We Used To Call It Socialized Medicine

What we now call single payer health insurance is what we used to call national health insurance and before that it was socialized medicine.

Do these name changes make the underlying ideas more palatable? Apparently not.

Vermont has now thrown in the towel on its plan to create single-payer heath insurance presumably an option states are permitted under the Affordable Care Act. State officials decided that even in blue state Vermont voters would be unwilling to agree to the huge tax hike needed to pay for the scheme: an 11.5 percent payroll tax and an income tax of up to 9.5 percent, on top of the current one.

Giving up cannot have been easy. It came at the end of a four-year, very expensive effort. Democratic Governor Peter Shumlin was elected in 2010 on an explicit single-payer platform and he has been trying ever since to make it a reality. As the Wall Street Journal editorial page explained:

Health and Human Services bestowed a $45 million grant for planning, and since 2011 Mr. Shumlins team has worked closely with HHS, the Treasury and White House budget office.

The state hired William Hsiao of Harvard and Jonathan Gruber of MIT to design the program. The former economist created Medicares price controls in the 1980s and the latter is sometimes called the architect of Obamacare.

So what was the point of the whole exercise?

Thats not clear. Almost everybody in Vermont already has health insurance (the uninsurance rate is 6.8%). And the insurance they have is more comprehensive than what most other Americans have. Its even more comprehensive than what Obamacare promises. As Avik Roy explains, Silver plans, used as the benchmark for Obamacares subsidies, have an actuarial value of 70 percent. That means that for every dollar of expected health costs, the insurance company will plan to pay 70 percent and patients will pay 30 percent in the form of co-pays and deductibles. By contrast, the actuarial value of the average Vermont private plan in 2011 was 87 percent, according to Hsiao and Gruber.

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We Used To Call It Socialized Medicine

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