care, etc., to administer/spread around, another $2.6 billion FOR STARTERS, hundreds of ADDITIONAL employees will be needed. Quite a few pro-Single-Payer people are lining up for the well-paying, steady, secure, long-term, jobs with platinum, state-level benefits!!! Is THAT cost accounted for?

          SOME VERMONT HISTORY AND FACTS

          Vermont’s government has been growing its footprint in the VT economy during the past 10 -15 years, but the private sector part of that economy, burdened by various taxes, fees and mandates, is being hollowed out and is barely growing.

          In year 2000, the VT population was 609,000. The budget was $2.2 billion. Fourteen years later, the VT population was 623,000. The FY2015 budget is $5.59 BILLION, a $3.39 BILLION increase, for a population increase of 14,000 people!! This is irrational, unsustainable idiocy!

          Basically, there has been near-ZERO net job growth in VT since 2000. For the decade 2010 to 2020, the STATE ITSELF forecasts 69% of all jobs created will likely pay LESS than $20 an hour, i.e., below a livable wage, especially considering the VT Cost of Living index of 120 vs. the US COL of 100, and the higher VT tax burden per person vs. the US tax burden per person.

          Vermont Yankee employs about 600 people with good, steady, secure pay and benefits. VT needs to duplicate such companies 100 times by making its business climate attractive for such companies, to finally increase living standards. HINT: EB-5 is NOT the answer.

          Vermont has become one of the most-socialized, heavily subsidized, not-for-profit states, which has led to reduced economic growth, reduced ability to pay taxes, recurring budget deficits, and adverse economic and societal outcomes, i.e., the people cannot pay all the state and local taxes, fees and mandates, and support all the “off-the-books”, quasi-government organizations, etc., such as the 5% mandated EV surcharge on electric bills, etc.

          Vermont’s mean REAL household income is just a few percent greater than of the US!!!! Ergo, Vermont households, whose real incomes have DECLINED since 2000, have had to skimp and scrape, i.e., be “energy efficient” and reduce other expenses to get by. Politicians often point out how “energy efficient” Vermonters are!!

          In such an environment, it is total madness to impose $2+ billion in NEW taxes on VT’s economy that has a growing government sector percent and a shrinking, less profitable, private sector percent, which has had hardly any REAL growth for the past 5 years!!!

          THE COST OF LIVING INDEX

          Vermont has a COL index 20% higher than the US COL, PLUS VT has a tax, mandated fees, etc., burden that is much higher than the US average, and VT also has a LOWER real household income than the NE average.

          – The COL index covers the total income of the households in the top 20% of households, by income.
          – The top 20% of households, by income, take in about 60% of ALL US household income.
          – Thus the COL index covers a lot of US household spending and is highly representative, certainly for these households.
          – The effect of any taxes, federal, state and local, is NOT taken into account in the COL index.
          – If a state is in the upper quarter of per capita tax burden, such as Vermont, then the exclusion of taxes from the COL is significant.

          DECLINING REAL HOUSEHOLD INCOMES

          Here are the REAL (inflation-adjusted) MEAN household income declines of the bottom 60% of US households:

          3rd quintile -8.4% since peak year in 2000

          4th quintile -11.1% since peak year in 2000

          5th quintile -15.9% since peak year in 1999

          This website also shows how the top 5% of households has faired so much better than the rest.

          http://www.advisorperspectives.com/dshort/updates/Household-Income-Distribution.php
          http://www.tax-rates.org/vermont/property-tax
          http://www.tax-rates.org/new_hampshire/property-tax

          • Willem Post

            …These revised paragraphs improve clarification:

            – Existing AARP Supplementary premium (for the 20% not paid by Medicare) of $213.16 per month for 2 people, $2,558 in 2015; up from $198.44 in 2014, or up 7.4%.

            NOTE: Under existing federal law, Medicare providers would continue to bill Medicare, even after enactment of a state Single-Payer, but the STATE would take over the function of Medicare supplementary insurance, such as AARP and Medicare Part D, and would pay the costs not covered by Medicare, just as Medicare supplementary insurance and Medicare Part D insurance do now. Would the couple pay whatever premium to the state, or will the NEW MEDICAL INCOME SURTAX be used for those costs? For lay people, it is so easy to say “let’s have Single-Payer/Universal Healthcare”, but things do get complicated!!!
            http://vermontforsinglepayer.org/What-You-May-Hear

            – Total premiums, WITHOUT drug benefit = $5,016 + $2,558 = $7,574 for 2 people, or $3,787 per person in 2015; about 3787/1449 = 161% more than a City of Rutland employee in 2014!!!

