Megan McArdle has run the numbers on Vermont’s single payer scheme, and they aren’t pretty:
Just two small issues need to be resolved before the state gets to all systems go: First, it needs the federal government to grant waivers allowing Vermont to divert Medicaid and other health-care funding into the single-payer system. And second, Vermont needs to find some way to pay for it.
Although Act 48 required Vermont to create a single-payer system by 2017, the state hasn’t drafted a bill spelling out how to raise the additional $1.6 billion a year (based on the state’s estimate) the system needs. The state collected only $2.7 billion in tax revenue in fiscal year 2012, so that’s a vexingly large sum to scrape together.
Vermont is a small enough state — and wealthy enough — for this experiment in Canadazation. Assuming they can pull it off, which seems unlikely given the initial 50% increase in state spending, you have to wonder if residents will vote first with their feet to live in other states, or vote first with their cars to seek medical attention in other states.
Either way, Vermont might have finally figured out a way to rid itself of the poor, the sick, and Republicans. “Healthy, wealthy Democrats” could be the new state motto.