Universal health care sounds good until it doesn’t; SJM 8006 offers a misguided wish
Some people are in love with the idea of universal, taxpayer-funded health care. It’s an idea most often laced with unicorns and rainbows, seen through rose-colored glasses. But well-intended advocates might break up with the idea after fully considering the potential outcomes and costs of this kind of system.
Today, the Senate Health and Long Term Care Committee heard testimony on Senate Joint Memorial 8006. It has our state “requesting that the federal government create a universal health care program.” Not only is the legislation full of statements that are debatable at best, the request and focus further limits state lawmakers from thinking about free-market approaches to help contain health care costs. There are many good examples out there of how turning to a direct-care model — not greater government dependency — can bring down costs. And the beauty of the free market is its potential for creativity. Right now, we don't have a free market in health care.
I testified at the hearing and am sending this love letter to the Senate committee as it considers SJM 8006:
This memorial has good intentions, but it sends the wrong messages and makes the wrong wish. In other experiences with government-run systems, we see that affordability, access and quality do not go together. Individuals’ health care doesn't benefit from taking away decisions made between doctors and patients. Citizens — not governments — are the best advocates for their health care needs.
Great Britain and Canada have taxpayer-funded universal care, and recent studies show problems with access. The Fraser Institute in Canada found that the average wait time between a primary care provider referral and specialty treatment was almost seven months in 2022. Wait times have grown over the years.
In Great Britain, a Wall Street Journal article just reported, people who suffer heart attacks or strokes wait more than 1½ hours on average for an ambulance. The Royal College of Emergency Medicine estimates 300 to 500 people suffer premature deaths each week because of a lack of access to timely care. It added that more than one in 10 people are stuck on waiting lists for non-emergency hospital treatment for things like hip replacements. That makes my knee hurt. More.
Universal care sounds good until it doesn’t — even before you get to the insurmountable costs that have had other states abandoning their plans and ours in a continual committee-creating holding pattern.
In Vermont, despite being a small and progressive state, more than a dozen financing concepts showed the only way to set tax rates as low as Vermont officials wanted would mean giving residents skimpier coverage than most insured Vermonters already had, wrote Third Way, a national think tank that champions center-left ideas. It added that the estimated cost of the new system would have been over $5 billion in 2021. “For context, the entire budget for the state of Vermont was $5.01 billion for 2012-2013,” Third Way notes.
Officials in Vermont determined that an 11.5% state payroll tax and a 9.5% income tax would be necessary to pay for the new health care system. ‘Enormous,’ is how the state’s then-Democratic governor described the tax hikes needed to fund the plan.
Right now, our state’s workers are rightly upset about a new long-term-care payroll tax of 58 cents of every $100 they make and a tax for paid family leave that keeps climbing. These taxes, and future ones that would be enacted for more taxpayer-funded health care, take away people’s opportunities to find solutions for life needs that fit their individual situations.
Even if taxpayers wanted new, substantially higher taxes instead of insurance premiums, as promoters of taxpayer-funded care promise, the pattern of universal, government-run health care is the rationing of medical care. Some patients are denied care to save money. Patient-centered health care is not the priority.
Our third-party-payer system is a large part of the problem: Patients are separated from knowledge about — and from prioritizing — health care costs. We need educated consumers who shop for health care. We need price transparency. We need safety nets reserved for people in need, not widened for all. Costs will continue to increase as long as someone else is paying the health care bills.
We need to start with an understanding that health care is not a right. It is a necessity of life, just like food and housing. We shop for those things, and assistance is rightly available for people in need. That is where we need legislative focus.
I hope unicorns, rainbows and SJM 8006 are left here on Valentine’s Day.