            – For a lesser income, retired couple, it would have been $2,508 + $2,558 = $5,066 for 2 people, or $2,533 per person in 2015; about 2533/1449 = 75% more than a City of Rutland employee in 2014!!!

        • Willem Post

          Joyce,

          The rapid graying occurs, because young people are moving out to find better job opportunities.

  • Walter Carpenter

    “It’s the old “bait and switch”. Bet they wish they could take their votes back.”

    It ain’t dead yet.

    • Carl Werth

      If it ain’t dead, is it merely “pining for the fjords”?

      • Mike Gagnon

        LOL. “Pining for the fjords!” No, no it’s resting. No it’s stunned. Pushing up the daisies. Gone to meet it’s maker. Kicked the bucket. This is an ex-health plan! Just in case you missed it: https://www.youtube.com/watch?v=4vuW6tQ0218

  • Jon Corrigan

    It’s always educational to watch the childish antics of those deluded enough to believe something the rest of us pay for should be free for them. Right on cue, just like a four-year old, they throw temper tantrums when things don’t go their way.

  • Jim Barrett

    The protesters were happy with the thought that Vermonters would be facing a financial crisis unseen in modern times. Vermont is one of the highest taxed states but it is obvious these protesters didn’t care. As for Shumlin, the decision was political as usual to try and make a last ditch effort to win votes by the legislature on who the next governor will be.

    • Paul Richards

      “As for Shumlin, the decision was political as usual to try and make a last ditch effort to win votes by the legislature on who the next governor will be.”
      Well it actually worked. The blueprint for hood winking the stupid voters was refined by the obama administration and gruber. Just look at the lies and deceit and payoffs that ushered in obamacare. Look at the delays and payoffs after the fact. It’s the gift that keeps on giving to the supporters and taking from the rest of us.

  • Bob Stannard

    Shumlin has done more to bring attention to the issue of healthcare than any other governor. He tried to implement single-payer. Name the other governor trying to do so. Did much beloved, Gov. Douglas, attempt to do anything at all about addressing healthcare for all?

    Maybe those who are so anxious to condemn the governor might see this as an opportunity to come together and work on the art of the possible. People who lead are the ones most likely to be criticized.

    Stop and ask if you would rather work with a leader or one who simply sits back and occupies the seat?

    It’s better to have tried and failed, than to never have tried at all.

    • Willem Post

      Bob,
      Shulman said he was going to concentrate on the art of the other “possible”: Get the Vermont near-zero-growth economy moving again.

      Here is what he needs to do:

      – Get rid of the posse of Single-Payer Kool-Aid drinkers that is surrounding and befuddling him.

      – Bring in level-headed Douglas as an advisor.

      – Clean house.

      – Make a fresh start.

      – Get the moribund, near-zero-growth economy growing again

      – Raise the minimum wage to $15

      – REDUCE the state budget and headcount by at east 10% in one year.

      • Raise the minimum wage to 20$ an hour and see how many WalMarts fold quickly, and how many rioters appear as suddenly.

        This is the NWO. A gift of the Bushes, and Clintons.

  • Randal Murray

    A whole 60 people showed up!??! What a joke!
    This is just damage control to try and keep his job!
    Good decision making, two parents involved and hard work is what will get you healthcare, not whining to the government for a hand out!

  • Rob Coates

    Vermonters should be outraged. We are now guaranteed to get screwed by the insurance companies and other “private market” forces to the tune of 15% + of their income. The ACA, at best, will only reign in some inflation.

    It’s not that Vermont is too small or over taxed to have a single payer plan. It’s those that are afraid of being small and over taxed don’t have the guts to demand better from their leadership.

    • Tom Sullivan

      Hey Rob,
      The single payer fiasco would have been administered by a third party which was said to be BCBS. So either way, you would still be dealing with a large insurance company.
      Sorry…….

