Like all loyal Republicans, Gov. Sean Parnell never liked big government’s Affordable Health Care for America Act. Now that’s it’s been declared constitutional by the U.S. Supreme Court, he’s set his sights on Medicaid expansion as the one provision he can resist implementing. The rest of his opposition has been reduced to political sound bites. But if he was really interested in helping Alaskans control the cost of health care, he’d be directing his Health and Social Services Commissioner to examine Vermont’s single payer plan that was signed into law two months ago.
On the tax front, the Affordable Care Act isn’t the “single largest tax increase in American history” as Parnell suggested. It barely ranks among the top 10 increases ever enacted. And most of the new taxes won’t affect the “working poor and middle class Americans” as our governor claims. More than 40 percent of the estimated tax increase will fall on individuals earning more than $200,000 per year ($250,000 for couples). They’ll be paying an additional 0.9 percent on the hospital insurance portion of the FICA payroll tax.
The 15 categories of new or increased taxes were all part of the act before the Supreme Court ruling. However, there’s a reason why Republicans didn’t rally around them two years ago. Most of them, like the hospital tax increase and the new annual fee on health insurance providers, won’t make points with the average voter.
The bull’s eye of the act has been the “individual mandate” that requires all Americans to have “minimum essential” health insurance coverage. And employers with more than 50 people on the payroll will be required to offer to them a plan that meets that minimum coverage. Otherwise, individuals and businesses will be subject to a tax, not a penalty, as it’s now defined by the Supreme Court.
What does this mean for Alaskans? Currently about 18 percent of the state’s population is uninsured. About a quarter of them have been living above the federal poverty threshold but will gain Medicaid coverage as long as Parnell doesn’t reject the provision which expands eligibility for the program to 133 percent of that threshold. His gripe is that it will cost the state $30 million a year. Even if his figures are accurate it’s a weak argument because that’s pennies relative to the state’s $12 billion operating budget.
The rest of the state’s uninsured will have to decide whether they want to pay an additional tax or purchase an insurance plan from an out-of-state health care provider. And here’s where Vermont’s single payer plan differs -- their residents won’t be forced to enrich the CEOs and shareholders of any big corporation.
The Vermont plan isn’t socialized health care. People can still to go to the private sector doctor or hospital of their choice. Its main objective is to eliminate the private insurers who only serve as a profit-making money exchange between doctor and patient. Just because those companies compete on the free market doesn’t mean they’re in the best position to contain the skyrocketing cost of health care. Indeed, they’ve failed to do just that over the past 60 years. Besides, the vast majority of us couldn’t tell which company offers the best policies because we haven’t got the expertise to decipher their pages of complex rules and fine print of exemptions and exclusions.
There’s a partial variant of single payer health insurance already at work in Alaska. It’s for employees and retirees of the state itself. Private companies may process the claims, but the funds to pay them come from the state treasury. Interestingly, when the Parnell administration announced last week that it was looking for ways to bring down the $600 million the state spends on health care, no one said they’d be turning to the private sector for help.
I’m not saying a single payer plan for Alaska is the solution. But only that the governor be openminded enough explore it without a prejudicial fear of socialism. Vermonters are moving in the direction of getting both the federal government and the large out-of-state insurance companies out of their lives. And that’s a goal all Alaskans should agree on.
• Moniak is a resident of Juneau.
Comments (22)
Add commentSocialist?
Vermont's Senator Sanders is the only self proclaimed socialist in the senate. Vermont is the retirement retreat for New York's ultraliberals.Perhaps Alaska should consider addressing the health needs of it's residents but it should never look to Vermont for anything but maple syrup!!
One of your best pieces yet, Rich
I particularly agree with your statement "...the private insurers who only serve as a profit-making money exchange between doctor and patient. Just because those companies compete on the free market doesn’t mean they’re in the best position to contain the skyrocketing cost of health care. Indeed, they’ve failed to do just that over the past 60 years."
I'm 100% certain that Parnell would be loudly supporting the ACA if it had been implemented by a republican president. Remember, the individual mandate idea was created by the conservative Heritage Foundation and promoted by republican senators. Their rallying cry was "No free-riders!"
But because the republican healthcare plan was passed by a democratic president, Parnell will cut off his nose to spite Alaskans faces.
Snagger
I don't think Sen. Bernie Sanders is a "self proclaimed socialist." The records show that is an "Independent": not a member of any political party.
Please give a reference or citation to verify your statement that he is a "self proclaimed socialist.
Thank you.
Switzerland
Rich Moniak. All universal health care systems are not the same. Recently Fareed Zacharia had a program on TV comparing health care systems around the world such as England, Canada, Taiwan, France and Switzerland. These countries have various forms of universal health care.
If I recall correctly, Switzerland has a system that is entirely based on individuals and private doctors - and from what he showed it seems to be working well.
I think you know more about these things than I do. Am I correct regarding the Swiss system????
"Like all loyal Republicans..."
As opposed to 'disloyal' Republicans? Another political pundit preaching to the choir.
Allow me to expound.
In my college days I had the good fortune to be mentored by one of the leading speech/debate (forensics) coaches in the Pacific Northwest, Orv Iverson.
As is true with all of the great teachers and professors, and those numbers are fewer than they should be, he had a large impact upon my own critical thinking and communication.
A common mistake made by many columnists is to envelope themselves within a predisposed bubble of approval by their peers and like-minded readership and the quickest route to this is by minimizing the opposing viewpoint.
This tactic serves two purposes: it creates a comfort zone within which the writer feels most comfortable, hence preaching to his/her 'choir', and it identifies opposing viewpoints early on as predictable and thus less deserving of merit.
This tactic is all good and well for its entertainment value but it serves little purpose in persuading which should be the primary goal.
