I think this is one of the best conceived plans I have heard of. Just in the telling it is apparent that not all of the issues have been thought through. I firmly believe in universal health care and think it is by far the best way to go. I really believe that it would be not that hard to design, as some combination of employer and individual payer, with provisions for the unemployed, and indigent with both state and federal contributions. That is providing you can keep the rent seekers, and "special interest" out of the process. My biggest concern with a universal health care program is what I call the python problem. Such a program would be under intense scrutiny with constant attempts to "cost justify" and "compare" to existing programs. Under our current program there is by definition, a significant amount of unmet health care needs. During the initial phases of any new universal health care program, people who have been delaying care or been denied care will rush to obtain services. This will have two effects one will be a shortage of qualified personnel, the other will be a temporary increase in costs. With patience and planning this would eventually work its way through the system. Also since we already have unmet needs we will may need to increase both personnel and facilities, at a slightly increased cost per person, although it may be that the increased efficiency of such a system would actually bring costs down below current levels. The big trick will be to keep special interests from driving the politicians to enact special privileges to create new rents.
It's so wild how much we spend on healthcare in America. I'm hoping the natural evolution will lead to universal healthcare. One of the challenges is that there is such a large middle man (for lack of a better term) industry in healthcare. But eventually, we need to flip the switch, right? It's not like those jobs are going to disappear.
Also... this article makes me want to move to Utah (haha).
So many factors...I think any state or organization that tries to fix this will create a mess, and my hope is the mess created is a step in the right direction. It’s atrocious.
I do think a lot of dollars/legislation is needed to change our farming, endemic loneliness, quality food access, and other environmental and societal factors that all tie into the dismal state of our health. Even if we fix insurance, if we don’t support or society from a health standpoint, the need for expensive disease care will continue to spiral out of control. I work as a consultant helping companies place their insurance in place and manage their programs. The acceleration of chronic disease is adding fuel to the fire. Our society has created a place where it is extremely difficult to prevent disease. We need to invest to change that!
Oct 17, 2023·edited Oct 17, 2023Liked by Elle Griffin
It makes perfect sense. Which is why politicians (and their minions) will oppose it. Plus the Insurance companies, who keep politicians in their pockets, will use their political influence to keep their companies from going out of business. I truly hope it happens. It could be a tipping point for other states. Common sense needs to finally beat special interests and dogmatic politics.
This is so exciting! The proposal makes so much sense - especially eliminating private health insurance. Healthcare and profit for shareholders are antithetical. Do you know whether this addresses the trend of venture capitalists buying up health systems and gutting them? Also, the U.S. has had a viable, successful government-run health care system for decades - for military families. Proof that it works.
I am watching this with interest. The UK's NHS is one of our largest employers - our taxes go directly to state funded hospitals, but it's slowly breaking apart due to the overhang from Covid and an increasingly elderly population with patchy social care. It's not enough to have accessible healthcare, if a quarter of hospital beds are occupied with dementia patients wauting for a nursing home or you can't get a rehab appointment after a stroke. I wonder how Utah will manage this?
The fact that we are still striving to make healthcare affordable is evidence of the failure of all past attempts to accomplish that task. I've been in healthcare since the early 1980s. Our healthcare delivery system was problematic then, and it remains so now. One of the main reasons for its perpetual challenges is that we operate (no pun intended) in an ever-changing environment—things are constantly in flux. Here is a list of some, though not all, of the factors: technological advancements, government regulation, institutional expansion, public expectations, educational costs, professional compensation, insurance considerations, legal pressures... and each of these is subject to both internal and external price inflation.
Frankly, there are many plates spinning, with money flowing in multiple directions. Unfortunately, patients' needs are often touted as the rationale for change and reform, but in reality, they only receive what is left after others have extracted their profit.
I wish Utah and anyone trying to improve the situation the best of luck. One piece of advice, however, is to deprioritize those regulators, industries, and opportunists who are hindering those committed to helping others.
Thanks for this post. We definitely need to remember the famous label of the states as "Laboratories of Democracy."
I think we should have universal healthcare. We can certainly afford it as a country and it is a huge cause and effect of inequality. I also think that in the competition for residents and businesses, a universal state plan could be a huge advantage.
In addition to looking at why Vermont did not succeed, it is also useful to look as well at what happened in Washington State in 2019 and to understand the POV of which institutions would oppose a plan.
