In the movie Magnum Force, Clint Eastwood coined the catchphrase, “A man’s got to know his limitations.” This should apply doubly to politicians.
The news this summer surrounding Vermont’s journey toward a single payer healthcare system has been abysmal. House Healthcare Committee chairman Mike Fisher called the results thus far a “crisis in our communities.” Lawrence Miller, Vermont’s chief of healthcare reform used the word “chaos,” and described the level of customer service as “god awful.” The director of the Office of the Health Care Advocate says users of Vermont Health Connect are increasingly “irate.” (VPR, 7/23/14)
Why shouldn’t they be? After spending over $70 million setting up this exchange, the list of problems with Vermont Health Connect is long and serious. According to recent news reports, hundreds of Vermonters who enrolled in plans and paid their bills are now uninsured because the bureaucracy “inexplicably” didn’t pass the information on to insurers. Over 14,000 Vermonters can’t change incorrect information regarding their plans, which is “impeding their access to care.” 22,000 Medicaid beneficiaries lost coverage because they couldn’t or didn’t complete their annual reviews on the Vermont Health Connect website, and the state doesn’t know why. (Vermont Digger, 7/23/14) Doctors have been required to provide thousands of dollars worth of services to patients without immediate compensation.
Miller says it will take another $100 million ($171 million total) to make Vermont Health Connect function properly. Keep in mind the reason the state is taking over the healthcare industry is because they promised to do things more efficiently for less cost. Yet the Vermont Health Connect project (essentially building a website, albeit a complicated one) is significantly less challenging than the $5-6 billion dollar job of building and operating a single payer healthcare system for all 620,000 Vermonters. And these same people tell us that’s what they expect to be doing just two-and-a-half years from now. What evidence exists that we should believe them?
How did we end up here? Rep. Fisher provides an insight with his comment to Vermont Public Radio, “[T]he Legislature’s ability to intervene in the situation is diminished by the fact that it’s not in session.”
Entrepreneurs who start businesses routinely spend sixteen hours a day, 365 days a year focused exclusively on making their endeavor a success. The people who write the laws that put these large, complicated, expensive schemes in motion spend at most a few hours a day, four days a week, a few months a year batting things around.
And, they’re not qualified.
Receiving a majority votes from a few thousand constituents does not impart special powers or superior wisdom. These are just ordinary people making tremendous decisions about things in which they have little if any experience.
For example, the House Healthcare Committee that wrote the legislation that led to the current crisis is comprised of a social worker (chair), a substitute teacher (vice chair), a former substance abuse counselor (ranking member), a school nurse (clerk), a truck driver, a marketing consultant, a lobbyist/professional activist, a home care nurse, one doctor (OB/GYN), and a landlord.
Now, all of these are good, smart people who care deeply about serving their communities. They make sacrifices to do so, and are deserving of our respect. However, none of them has anything close to the kind of resume you’d look for to build, organize, and oversee a $5-6 billion healthcare delivery service. It reminds me of another movie quote from Martin Sheen in Wall Street when his stockbroker son shares plans to take over the company he (the father) works for, “Course my son did work three summers as a baggage handler and freight loader. With those qualifications, why should I doubt his ability to run an airline?”
For the same reasons we should doubt Montpelier’s ability to run a healthcare system.
Add to the lack of expertise, and lack of oversight ability the fact that any government run system must pass through and exist within a highly politicized gauntlet of checks and balances that were designed to limit the scope and speed with which government can act, the results we’re seeing today are not surprising at all.
The state was not constructed to take on these kinds of jobs, therefore, it never, ever does them well.
Abraham Lincoln said it best, “The legitimate object of government, is to do for a community of people, whatever they need to have done, but can not do, at all, or can not, so well do, for themselves – in their separate, and individual capacities. In all that the people can individually do as well for themselves, government ought not to interfere.” Or, as Dirty Harry might have said, a government – particularly a government specifically designed to be limited — has got to know its limitations.
- Rob Roper is president of the Ethan Allen Institute