Vermont governor abandons single-payer health care plan

[JakeStarkey]

I am not even going to go into how the problem has not been defined...so the solution is never clear.

My point in posting this is that they are looking at it and they should learn some things.

Obama would have done well to look at Tenncare which has been around a long long time.

Now....

If Mass has Romneycare....

Tenn has Tenncare......

Vermont gets something.....

Are not the states doing the will of the people......

And if the will of the people in a state is that they don't want it......

Then let's scrap this mess they call Obamacare.

Glad you came around to state level health care for the people.

Good for you. And the people have ACA who can't or won't do through the state.

 

[Listening]

I am not even going to go into how the problem has not been defined...so the solution is never clear.

My point in posting this is that they are looking at it and they should learn some things.

Obama would have done well to look at Tenncare which has been around a long long time.

Now....

If Mass has Romneycare....

Tenn has Tenncare......

Vermont gets something.....

Are not the states doing the will of the people......

And if the will of the people in a state is that they don't want it......

Then let's scrap this mess they call Obamacare.

Glad you came around to state level health care for the people.

Good for you. And the people have ACA who can't or won't do through the state.

Shut up Jake....

I've always been for states having that conversation. That does not mean they have to do it....it's up to them.

F**k that ACA.

Got that trip to Omaha rescheduled ?

 

[westwall]

I said four years ago when they passed this shit it would never get implemented. If Vermont can't afford it how the hell are we supposed to do it nationwide?

Vermont is the most rural state we have. In that sense it would have been more a challenge for them than a more urbanized and populated state, and certainly for the nation as a whole.

In other words if Vermont could find a way to do it, anybody could.

The Canadian system grew out of a provincial plan. Saskatchewan IIRC.

More than North Dakota? Or Montana? Vermont? I seriously doubt that for some reason.

You left out Wyoming and Alaska, but yes. Something I learned living there. It means as a percentage of population living in an urban versus a rural area. Vermont has one "city" (Burlington) and as cities go it's tiny.

Montpelier is also the smallest state capital in the nation, smaller than Pierre etc. And it's a lovely charming little town of (IIRC) about 10,000.

Montana, 4th in size. 48th in Population density. Vermont, 45th in size. 30th in population density.

 

[Pogo]

I said four years ago when they passed this shit it would never get implemented. If Vermont can't afford it how the hell are we supposed to do it nationwide?

Vermont is the most rural state we have. In that sense it would have been more a challenge for them than a more urbanized and populated state, and certainly for the nation as a whole.

In other words if Vermont could find a way to do it, anybody could.

The Canadian system grew out of a provincial plan. Saskatchewan IIRC.

More than North Dakota? Or Montana? Vermont? I seriously doubt that for some reason.

You left out Wyoming and Alaska, but yes. Something I learned living there. It means as a percentage of population living in an urban versus a rural area. Vermont has one "city" (Burlington) and as cities go it's tiny.

Montpelier is also the smallest state capital in the nation, smaller than Pierre etc. And it's a lovely charming little town of (IIRC) about 10,000.

Montana, 4th in size. 48th in Population density. Vermont, 45th in size. 30th in population density.

I said nothing about "population density" in geographical terms.
Here they are:

​

From here, which goes on:

>> Nearly three out of ten Americans live in a rural area or a very small city, according to the latest figures released by the U.S. Census Bureau.

That’s the national average — 28.8 percent of Americans can be found either in an unincorporated area or in a city of between 2,500 and 50,000 residents.

But the national average is dominated by large populations in a handful of very large metropolitan areas in Texas, California, New York, Florida and Illinois. Most states, like the children in Lake Woebegone, are well above average when it comes to the size of their rural populations.

Seven out of ten states (34 of 50) have more than 28.8 percent of their people living in rural settings — either in small cities or in unincorporated areas. Fifteen states have more than half their populations living in rural areas or in towns under 50,000 population.

The most rural state is Vermont, with 82.6 percent of its population living in either rural areas or small cities. <<​

Well? You think I make this stuff up?

 

[westwall]

I said four years ago when they passed this shit it would never get implemented. If Vermont can't afford it how the hell are we supposed to do it nationwide?

Vermont is the most rural state we have. In that sense it would have been more a challenge for them than a more urbanized and populated state, and certainly for the nation as a whole.

In other words if Vermont could find a way to do it, anybody could.

The Canadian system grew out of a provincial plan. Saskatchewan IIRC.

More than North Dakota? Or Montana? Vermont? I seriously doubt that for some reason.

You left out Wyoming and Alaska, but yes. Something I learned living there. It means as a percentage of population living in an urban versus a rural area. Vermont has one "city" (Burlington) and as cities go it's tiny.

Montpelier is also the smallest state capital in the nation, smaller than Pierre etc. And it's a lovely charming little town of (IIRC) about 10,000.

Montana, 4th in size. 48th in Population density. Vermont, 45th in size. 30th in population density.

