9-5-14 – You Can’t Get There From Here

 A Vermont Health Care Parable By Randy Brock

A man and his family stopped their car in front of the general store and, spying an old Vermonter, called out, “We’re moving into town. Can you give us directions to where we can buy health insurance?”

The old man thought for a moment and said, “You just keep on through town ‘til you come to what’s left of the old Free Market. It’s pretty much boarded up and out-of-business now. It had been going downhill for twenty years, ever since most of the insurance companies got run out of town.”

He continued, “Right there, turn left onto Regulation Road. There’s a sign there. In fact there must be a hundred signs – most of ‘em in print too small to read. The state comes and puts up another one every couple of days.”

The old-timer went on, “Watch yourself though, ‘cause there’s more speed bumps along there than you’ve ever seen. Oh, and you can count on getting’ stuck behind a manure spreader. Lots of manure on that road. And after a few miles, it turns into a toll road. “

“How much is the toll?” the man asks.

“Dunno. We keep asking, but they won’t tell us. Doesn’t matter, though. See, you pay the toll when you start out. But everybody gets charged a different amount. Then, there’s another toll house at the end of the road. They either charge you even more or give you a refund. Problem is, you can’t ever predict which. My advice is take a lot of cash; you’ll need it.”

“Follow Regulation Road ‘til you get to Subsidy Four Corners. You’ll know when you get there because you’ll see the road construction. They’ve been building that entrance ramp to the Single Payer Turnpike for three years, but it’s still not finished. Mostly, the contractors just stand around waiting for payday, asleep on their shovels.”

“At the corners, you’ll see the Nothing Burger Diner – worst food in Vermont. Turn left there onto Swamp Road. In fact, just remember to turn left every chance you get. Continue along, but watch out for the potholes. A lot of them are big enough to swallow up whole families. But at least there’s no speed limit – they want you to go as fast as you can, even through the fog. Oh, the road at this point is one way. No way to turn back.”

“You’ll go over Bungling Brook, cross Crony Creek, past the Rube Goldberg farm and around Finger Point.”

“When you see the big train wreck up ahead, you’ll be at the junction of Arrogance and Incompetence. Yup, Arrogance and Incompetence. That’s the only place where you can buy health insurance in Vermont anymore. Believe me, you’ll know it when you get there.”

“Thank you,” says the man, beginning to drive off.
“Just a minute,” says the old Vermonter, thinking. “Are you sure you want to go down this road? You know, if

I were looking to buy health insurance for my family, I sure wouldn’t start from here.”

– Randy Brock heads Rockledge Risk Advisors LLC. He is a former Vermont state auditor, state senator and he was the 2012 Republican nominee for Governor of Vermont. He is a Certified Fraud Examiner. 

{ 7 comments… read them below or add one }

Ivan Smith September 5, 2014 at 7:10 pm

Cute, albeit inane fable.

I understand the strategy that will be used against single payer will be to lump it as the same as the problematic exchange. Ours was not the only one to have problems though. In spite of all the other things the fable brings up the regulation, and gasp, insurance companies ran out of town, it is suffice to say that health care in Vermont isn’t so bad as it is right now. The two insurance companies that stayed after the others were ran out of town, can’t by law sell junk insurance, where they take your money but not pay for what the doc wants, or charge ridiculous fees and deductibles. This was before the much dreaded ACA. 90% of children are covered; not from the magic of the market place, but from an expanded state program (Dr. Dinosaur i.e. Medicaid) We are one of the healthiest states in the country too.

The ruthless arrogance of the for profit insurance companies are what drove the regulation in Vermont to run Companies like Cigna to leave the state, and good riddance. The ACA (Obama Care) was also a response to that; now there are rules that hopefully will weed out the worst of the bad players in the realm of medical insurance nationally.

But the goal of Single Payer in Vermont is to change the paradigm all together. Instead of have buy insurance, so that they can take your money, and then gamble that you won’t need health care, there will be a publicly financed pool of money, hopefully raised equitably, that will pay for health care when you need it. No premiums, no deductibles. Hopefully small copays at the most.

In short, going from having to buy insurance, or having it from your job, to the right to care it self. No barriers, no eligibility rules, other than residency of the state.
Like Medicare or Medicaid, the overhead of the system should be no more than 10% That means 90%+ of the money we spend on the system actually goes to healthcare. Before the ACA capped it at 20%, some for profits were at 25%+.

What would you want your money to go to, 90% for health care and everyone’s covered? Or 80% going to healthcare not everyone covered, and CEO making ridiculous salaries and perks etc.