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I think this is one of the best conceived plans I have heard of. Just in the telling it is apparent that not all of the issues have been thought through. I firmly believe in universal health care and think it is by far the best way to go. I really believe that it would be not that hard to design, as some combination of employer and individual payer, with provisions for the unemployed, and indigent with both state and federal contributions. That is providing you can keep the rent seekers, and "special interest" out of the process. My biggest concern with a universal health care program is what I call the python problem. Such a program would be under intense scrutiny with constant attempts to "cost justify" and "compare" to existing programs. Under our current program there is by definition, a significant amount of unmet health care needs. During the initial phases of any new universal health care program, people who have been delaying care or been denied care will rush to obtain services. This will have two effects one will be a shortage of qualified personnel, the other will be a temporary increase in costs. With patience and planning this would eventually work its way through the system. Also since we already have unmet needs we will may need to increase both personnel and facilities, at a slightly increased cost per person, although it may be that the increased efficiency of such a system would actually bring costs down below current levels. The big trick will be to keep special interests from driving the politicians to enact special privileges to create new rents.
It's so wild how much we spend on healthcare in America. I'm hoping the natural evolution will lead to universal healthcare. One of the challenges is that there is such a large middle man (for lack of a better term) industry in healthcare. But eventually, we need to flip the switch, right? It's not like those jobs are going to disappear.
Also... this article makes me want to move to Utah (haha).
So many factors...I think any state or organization that tries to fix this will create a mess, and my hope is the mess created is a step in the right direction. It’s atrocious.
I do think a lot of dollars/legislation is needed to change our farming, endemic loneliness, quality food access, and other environmental and societal factors that all tie into the dismal state of our health. Even if we fix insurance, if we don’t support or society from a health standpoint, the need for expensive disease care will continue to spiral out of control. I work as a consultant helping companies place their insurance in place and manage their programs. The acceleration of chronic disease is adding fuel to the fire. Our society has created a place where it is extremely difficult to prevent disease. We need to invest to change that!
It makes perfect sense. Which is why politicians (and their minions) will oppose it. Plus the Insurance companies, who keep politicians in their pockets, will use their political influence to keep their companies from going out of business. I truly hope it happens. It could be a tipping point for other states. Common sense needs to finally beat special interests and dogmatic politics.
This is so exciting! The proposal makes so much sense - especially eliminating private health insurance. Healthcare and profit for shareholders are antithetical. Do you know whether this addresses the trend of venture capitalists buying up health systems and gutting them? Also, the U.S. has had a viable, successful government-run health care system for decades - for military families. Proof that it works.
I am watching this with interest. The UK's NHS is one of our largest employers - our taxes go directly to state funded hospitals, but it's slowly breaking apart due to the overhang from Covid and an increasingly elderly population with patchy social care. It's not enough to have accessible healthcare, if a quarter of hospital beds are occupied with dementia patients wauting for a nursing home or you can't get a rehab appointment after a stroke. I wonder how Utah will manage this?
The fact that we are still striving to make healthcare affordable is evidence of the failure of all past attempts to accomplish that task. I've been in healthcare since the early 1980s. Our healthcare delivery system was problematic then, and it remains so now. One of the main reasons for its perpetual challenges is that we operate (no pun intended) in an ever-changing environment—things are constantly in flux. Here is a list of some, though not all, of the factors: technological advancements, government regulation, institutional expansion, public expectations, educational costs, professional compensation, insurance considerations, legal pressures... and each of these is subject to both internal and external price inflation.
Frankly, there are many plates spinning, with money flowing in multiple directions. Unfortunately, patients' needs are often touted as the rationale for change and reform, but in reality, they only receive what is left after others have extracted their profit.
I wish Utah and anyone trying to improve the situation the best of luck. One piece of advice, however, is to deprioritize those regulators, industries, and opportunists who are hindering those committed to helping others.
Thanks for this post. We definitely need to remember the famous label of the states as "Laboratories of Democracy."
I think we should have universal healthcare. We can certainly afford it as a country and it is a huge cause and effect of inequality. I also think that in the competition for residents and businesses, a universal state plan could be a huge advantage.
In addition to looking at why Vermont did not succeed, it is also useful to look as well at what happened in Washington State in 2019 and to understand the POV of which institutions would oppose a plan.
https://www.nytimes.com/2019/06/27/upshot/washington-state-weakened-public-option-.html