walkitout (walkitout) wrote,

Single Payer

Almost exactly a year ago, the Governor of Vermont said, you know? We're not going to do single payer after all.


Why? Well, that's a little tricky to decipher. Vermont has a lot of small businesses that do not supply health care to their workers, so this was straight up added cost -- a big hike in the employer payroll tax (exactly what Senator Sanders proposes for the US as a whole) and a big hike in income taxes for the worker. Obvs, if you were already paying for health insurance, and it was taking a _bigger_ percentage of your income, this would be an improvement. Apparently, this worked out to a good deal if your household makes less than $150K or thereabouts, and a bad deal otherwise.

In the ensuing year, a variety of people have weighed in on _why_ the economics and politics of single payer in Vermont did not work out. But they're so blue! And it's such a small state! It clearly would be cheaper overall! Etc. Well, there were some issues. People who didn't _live_ in Vermont who _worked_ in Vermont were sort of an interesting case. People who worked for the federal government while in Vermont were an interesting case. Etc.

Here's a postmortem:


This is the quote that I think a lot more people should be paying attention to.

"At some point, perhaps 5 to 15 years from now, as the size and scope of Medicare, Medicaid, and the ACA subsidy structure balloon far beyond today's larger-than-life levels, our political leaders may discover the inanity of running multiple complex systems to insure different classes of Americans."

Inanity is a tricky concept: some synonyms include vapid, fatuous, shallowness, pointlessness.

This author thinks it is crazy/stupid/laughably nuts that different classes of Americans might want different kinds of health care.

I guess I don't need to worry about this ever happening, then. Because if that's the perspective backing this horse, it ain't never gonna win any race it runs in.

I think you can make a ton of solid, valid arguments for single payer -- and I say that recognizing that precisely what constitutes single payer is undefined. What I _don't_ think you get to do is to just dismiss out of hand all the counter arguments, wishes, preferences, etc. embedded in the status quo as crazy. You actually _do_ have to deal with all of that. That is how politics works. I am sorry. I wish it was not so. And yet, there it is.
Tags: politics
  • Post a new comment


    default userpic

    Your reply will be screened

    Your IP address will be recorded 

    When you submit the form an invisible reCAPTCHA check will be performed.
    You must follow the Privacy Policy and Google Terms of use.