Tiny Vermont is probably the most leftist state in the union.
Like many other New England states, it has a mix of old-time residents and their offspring, who tend to be more conservative, and relatively new arrivals (“new” in New England meaning anyone who arrived during the past 70 years) “from away,” who tend to be very liberal.
Like other New England states except for Massachusetts (population 6.6 million; see this for all states) and Connecticut (3.5 million), it has a tiny population. Maine is big in geography but only has about 1.3 million people, as does geographically smallish New Hampshire, and diminuitive Rhode Island has about a million. But Vermont, with about the same square mileage as New Hampshire, has half the people, with a population of about 625,000. That’s only about the size of a medium-large city, although Vermont is decidedly rural. Its biggest city, Burlington, hardly even qualifies for urban designation at all at 42,000 people.
So whatever health care solutions Vermont comes up with, it will be difficult to extrapolate the results to the rest of the country, except perhaps for others of its ilk in the bottom tier of population (although their populations tend to be far more conservative than Vermont’s, such as that of Alaska and Wyoming).
That’s one of the reasons that federalism is a good idea. States are free to experiment with health care insurance systems for their residents. And Vermont has done just that, taking a step described as being on the road to a single-payer system.
I’m not so sure that’s so. Take a look for yourself:
Legislators say the plan, approved by the Democratic controlled House and Senate this spring, aims to extend coverage to all 620,000 residents while containing soaring health care costs.
A key component establishes a state health benefits exchange, as mandated by new federal health care laws, that will offer coverage from private insurers, state-sponsored and multi-state plans. It also will include tax credits to make premiums affordable for uninsured Vermonters.
Private insurers are included there rather than single payer. But the goal is certainly eventual single-payer, and in the next few years rather than later:
The exchange, called Green Mountain Care and managed by a five-member board, will set reimbursement rates for health care providers and streamline administration into a single, unified system…As designed, the goal is an eventual state-funded and operated single-payer system.
There are a number of things that have to happen first, however, and they could represent big speedbumps or even roadblocks along the way. Vermont has to make a good case (the word the article uses is “ensure,” whatever that might involve) that the new plan will be cheaper than the old. Of course, we’ve learned that’s not all that hard to do by making sanguine assumptions that are unproven. The state also must ultimately get a federal waiver from Obamacare in order to institute single payer, assuming Obamacare is still around by 2017.
I mentioned that Vermont is loaded with recent immigrants “from away.” One of them is Dr. Deb Richter, who moved to Vermont from Buffalo NY in 1999 for the express purpose of pushing single payer health insurance. She had found the atmosphere in New York state to be unreceptive, and correctly surmised that the idea might encounter more fertile soil in leftist Vermont.
Certain Vermonters of the Republican persuasion aren’t too happy about that:
John McClaughry, a former Republican state senator who is against the new law, said Dr. Richter meant well but did not understand the “long-term damage” it would wreak. In particular, he said the law would drive away businesses that did not want to help pay for it.
Businesses? Vermont?? The state is not known for its welcoming business atmosphere to begin with. For example, it was ranked as number 45 out of 50 states by Forbes in 2010. For comparison, note that New Hampshire, its more business-friendly twin, was number 19, and behemoth Massachusetts was 16. But Vermont needn’t be ashamed before most of its fellow New England states—Connecticut was 36, and Rhode Island and Maine brought up the rear at numbers 49 and 50, respectively.