I said nothing about "population density" in geographical terms.
Here they are:

​

From here, which goes on:

>> Nearly three out of ten Americans live in a rural area or a very small city, according to the latest figures released by the U.S. Census Bureau.

That’s the national average — 28.8 percent of Americans can be found either in an unincorporated area or in a city of between 2,500 and 50,000 residents.

But the national average is dominated by large populations in a handful of very large metropolitan areas in Texas, California, New York, Florida and Illinois. Most states, like the children in Lake Woebegone, are well above average when it comes to the size of their rural populations.

Seven out of ten states (34 of 50) have more than 28.8 percent of their people living in rural settings — either in small cities or in unincorporated areas. Fifteen states have more than half their populations living in rural areas or in towns under 50,000 population.

The most rural state is Vermont, with 82.6 percent of its population living in either rural areas or small cities. <<​

Well? You think I make this stuff up?

The link isn't active. I did find this one though which shows Montana having about 7 percent more living in non core areas than Vermont.

http://www.rupri.org/Forms/Vermont.pdf

 

[Pogo]

Oh poster please. Man up for once in your sad little existence and admit you're full of shit already.

"Link isn't active" -- where do you think I copied it from??
DAMN.

 

[westwall]

Oh poster please. Man up for once in your sad little existence and admit you're full of shit already.

"Link isn't active" -- where do you think I copied it from??
DAMN.

It's not active! I'm not making it up! If that is the site you are using then that's great but looking between the two states shows that Montana has more urban but less micro urban population. Between the two Montana is slightly more rural.

 

[Greenbeard]

You mean taxes would have had to be raised in order to have a single-payer system ?
Color me shocked.

What's interesting (and not really being noted here) is what changed in the last year or two.

Vermont was counting on re-purposing Medicaid funding to support that new system and it was also counting on getting the value of its ACA exchange subsidies from the federal government (since under the ACA's state innovation waivers, states are given the equivalent of their ACA funding to put toward whatever their alternative model is).

But both of those of those things have dropped substantially from what they were anticipating. In other words, falling per beneficiary Medicaid costs and lower-than-expected ACA exchange subsidies have taken the wind out of their sails.

The premise of Vermont's experiment is that it would be significantly cheaper than the status quo--the more the existing system (under the ACA) comes in under budget expectations the more the financial argument for switching to their pseudo-single payer concept withers.

Record low premium growth (in both the employer space and in the individual commercial markets) and record low spending growth are good news for most people but bad news for Vermont's ambitions. They've taken a huge hit from the financial over-performance of the ACA. Something that's ultimately going to be true for the single-payer movement outside of Vermont.

This is from their explanation of what went "wrong" (though these are actually good indicators of what's going right with the health care system):

 

[westwall]

You mean taxes would have had to be raised in order to have a single-payer system ?
Color me shocked.

What's interesting (and not really being noted here) is what changed in the last year or two.

Vermont was counting on re-purposing Medicaid funding to support that new system and it was also counting on getting the value of its ACA exchange subsidies from the federal government (since under the ACA's state innovation waivers, states are given the equivalent of their ACA funding to put toward whatever their alternative model is).

But both of those of those things have dropped substantially from what they were anticipating. In other words, falling per beneficiary Medicaid costs and lower-than-expected ACA exchange subsidies have taken the wind out of their sails.

The premise of Vermont's experiment is that it would be significantly cheaper than the status quo--the more the existing system (under the ACA) comes in under budget expectations the more the financial argument for switching to their pseudo-single payer concept withers.

Record low premium growth (in both the employer space and in the individual commercial markets) and record low spending growth are good news for most people but bad news for Vermont's ambitions. They've taken a huge hit from the financial over-performance of the ACA. Something that's ultimately going to be true for the single-payer movement outside of Vermont.

This is from their explanation of what went "wrong" (though these are actually good indicators of what's going right with the health care system):

Oh, so the only way that Vermont could hope to support a single payer system was by outside support. There was no way they could fund it with wholly internal revenue? Interesting.

 

[Greenbeard]

Oh, so the only way that Vermont could hope to support a single payer system was by outside support. There was no way they could fund it with wholly internal revenue? Interesting.

Re-purposing state Medicaid funding is internal revenue. ACA exchange subsidies are not.

The fact that health care is cheaper than expected reduces the bite of both funding sources.

 

[JakeStarkey]

I am not even going to go into how the problem has not been defined...so the solution is never clear.

My point in posting this is that they are looking at it and they should learn some things.

Obama would have done well to look at Tenncare which has been around a long long time.

Now....

If Mass has Romneycare....

Tenn has Tenncare......

Vermont gets something.....

Are not the states doing the will of the people......

And if the will of the people in a state is that they don't want it......

Then let's scrap this mess they call Obamacare.

Glad you came around to state level health care for the people.

Good for you. And the people have ACA who can't or won't do through the state.

Shut up Jake....