  • John Freitag

    Those who supported Peter Shumlin’s cynical wait for over 2 years ( and weeks after the election) to release the details of his health plan should take some responsibility for their own inability to get beyond their ideological commitment to single payer for Vermont.
    I voted for Peter Shumlin in 2010 and 2012. I did not vote for him in this election because it was clear after years of study that single payer , while a viable option for nations, could not work for a single state. This combined with the ineptitude of the Shumlin administration’s oversite of Vermont Health Connect left no doubt to those who objectively looked at what
    the situation as to what the results would be once the numbers came out.
    Peter Shumlin has shown himself again and again to be more interested in his own political career than an honest airing of the costs and benefits of programs. The next shoe to drop will be when the numbers on the mandate to provide $3,000 worth of educational services to every three and four year old is finally released. Simple math, 3,000 times 10,000 children in this age group, shows that the cost of this program to the education fund primarily supported by property taxes will come to at over ( when you add in administrative costs) 30 million dollars. This cost was hidden by a last minute delay for a year in the program but it will come out and likely offset most any potential savings from possible structural realignment.
    John Frietag

  • Paul Donovan

    Targeting the Governor, who is merely acknowledging the fiscal reality, is a huge tactical blunder providing single-payer opponents a golden opportunity to beat up on the Workers Center as well as the Governor, and they pounced. The Center needs to listen to cooler heads, and redirect their legitimate anger where it will do some good.

  • Kathy Callaghan

    The whole point is to get people covered under a decent plan that takes away their financial suffering. Single payer won’t do that, and it’s shameful that the administration wasted so much time and money to prove what was obvious from the start. That’s the real tragedy. Imagine how many people could have been helped with the money wasted on trying to prove that single payer would work.

    Now it’s time for the Legislature to get to work to provide real relief for suffering Vermonters. These stories are real, and I’m glad that the GMC Board took the time to listen, rather than throwing everyone out, which they could have done. Perhaps bring back Catamount which did seem to work, and certainly repeal the law that forces individuals and small businesses to buy only through Vermont Health Connect. That law was passed ONLY to force more people into the “single payer” pipeline for when single payer became a reality. No other state does this. The Exchange is supposed to be a free marketplace to shop for coverage.

    Now that “single payer” won’t happen, it’s time to repeal that law and let people use the Exchange if it works for them, or buy on the open market. Insurers should bring back plans they may have cancelled, and Vermont should move more toward where New Hampshire is, with 40 plans to choose from, and 5 insurers. Competition has brought premiums down in Year 2 of their Exchange.

  • Craig Powers

    Childish antics and temper tantrum come to mind when I see scenes like this. They also loudly interrupted a GMCB meeting with rants, sobbing and chanting (like that helps to create any type of dialog). The GMCB should have had them removed.

    The VWC also issued a press release that said 100+ showed up to protest. VTD says sixty. The BFP says about 40ish. VWC claims that they represent a majority of VTer’s wishes. This claim is certainly a huge stretch of their imagination.

    Do us all a favor VWC…put up a Progressive candidate for Gov (please have them wear a red shirt at all times so they are easily identified) next time instead of throwing your votes to a Democrat. That way you will not get burned and you can see that your candidate might garner at most 20% of the votes. Then you can rewrite your press releases to say that you represent a very small minority of VTer’s

  • Rob Gaiotti

    Wonder what happened to the toast?

  • rosemarie jackowski

    The only surprise here is that anyone is surprised with the governor’s announcement. For a very long time, I have been blogging on Common Dreams and other sites that the democrats will not deliver on Single Payer.

    Vermont needs a political movement that supports the people too – not ONLY the business community. We already have that ‘movement’ – the Liberty Union Party.

    Now what should we do? What is plan B? Maybe set up clinics around the state to offer medical/dental care to those who have no access…. and in the meantime, let’s publish the administrative costs of the hospitals. How much does the hospital CEO get. This is a bit like the problem of funding education. While we all complain about the high cost of student loans etc., the salary of the president of UVM is sort of off limits.

    Put everything on the table -total transparency. What is a fair annual income for a doctor? $100,000? $200,000? A Million? A while back NADER wrote an article comparing the cost of medical procedures in the US and the rest of the world. We need to dig that one up and read it again.

    The governor and the democrats can wait. A person who is ill or has a tooth infection cannot.

  • Stan Shapiro

    There is a great deal of emotion generated and appropriately so from all sides.What needs to be stated is that the cadre of well qualified and interested individuals in both the public and private sectors of health care have not been sitting idly by watching Rome burn. The GMCB is putting tremendous energy and work with hospitals to achieve the triple aim of the improving patient care experience,improve the health of populations,and reduce cost. In addition if you were an act 48 supporter you would realize the governor did his due diligence and found that it would not fulfill the criteria that were imposed for moving forward.Everyone in health care anticipates that the work is far from done and the public should understand that that efforts by all to improve our health care system will not languish.

  • Neil Johnson

    60 people get front page news! Wow way to skew a story!

    We could have the best health care in the world for less money, in Vermont. It could be cheaper, but the problem is we want more expensive medicine rather than effective medicine.

