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Old 01-12-2019, 12:31 AM
SlackerInc SlackerInc is online now
Join Date: Feb 2003
Posts: 9,763
Even in Vermont, single payer ended up crashing on the shoals because all the taxes and disruption were, at the end of the day, too big a lift. Vermont. Home of Bernie Sanders (and Howard Dean for that matter). If voters in that state of all places balked, what do you think is going to happen in Ohio?

BLUMBERG: I think there's a combination of causes why it didn't work. So the lack of funding is clearly part of it because once they sat down and assessed what types of taxes they would need in order to make the plan feasible, they were, on the face of them, pretty high. And so they figured that they would not be politically palatable.
But I think part of it aside from just the sheer tax revenue that would be needed to finance a program like this - what they ran into was a real administrative and process problem also because they weren't explaining to people in a clear way over time, here's what the costs are going to be; here's what the benefits are going to be. Here's who's going to pay more. Here's who's going to pay less. This is why it's worth it for us to move from the system we're in to another one. And because this is such a big change, then when you just see the price tag, it's very shocking if you don't have an understanding of what is the core value behind doing this kind of change.

SHAPIRO: In Vermont, Governor Shumlin ultimately backed away from his signature policy after a few years. And having studied it, I wonder whether you see a way that it could easily have worked. Is there a simple fix that would have made it successful, or is the lesson that it's just really, really complicated and difficult to get something like this in place?

BLUMBERG: I think the lesson is it's very difficult. And it's not that it can't be done. We could certainly raise enough revenue to finance a program like this. But the problem is - is that any program like this has to assess what's going to be the role for private insurers? What's going to be the level of benefits and cost-sharing requirements? How are - at what level are providers going to be paid? These are political challenges at every turn.[…]

SHAPIRO: What kind of impact did the failure of this state policy in Vermont have on the national conversation around single-payer health care?

BLUMBERG: Well, I think it was a - an indication for a lot of folks who look at these issues regularly that, you know, the financing part and the face difficulty, the challenges of seeing these large tax increases is really very politically challenging. And that's aside from having a national political resistance from industries like the private insurance industry, the providers and others. So it really I think is a telling example of what the challenges are. Not that they couldn't someday be overcome, but there's a real transition issue between getting from here to there.

These are difficulties that people here, and more broadly most progressives who are rallying behind the MFA banner, just aren't honestly reckoning with.
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