I've always been for states having that conversation. That does not mean they have to do it....it's up to them.

F**k that ACA.

Got that trip to Omaha rescheduled ?

It's good to see that you are moderating.

So is Antares. That is smart of him. And you, too.

 

[Listening]

I am not even going to go into how the problem has not been defined...so the solution is never clear.

My point in posting this is that they are looking at it and they should learn some things.

Obama would have done well to look at Tenncare which has been around a long long time.

Now....

If Mass has Romneycare....

Tenn has Tenncare......

Vermont gets something.....

Are not the states doing the will of the people......

And if the will of the people in a state is that they don't want it......

Then let's scrap this mess they call Obamacare.

Glad you came around to state level health care for the people.

Good for you. And the people have ACA who can't or won't do through the state.

Shut up Jake....

I've always been for states having that conversation. That does not mean they have to do it....it's up to them.

F**k that ACA.

Got that trip to Omaha rescheduled ?

It's good to see that you are moderating.

So is Antares. That is smart of him. And you, too.

You are full of shit.

When was that Omaha trip ?

 

[Listening]

Oh, so the only way that Vermont could hope to support a single payer system was by outside support. There was no way they could fund it with wholly internal revenue? Interesting.

Re-purposing state Medicaid funding is internal revenue. ACA exchange subsidies are not.

The fact that health care is cheaper than expected reduces the bite of both funding sources.

So, it should have moved forward...right ?

 

[Greenbeard]

Oh, so the only way that Vermont could hope to support a single payer system was by outside support. There was no way they could fund it with wholly internal revenue? Interesting.

Re-purposing state Medicaid funding is internal revenue. ACA exchange subsidies are not.

The fact that health care is cheaper than expected reduces the bite of both funding sources.

So, it should have moved forward...right ?

...no. Health care spending growth just reached lowest levels ever recorded last year. That means the argument that single-payer is needed to control health spending growth is diminished significantly.

Single-payer is supposed to be the white knight that saves us from what's going on now. But under what's going on now we're getting the best results we've ever seen in this country (the lowest-ever health spending growth, highest-ever insurance rates, the safest and highest quality care we've ever seen, the greatest state-level investment in health system change we've ever known).

It would've been a fine experiment, particularly for a small state, but most of the arguments for it have evaporated. They made the most sense in a pre-ACA world. But we're now in a post-ACA world. Which means most of the wind has been taken out of their sails because we're already seeing much of what they aspire to achieve.

Single-payer is largely predicated on the hope that the ACA underperforms hopes/projections. So far it's overperforming. So single-payer goes kaput (see: Vermont).

 

[JakeStarkey]

I am not even going to go into how the problem has not been defined...so the solution is never clear.

My point in posting this is that they are looking at it and they should learn some things.

Obama would have done well to look at Tenncare which has been around a long long time.

Now....

If Mass has Romneycare....

Tenn has Tenncare......

Vermont gets something.....

Are not the states doing the will of the people......

And if the will of the people in a state is that they don't want it......

Then let's scrap this mess they call Obamacare.

Glad you came around to state level health care for the people.

Good for you. And the people have ACA who can't or won't do through the state.

Shut up Jake....

I've always been for states having that conversation. That does not mean they have to do it....it's up to them.

F**k that ACA.

Got that trip to Omaha rescheduled ?

It's good to see that you are moderating.

So is Antares. That is smart of him. And you, too.

You are full of shit.

When was that Omaha trip ?

You hit like a pansy, Listening.

I am glad you are admitting you are moderating.

 

[JakeStarkey]

Oh, so the only way that Vermont could hope to support a single payer system was by outside support. There was no way they could fund it with wholly internal revenue? Interesting.

Re-purposing state Medicaid funding is internal revenue. ACA exchange subsidies are not.

The fact that health care is cheaper than expected reduces the bite of both funding sources.

So, it should have moved forward...right ?

You have no idea. Study the Governor's report of the delay not the "abandonment."

 

[JakeStarkey]

If the cost savings and benefits of ACA is greater than we hoped, then we have no need for single payer.

 

[DigitalDrifter]

Yeah somebody posted this yesterday. Sad story.

Uh, yeah, I posted this thread, yesterday. Hitting the egg nog a little early ?

 

[CrusaderFrank]

Governor has delayed not abandoned the plan.

Shumlin told Vox in March that the stakes for a single-payer pilot program were high, saying, "If we screw it up, it will set back this effort for a long time."

It wasn't clear on Wednesday when Vermont might resume the effort, Vox reports.

Read Latest Breaking News from Newsmax.com http://www.Newsmax.com/US/single-payer-healthcare-vermont-failing/2014/12/17/id/613685/#ixzz3MHllB2aW
Urgent: Should Obamacare Be Repealed? Vote Here Now!

Jake, need a hankie?

 

[CrusaderFrank]

If the cost savings and benefits of ACA is greater than we hoped, then we have no need for single payer.

who is "we"?