The State of Vermont is rapidly moving down the road towards a single payer health care system. There are lots of passionate people on both sides of this issue. If you live in Vermont, or even if you don’t, you’ll likely have some sort of an opinion about whether a single payer system is a good or bad idea.
I’ve come to believe that a single payer health system is the only way of providing health care that makes sense. When I say a single payer I mean a true single payer, not the partial one the present Administration is proposing. I also mean a single payer, not a single provider. Having competition between health care providers is still possible and advantageous.
A problem with the health care bill as proposed is everyone is not included. I’m not talking about coverage; I’m talking about who will be paying in. The Administration has made it very clear that ERISA plans that include large employers like the hospital, state employees, and large private employers that have more than 100 employees are exempt.
In the insurance world there is a principal called adverse selection. This is where the only people who buy insurance are the ones who have a high probability of using it.
The Administration has set up a system where adverse selection is baked into the program. They’ve allowed large employer to opt out. Large employers tend to have the healthiest part of the health care population. This allows the larger employers to pay a much lower rate than the rest of the people who live in the state.
As a small employer I resent having to subsidize large organizations. I already pay enough in taxes, the medical facilities have lots of resources, and large corporations can certainly afford to join us poor peons. If you’re going to truly have a single payer system then that system needs to be fair. Fairness in this case means everyone paying their fair share and everyone having the ability to have similar benefits.
I’m not opposed to and endorse having supplemental policies such as ones that exist today in Medicare. I don’t think it’s appropriate or affordable to allow such large health groups to opt out of a plan that’s supposed to bring health care that makes sense to all.
We have enough corporate welfare in this country. Vermont doesn’t need to be another Government entity that promotes the large at the expense of the small. I’m hoping that we either truly reform health care in Vermont or just skip the whole process. Anything in between is patently unfair.
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