    We don’t allow competition and the mergers continue, pretty soon it will be one doctors office for the state and one health insurance company for the state.

    If people knew, what they were paying for health care things would change quickly. If employers were only allowed to reimburse money for health care and people had to write the actual check every month…….and they had an opportunity to go to a different doctor or provider we’d get some change quickly.

    It shouldn’t be much more difficult than car insurance. Instead we get all the convoluted plans which really hide the true cost and get taxes from somewhere else to pay for things so the insiders of the medical field can pad their pockets.

    How is it that no doctors office can tell you how much something costs. You can’t pay cash, it has to go on the insurance coverage.

    Instead we argue about how to make a monopoly health care system with the thought that it’s going to be cheaper, when we could actually be solving some real problems with the free market.

    • Paul Richards

      The road to hell is paved with good intensions. We need to stop voting on emotion and get real. The states and federal governments are way to corrupt to ever effectively run a system as complicated as health care. As a result we end up with nothing but an inept system destined to fail, nothing but a huge slush fund for a bunch of corrupt bought an paid for elite career politicians. Don’t vote for Democrats or Republicans, vote for constitutional conservatives or throw this country away, it’s done.

  • Michael Keane

    Wow. It appears to be official: It’s “Dump on Shumlin Time.”

    Shame on us. I’m going to agree with Bob Stannard: practically no other governor in the country, in the country, mind you! was willing to take on the health care system, the place where your health and mine have been “dollarized” for years.

    It appears that we all expected miracles when we should have realized that the process of health care reform is one with so many moving parts that it almost has to be a “voyage of discovery” concerning costs, payments, implementation choices, and methods, and situations where we may have to fall back and re-group, in order to re-start the initiative in a better way. We might be better off using a bit of patience. This “Rome” will not be built in a day either.

    I was lucky enough to live and work for 11 years in Scandinavia and experienced the sheer genius of the Scandinavian way in ensuring that the basic needs of life, education, health care, shelter, and nourishment, are available to all, according to need. Scandinavians pay high taxes to achieve that, but it means that no one would be bankrupted by a major illness, and no student would start off working life with enormous debts. And it took a long time to get there: Sweden first looked to adopt a national health insurance program in 1946 with the passage of the National Health Insurance Act. The plan was not initiated until 1955. It called for universal coverage for all citizens. So it took 9 years to get that off the ground. And we expect Vermont, a state with a smaller population than my old neighborhood in Brooklyn, to get it right the first time.

    Maybe a little patience, some deeper digging into the numbers, some groundswell to re-inject momentum into the effort, and fewer pejorative comments, would work better.

    • Walter Carpenter

      “but we still marched down this road expecting or hoping it would work out.”

      And we will keep marching down this road. One of the biggest obstacles became the affordable care act and when it was implemented.

  • Roger Widlow

    I wonder how many of the protesters had to skip work to march?

    • Walter Carpenter

      “I wonder how many of the protesters had to skip work to march?”

      What’s the difference? They were there because they wanted to be there to make a statement which needs to be made.

      • Roger Widlow

        “What’s the difference”, Walter Carpenter?
        How many of the protesters are hard-working taxpayers vs. free-loaders.

  • Scott Woodward

    To Neil Johnson’s point, price transparency should be one of the next frontiers in Vermont. It’s an area ripe for improvement. A blood draw costs 7 times more at UVM Medical Center than it does at Mt. Ascutney ($1,284 vs. $175). Granted, this is a cherry picked example, but there are plenty of examples that are worthy of attention.

    In a recent evaluation, Vermont got an overall grade of ‘C’ for transparency, relatively good compared to the rest of the country, but it got an ‘F’ for its website (pg. 17 in the link below).

    http://www.hci3.org/sites/default/files/files/Report_PriceTransLaws_2014.pdf

    We can do better. Compare Vermont’s website to Maine’s and you’ll quickly see the difference. Maine’s is much more useful.

    Vermont’s: http://www.dfr.vermont.gov/insurance/insurance-consumer/2012-pricing-financial-reports

    Maine’s: https://mhdo.maine.gov/healthcost2014/CostCompare

  • Stan Shapiro

    To Mr. Woodwards point Mt Ascutney has to charge more because of the payer mix. The larger the Medicaid -Medicare cohort compared to commmercial insurers the more operating costs need to be covered by the cost shift.Therefore higher prices . Well off areas can charge less due to the fact that their is reasonable reimbursement. Being paid 30-60 cents on the dollar does not allow even expenses to be covered by areas with high publicly funded populations.

