One of the myths perpetuated during the debate over the Affordable Care Act (and nowhere more so than in the Michael Moore movie “SiCKO”) was that it would provide “free” health care “like in Europe.”
Such myths die hard – and especially in Vermont.
The Wall Street Journal writes:
Last week, in a reversal that deserves more attention, Democratic Governor Peter Shumlin announced that Vermont would no longer create America’s first statewide single-payer health system. Vermont was seeking a waiver from the Affordable Care Act to abolish what’s left of the nominally private insurance market by 2017, but Mr. Shumlin’s budget gremlins concluded the plan was too expensive and would damage the state economy … The state accountants estimated that his plan required an 11.5% tax on worker payroll, with no exceptions. Individuals, meanwhile, would have paid as much as 9.5% of earnings, which would have applied to everyone making more than four times the poverty level, or $102,220 for a family of four—hardly the 1%. The full $2.59 billion in necessary funding would roughly double current state revenues (about $2.85 billion today).
(The full Wall Street Journal editorial can be found here.)
In other words, there is no such thing as “free” government-supplied health care.
This shouldn’t have come as a surprise. In Canada, while the percentage of taxes used to provide health care varies, it’s estimated that about 22% of taxes collected go into the health system and several provinces, including Quebec, Ontario, Alberta, and British Columbia also charge additional premiums. Citizens in the U.K. pay 11% of each pound they make in weekly income, between £100 and £670 for the NHS,
And what can’t be overlooked is that price controls equals choice controls.
When it comes to the Affordable Care Act, patients can access any medicine they need -- as long as it's on the exchange formulary. Sure, the ACA limits the degree to which insurers can charge higher premiums for sicker patients, but ObamaCare plans found a way around these rules: impose higher out-of-pocket costs for all or most specialty drugs. High co-pays effectively remove choice from the system for many patients.
The breakdown of Silver plans (the most popular category) is particularly revealing. In seven classes of drugs for conditions from cancer to bipolar disorder, more than a fifth of these plans require patients to shoulder 40 percent of the medicine’s cost. And 60 percent of Silver plans place all drugs for illnesses like multiple sclerosis and rheumatoid arthritis in the “formulary tier” with the highest level of cost-sharing.
Nearly every Silver plan across the country, in fact, puts at least one class of drug exclusively in the top cost-sharing tier. In effect, this leaves patients with a given condition — whether HIV or Crohn’s disease — without a single affordable treatment option. Silver is the new Black.
Referring to the Model T, Henry Ford famously said, "Any customer can have a car painted any color that he wants so long as it is black.” That worked out fine – until there was competition. Choice is the great emancipator. The same is true when it comes to healthcare – and a lot more important.