Mr. Moniak's opening remark to Republicans made it clear where he placed those readers and in those first few words he casually dismissed at least half of his audience.
Fortunately for him, though, he is not addressing his judges in competition. The first words should not be insulting.
Rough Cut
Perhaps others would like to buy you a one-way ticket too
Why not give others and option and indicate where you would like to relocate.
Snagger is correct
Vermont has both a sales tax and an income tax. Vermont has severe fiscal difficulties despite (or perhaps because of) the heavy tax burden. We don't want any Alaska governor looking to Vermont for anything.
By the way, salmon farming is big in Vermont. And even though Vermont is smaller than the Tongas NF, far, far more timber is cut in Vermont than in all of Alaska. How can that be?
Sanders is in fact a socialist but he attacks D's as well as R's, and as with listening to Public Radio, it's good to know what the other side is thinking. And he may be the most honest person Vermont has sent to Congress in a long time. The bar is not placed very high in that respect.
I will not offer this opinion but someone might say that we should only look to Vermont for maple syrup and farm girls. Snagger only mentioned the syrup, which is also sweet and can have a bite to it if left unattended. Heat them up again however and you're good to go.
Glacier dogs
Perhaps rather than using the plural "we" it might be much safer to say "I" and not pretend to speak for all other Alaskans.
Glacier Dogs
Looking through the dictionary defining the term "socialist", I don't see Senator Sanders fitting that definition. What I see is a member of Congress who appears to be "independent" and not a member of any political party.
How do you define "socialist" and what is your evidence for saying he is a socialist. Please, reference your statements with voting records and facts to show that he is "in fact a socialist" "In fact," means the facts are there. What are your "facts." ?????????????????
Rough cut
I will agree to help pay for the ticket on the condition that at Seymour canal, you and old the old brown bear engage in hand-to-claw combat. Hopefully you will come out the winner as a great "Rough Cut" Alaskan, tougher than a brown bear.
Should I contribute to a one-way or two-way ticket??
Wallyolly, Snagger remains correct.
The following is excerpted from the Burlington Free Press, the city newspaper where Bernie was mayor before running for Congress:
"When Vermonters chose Sanders to replace retired Sen. Jim Jeffords, I-Vt., in 2006, some senators doubted whether the impassioned socialist known for his untamed white hair and fiery oratory would fit in with the staid Senate."
Wallyolly, note that in Burlington the media do not use socialist as a pejorative term (whereas I usually do). At the same time, I think I gave credit to Sanders as due.
Do the right thing?
Perhaps a number of social thinking Alaskans would be willing to give up their PFD and pay for the medical expenses of others. I have no problem with wmo spending his money any way he wants!
Most of Obamagarbage will not be paid for by taxing the wealthy
The people being taxed to pay for Obamagarbage are those earning $200k and up BUT that hardly pays for this disaster as Rcih's piece seems to suggest.
1/2 BILLION cut from senior citizens who can least afford cuts are supposed to pay for a major chunk of giving more handouts to people too lazy to work however long to takes to provide for their kids properly. It's not a tax-we're just going to shorten their lives by cutting their services.
The other major funding comes from forcing the youngest, healthiest people who can't afford to purchase and could never afford to utilize health insurance to pay for those people who are too lazy to do what it takes to support their families responsibly. To heck with these young people paying for their own retirements. They need to pay for welfare programs for other people first.
There simply is no scheme you can devise that will provide unlimited funding for people without requiring a shred of personal responsibility.
VT healthcare reform actively taxes the poor who don't
pay in for health insurance they can't afford and won't use for years to come. Still a far cry from his portrayal that this will all magically be paid for by taxing the wealthy.
The analysis on the VT plan also was too underfunded to take into account the impact on the state economy. According the Dr Hsiao who was commissioned to perform the analysis, a study that in depth would cost a million or more and take a year to complete.
It never ceases to amaze me how people will jump at the possibility of a magic money fountain if it looks like they will get something for nothing.
As the token socialist wannabe...
...this would all be so much easier if the U.S. just made Medicare available for all.
Our health care system is so broke it is laughable. Last health care plan I had guaranteed a maximum out-of-pocket expense of $1000.
yeah. right.
"Oh, but that didn't include blah blah blah..."
And I basically paid for all of my health care last year, AND still had to pay ridiculous premiums on top of it. But they'd spring for the occasional $14 prescription, or at least 60% of it.
Medicare for all!
@DoRight
What's your solution?
Always worth considering another proposal
I think looking into a state health care trust is a great idea. I am part of a health trust, and one of the great things about it is that no insurance company is scooping 25-40% off the top for profits. The cost of overhead is 6%, far less than any for profit health company. The rest is put into paying health costs. The cost has gone up nominally the past couple of years, and none this year, and they have expanded what is covered for the past 3 years. Don't throw something away just because who or where it comes from. The despicable way that health insurance companies were tossing the sick out and denying coverage while pocketing record profits is reason enough to turn our back on them.
Although I agree with you Jo, it will not happen as long as we allow money in politics. Too much at stake for insurance companies, for profit hospitals, and pharmacutical co. Richard, thanks for writing this.
Response or question for Jo MacNamara
Why Medicare; why not make all Alaskans eligible to use BIA health care? The clinics and hospitals are already in place. The costs are known.
We're paying for "uninsured" already via emergency room visits
...because hospitals have to treat them, regardless of ability to pay. Makes more sense for them to have coverage, doesnt it?
As an aside, it would be great when everyone has insurance and can go see a non-ER doc for their sniffles, etc., so people who go to the ER with a real emergency or urgency arent waiting for hours.
It is disengenuous for Romney and the GOP to flip out about Obamacare when Romney passed essentially the same in MA - and even encouraged Obama to adopt it country-wide, until, of course, he found it politically convenient to say otherwise.