Commentary: A Better New Path To Health Care Reform (January, 2015)

by John McClaughryJohn McClaughry

Afew days after his news conference announcing the death of single payer health care at least for now, a dejected Gov. Peter Shumlin announced his determination to carry on down the same perilous path. Said he, “I’m open to any ideas that any legislators have that would get us where I want to go. If someone can find a path forward that we didn’t, I’m all ears.”

Vermonters should pay careful attention to the governor’s choice of words here, because they presage yet another costly fool’s errand.

First, note that the governor is only open to ideas from “legislators.” Where the six independents are coming from is never clear, but the eight Progressives will continue to demand “Single Payer Now” because it’s the only chant they know. Similarly, the majority Democrats are with only a handful of exceptions completely wedded to Shumlin’s single payer bill of goods, prominently featured in their party’s platforms for years.

Over the past four years the minority Republicans have offered amendments to make Green Mountain Care more transparent and less onerous. When the Democrats and Progs overwhelmingly voted them down, the Republicans unanimously (with one exception) voted against Green Mountain Care. However the Republican legislators evinced no capacity to develop alternatives to Shumlin’s plan to impose centralized state control over $5 billion worth of the state’s economy.

So exactly which legislators are likely to produce a principled, practical and affordable health care reform that isn’t the failed single payer in a different costume? Most likely, very few to none of them.

Now return to the governor’s statement: “I’m open to any ideas that any legislators have that would get us where I want to go.” He is not asking for creative ideas for improving the health care of Vermonters. He is asking only for ideas that will get us where he, Peter Shumlin, wants to go.

And we know where he wants to go, because he has restated it time and again for the past four years. He wants a government-managed, price-controlled, taxpayer- financed monopoly health system that gives everybody their right to “appropriate care at the appropriate time in the appropriate setting” (Act 48), at least until the money runs out.

Hard fact: There are not any workable, affordable ideas that will get Vermont to where the governor wants it to go. He should have learned that from the four years and untold millions of taxpayer dollars he spent trying in vain to inflict single payer on the people of the state.

So what should our next step be? My recommendation is for the governor, policy makers and legislators to invite some experts in who really understand how health care works, hear them out, pose hard questions, and absorb their experience and wisdom. Here are just a few at the leading edge of real health care reform.

• Professor Clayton Christensen of Harvard Business School, whose widely hailed 2009 book “The Innovator’s Prescription” explains how the American health care business model is woefully outdated, and how disruptive change can bring far better and less costly health outcomes.

There are not any workable, affordable ideas that will get Vermont to where the governor wants it to go. He should have learned that from the four years and untold millions of taxpayer dollars he spent trying in vain to inflict single payer on the people of the state.

• Professor Michael Porter of Harvard Business School, whose 2006 book “Redefining Health Care: Creating Value-Based Competition on Results” became an instant classic.

• Professor Regina Herzlinger of Harvard Business School, whose three books on consumer-driven health care have shaped a whole new field of health policy thinking.

• Dr. John Goodman of the National Center for Policy Analysis, a nationally respected health economist and the “Father of the Health Savings Account.”

• Eric Topol, MD, author of the pathbreaking 2012 book “The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care.”

• Greg Scandlen, former executive director of the Council for Affordable Health Insurance and chronicler of grassroots citizen efforts to improve their health.

• Jonathan Bush, CEO of Athena Health and author of “Where Does It Hurt? An Entrepreneurs Guide to Fixing Health Care.”

When back in 2007 Sen. Peter Shumlin became captivated with the need to make Vermonters combat “climate change,” he occupied the new Legislature with a two week seminar on that subject. He was careful not to invite any speakers whose views might depart from his (and VPIRG’s) preferred narrative.

We don’t need more of those rigged performances. But we should have another seminar or conference, this time featuring independent health policy experts with experience and ideas, such as those mentioned above.

The single payer gurus had their chance, and banished all non-conforming ideas. They installed a scheme that has cost us a lot of time and money, and almost cost the Promoter in Chief his job.

It failed, and it’s time for the single payer advocates, including the governor and legislators who followed their directives, to take a seat in the audience and start listening.

- John McClaughry is vice-president of the Ethan Allen Institute (

{ 2 comments… read them below or add one }

forbes August 9, 2015 at 12:52 pm

So the problem has been identified.. What is wrong with the citizens hosting a state wide review and recommendations for this crippling problem . Legislators could attend with no speaking time allotted. They would need to listen for once! What harm would it cause since it effects every one?


Bob January 22, 2016 at 4:02 pm

John Goodman’s name might be on the HSA’s birth certificate, but I know you’re the “biological” father.


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The Ethan Allen Institute is Vermont’s free-market public policy research and education organization. Founded in 1993, we are one of fifty-plus similar but independent state-level, public policy organizations around the country which exchange ideas and information through the State Policy Network.

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