And I know from my mothers experience that Medicare works pretty good. And I have never had a problem with VHAP or expanded Medicaid under the ACA

Now, if you think you are better off with having to buy insurance, or get it from your job, to have them gamble against you being sick or injured, having to pay deductibles so that the insurance companies can pay their CEO’s and share holders more money, and argue with the doc about what it will cover on a regular basis. Then you have been had.

If you think Cigna or other for profits, if we allowed them back into the state, would put the patients interest before their bottom line, then you’ve been had! Seriously.

It is time for Vermont to lead the way to a real system that does the 3 things you want a health care system to do: Cover everybody, control costs, and produce good out comes.
The vaunted free market system, left to its’ own devices, that you laud as the answer will not do that, I challenge you to show me any where in the industrial world where it has.

Reply

David Bresett September 11, 2014 at 2:14 pm

Well said. But, sadly Ropers fee market isn’t free a all. Ropers free market values the rich only.

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john mendenhall September 6, 2014 at 3:50 am

“Instead of have buy insurance, so that they can take your money, and then gamble that you won’t need health care, there will be a publicly financed pool of money, hopefully raised equitably, that will pay for health care when you need it. No premiums, no deductibles. Hopefully small copays at the most ”

You have neglected to discuss several important items. First, show me where in the Bill of Rights that health care is a right. It is a ” feel good right”, not a legal right, the same goes for housing and food. The state of Vermont does not have a printing press for currency, they can only confiscate through taxation. And while many “rights” sound well intentioned , the conscequences are depletion of my personal income attained by my efforts to pay for someone else who is unable or unwilling to work .
Freedom and my right to persue happiness are assurped for the “greater good”. Under the mandated confiscation of my personal assets,
” …there will be a publicly financed pool of money,”
I have lost the right to choose what is best for my family.

Are you suggesting that replacing the private corp. bean counters with state managed bean counters will be any better? I see we are $30million short in our current state budget. Oops! Just an accounting error?

“… so that the insurance companies can pay their CEO’s and share holders more money…”
Last time I checked BCBS was a non profit? I remember many years(30) ago the CEO was making in excess of $600K. Some thought it was excessive back then.
As for shareholders making money? Who are they to demand profits anyway?
Mutual funds, pensions, retirement funds ,401Ks, Ma and Pa investor? How dare they? They are us and have a vote in how the companies are run including executive compensation.
I have no say in how much the governor makes nor any panel or committee
who might run a government system. How many years has the fed had to “get it right” with the VA? “…Medicare works pretty good”,but are rife with fraud and waste.

I challenge you to show me any where in the government that they can run anything more efficiently and transparently.

Reply

Ivan Smith September 6, 2014 at 8:59 pm

Medicare is rife with fraud and waste because it is an honor system. They don’t spent the resources necessary to root it out on a regular basis. Recently there have been sting operation that caught allot of perpetrators doing that.

“I challenge you to show me any where in the government that they can run anything more efficiently and transparently.” How about Social Security, very Transparent and cost effective. In spite of the propaganda, it’s not going broke. It will be able to pay full benefits until 2029 at least, and that can be easily fixed raising the income cap from $110k to starting at $250k and up; which would make it solvent for the next 75 years, which in actuarial terms is for ever. Show me a pension or hedge fund that is more transparent than Social Security.

And may be the right to healthcare should be in the Constitution.
For the love of Christ stop hiding behind the Constitution. The more we have an honest discussion about the virtues and benefits of having universal health care, the more people will like and want it. And that is what EAI and those entities it carries water for fear the most.

Watch this: https://www.youtube.com/watch?v=UwUL9tJmypI

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Ivan Smith September 6, 2014 at 10:51 pm

And besides no one is an ISLAND; there can not be personal responsibility, with out social responsibility.

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H. Brooke Paige September 8, 2014 at 4:19 pm

ShumlinCare – Healthcare as Great as Its Namesake !

ShumlinCare will be universally “crappy” healthcare for everyone. Long waits to be treated by a handful for practitioners’ who were unable to relocate to greener (more profitable) pastures in states where this “single payer” chaos has not taken hold!

To be sure, competent care will be available on a “fee for service” basis for those with the cash to pay for it AND the State Employees, the Teacher’s Union members, Federal Gov’t. employees, employees at large companies, etc. certainly will not be subjected to the expanding experiment.

Those of us who have been “compelled to participate” in ShumlinCare (VHC) feel more like lab rats every day – we don’t appreciate the experience and the experiment is just beginning!

H. Brooke Paige

postscript: If this “steamy pile of … crud” is such a great deal – why doesn’t Shumlin sign himself, his wife and his kids up for the experiment?

Reply

David Bresett September 11, 2014 at 2:19 pm

So sad how Roper only writes parables that lean to the right so far that they fall on their face. Stick to the scripts FOX writes for you slick..

Reply

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