Editorial: Unthinking Opposition

Vt. GOP’s Odd Stance on Single-Payer

While evidence-based medicine has been advancing on all fronts in recent years, evidence-based politics is on its death bed — as demonstrated by last Saturday’s Vermont Republican State Committee meeting, which adopted a resolution urging legislative and statewide GOP candidates “to publicly oppose single-payer/government-run health care due to the negative impacts on the state’s economy and the lives of Vermonters.”

Several observers interpreted this resolution as an attempt to pressure Lt. Gov. Phil Scott, the party’s highest-ranking officeholder, to come out against Democratic Gov. Peter Shumlin’s intention to create a universal, publicly funded single-payer health care system in Vermont in 2017.

Scott has very reasonably declined to do so on the grounds that since there is no actual plan as yet for how this would be achieved, he is withholding judgment. Indeed, the governor does not plan to present a financing mechanism to the Legislature until next January, to be followed by a description of the benefits offered to Vermonters.

Scott told the Vermont Press Bureau for an story published in Tuesday’s Valley News that based on his travels around the state, he thinks residents have mixed views on single-payer. “There are many that want health care, and they want to be able to afford it. I think that’s what everyone wants,” he said.

Well, maybe not everyone. Take Darcie Johnston, a veteran Republican operative who is trying to kill single-payer through a nonprofit she formed called Vermonters for Health Care Freedom — “health care freedom” in this case perhaps meaning the freedom to go without.

For her, the state committee’s resolution was just the ticket. “I think it’s the ticket to raising money. I think it’s the ticket to recruiting candidates to run,” she said. We note that she did not say that it was the ticket to actually winning elections, something Republicans have done remarkably little of in Vermont in recent years.

Scott, on the other hand, has been elected to his current office twice and perhaps has a keener appreciation than some of his Republican brethren that applying a litmus test to something as complicated as constructing a health-care system is not calculated to produce a spate of victory parties come Election Day.

Scott has categorized himself as skeptical about the prospects for single-payer, and very probably he will oppose it once the Shumlin administration makes its long-awaited proposal public. But there is something appealing in the notion that a public figure might actually believe enough in the saying that the devil (or God) is in the details to want to examine those details before taking a position. Contrast this with the resolution the GOP state committee approved, which cited “negative impacts on the state’s economy and the lives of Vermonters” — negative impacts that are as yet unknowable, if indeed they will exist at all.

If the state Republican Party really wants to rally the faithful (and attract needed middle-of-the-road voters), the way to do that would be to articulate a detailed multiple-payer health care vision for the state that does not begin and end with the abstract notion of competition as a cure-all, but treats seriously the issues of access, affordability and cost control. Maybe that’s something even its candidates could get behind.