    • Ron Pulcer

      Stan,

      I think you flipped around Scott’s comparison of UVM vs. Ascutney hospitals for “blood draw” service. Here is Scott’s quote:

      “A blood draw costs 7 times more at UVM Medical Center than it does at Mt. Ascutney ($1,284 vs. $175).”

      UVM has the higher cost, in this one example. While Medicare – Medicaid cohort per region is a factor in any service comparison, perhaps the place to look is management overhead, and maybe infrastructure. Remember the Renaissance Project at Fletcher Allen, aka UVM several years ago?

      But you are correct, all these factors need to be reviewed, which I suspect that GMCB has been doing for the past several years.

      There has to be “some explanation” why UVM blood draw is 7X higher than Ascutney. These are the types of questions that need to be asked by patients, businesses, GMCB, and Legislature. We have had decades of “cost shifting” for various reasons. How much of a given service price difference today is legitimate and how much is “cost shifting”, management and administrative overhead, and/or accounting gimmicks?

  • The present health care system is unsustainable. We are at 20%oGDP for Vt.and 18+% GDP for the country and growing in both cases..it doesn’t take a rocket scientist to see that a completely new system will be needed, probably sooner that later. Either that, or our medical system will have to “triage” the general population as health care will be a commodity that most will not be able to afford. We are we are actually doing some of that now with deductibles, co-pays, and premiums.

    Triage-A system used to allocate a scarce commodity, such as food, only to those capable of deriving the greatest benefit from it.

  • “This is like turning the Titanic”

    No Deb, it is like ramming the titanic into the iceberg! The ones who want to reverse the misguided course that we have been taking on health care reform for over 20 years are the ones trying to turn the titanic. We would like to replace a top down, government by bureaucratic decree approach with one that focuses on patient choice and preserves the integrity of the doctor patient relationship. It is a Davic vs. Goliath approach.

  • Stan Hopson

    Bob Stannard says Shumlin was bold for attempting healthcare reform, I say the Governor played these third-party healthcare activist groups like a fiddle cementing his re-election.

  • Walter Carpenter

    “We would like to replace a top down, government by bureaucratic decree approach with one that focuses on patient choice and preserves the integrity of the doctor patient relationship.”

    Exactly what is patient choice? How would patient choice be different under single-payer versus the so-called Free market, if there is such a thing? I have experienced this patient choice under the private system versus the public one. I can tell you what patient choice is under each. In the private system, the insurance company rules your choice. They rule which facilities/physicians you can see through networked providers; they dictate what tests/procedures/pharmaceuticals you can have through prior authorizations and can reject them as “medically unnecessary. Under the public system, Medicaid/vhap, in this case, no one told me who I could see, when, or what procedures were medically unnecessary. I just went in and had what I needed without interference from a medical director.

  • sandra bettis

    Our towns and cities and schools and state are all in trouble financially – largely due to health care costs – single payer would have been a win win for everyone. It is too bad that Mr Shumlin has taken the coward’s way out.

  • sandra bettis

    We, as taxpayers, will be paying for this decision over and over until someone has the guts to make this happen. Remember that every time you complain about your property taxes (based on education costs which include exorbitant health care costs).

  • sandra bettis

    When a service is privatized, taxpayers and clients lose money and services. This is how I know that taking health care out of the hands of the ins cos would be a win win for all of us.

  • David R. Black

    Burning of medical bills reminds me of burning draft cards. Ahhh, the good old days of the 60’s.

  • Cairn Cross

    From more than 3 years ago: http://vtdigger.wpengine.com/2011/02/08/cross-single-payer-many-sweatshops/ It was pretty easy to figure out then…it is pretty easy to figure out now. The obfuscation for three years and the recent reversal in position are simply politics. Governor Shumlin will pay the political price for this but complicit alongside him are the many legislators who did not dig in to the numbers and force accountability many years ago. If so we may have been well along a path towards health care reform. The legislators who were complicit in this charade should also be held accountable.

    • As long as only a small minority cares about voting, the incumbents are safe as pigs in a blanket.

  • Randy Koch

    What an unfortunate metaphor Deb Richter uses about how we must be patient because it’s so hard to “turn the Titanic”

  • Dave Bellini

    “This is like turning the Titanic,”

    The analogy to the Titanic is 100% accurate.

  • Sam Adams

    Wait for Hillary, she loves to kick hippies.

  • All 60 of them took the day off from paying taxes in order to make everyone else pay more, is how it seems to me.

  • sandra bettis

    Willem, Medicare sucks. I would much rather have single payer.

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