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Single Payer Plan

04/21/05 12:00AM By John McClaughry
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(HOST) As VPR continues to search for a Hands-on Health Care solution for Vermont's Health Care ills, commentator John McClaughry worries that a single-payer system would create a state monopoly that would degrade health care in Vermont.


(MCCLAUGHRY) "Universal" single-payer health care coverage is on the front burner in Montpelier. On March 25, the House Health Care Committee released its draft bill. It intends to create a "publicly- financed, integrated, regional health care delivery system" that is equitable, universal, well-coordinated, patient-centered, cohesive, unified, comprehensive, continuous, sufficient, fair, sustainable and accountable.

"All Vermont residents must be included in the new System." That means that if you are a resident of Vermont, this is the System for you. No options. No choices. Not for anyone. Why not? Because the Government said so.

"All essential health care services must be covered." Who decides what is "essential"? The bill explains that "A process must be developed to define essential health care services." Health care is to be delivered by an "integrated, community-based system." That means that all providers of "essential" health care are locked into a government-controlled System where the bureaucrats tell doctors what they can and cannot do. This system will allocate $2.2 billion dollars with, presumably, typical Government efficiency and compassion.

The new mega-system will be financed by "Broad based taxes based on ability to pay." The bill says this will come from higher payroll taxes and income taxes.

Costs are to be controlled by a "global budget" set by the Government. That is a cap on how much the System will spend on "essential" services. Presto! Costs are contained!

How will the System be "accountable to the people"? Since in the proposed government-run monopoly System all health care will be thoroughly politicized, no one should be surprised that politicians will make the key decisions. You get to vote for those politicians - Governor, Senators, Representatives. If your doctor and hospital tell you it will be a year-long wait for a hip replacement, your legislator will be only a phone call away.

There are plenty of ways to achieve the real policy goal: helping Vermonters to enjoy improved health. The overall goal of the draft bill is quite different: it's to put Government in charge of an all-inclusive, taxpayer-financed, bureaucrat-intensive monopoly health care System.

To the authors of the bill, that is a worthy - indeed the highest - possible goal. That is so even if, in practice, there turn out to be some annoying inconveniences, like rationing, waiting lines, maddening bureaucracies, demoralized doctors and nurses, shabby facilities, obsolete technology, declining quality of care and, of course, much higher taxation.

Don't worry. Your Government can work those things out.

This is John McClaughry. Thanks for listening.

John McClaughry is president of the Ethan Allan Institute, a Vermont policy, research and education organization. He spoke from our studio at the Fairbanks Museum in Saint Johnsbury.
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