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By Chuck Gregory
Excellent editorial piece in your paper! (The Valley Reporter, June 5, 2014.) I thought just FYI to give you a few insights about the problems your editorial touches on.
1. There's a difference between the operation of the exchanges and the coverage of Obamacare: The former is mostly dependent on the programming algorithms that are supposed to ensure smooth processing of applications; the latter is designed to curtail only the worst abuses of the private health insurance system.
2. Because insurers are now required to accept clients with pre-existing conditions, it is necessary for their profitability to increase prices. However, they highball their increases in the presumption that the state is going to negotiate them downward.
3. Good as it is, Obamacare was passed only because it guaranteed continued profits for insurance companies – and $80 billion in profits over the next decade for the pharmas. Green Mountain Care is going to take away the insurance companies' business, which means immediate cost reductions. This is where even the most pessimistic of the five studies done – that of the Valere Group – admits cost savings of half a billion over what Vermonters are now spending.
4. As I am fond of saying, when it comes to taxes, the state Legislature is like a debutante who believes her boyfriend is the only man in the world and that he will leave her if she does not whore for him. Because most costs will be paid by taxes, it is dependent on the Legislature to get over that mindset. Companies with their own health care plans should be taxed as well; it will encourage them to do better by their employees (you've seen SiCKO, I hope). The cost should not be borne simply by a payroll tax, but by both increased income tax and a tax on the (my estimate) $32 billion of privately held property that has hitherto been exempt from property taxes.
5. In per capita GDP (per CIA data), Vermont is wealthier than 21 of the 36 countries that have better health care and better health care outcomes than the U.S. There's no reason why the Legislature shouldn't shoot for an "all for one and one for all" approach in its better alternative to the ACA.
Chuck Gregory lives in Springfield, VT.