So the latest news in the saga of Vermont’s health care reform effort was the presentation to lawmakers of an “independent study” on the costs of a single-payer system. It found that the administration’s estimated cost of $1.6 billion may be low: its estimate of the true cost is between $1.9 and $2.2 billion.

This made headlines across the state, and caused a few mild cases of the vapors under the Golden Dome.

But a few caveats are in order. Also, don’t believe what you saw on TV.

First off, I’ll point out that the study was done at the behest of hospital, medical, and business groups. VTDigger:

Vermont Partners for Health Care Reform – a coalition of groups that consists of Blue Cross Blue Shield of Vermont, Vermont Medical Society, the Vermont Association of Hospitals and Health Systems, Fletcher Allen Health Care, the Vermont Chamber of Commerce, the Vermont Assembly of Home Health and Hospice Agencies and the Vermont Business Roundtable – paid Avalere, a Washington, D.C-based research and consulting firm, to carry out an analysis.

Now, that doesn’t prove the study was flawed or slanted, but its conclusions should certainly be taken with a grain of salt. (I also have to snicker at the name “Vermont Partners for Health Care Reform,” which would more accurately be “Powerful Institutions Fearful of Health Care Reform.”)  

Then again, maybe I’m just being my cynical old self.

But let’s move on to what the study actually says about single-payer’s cost.

After the jump: a covey of “coulds,” a smoking gun, and WGOP strikes again.

The Freeploid:

• Doctors and other health care providers could see significant reductions in reimbursements, which might affect recruitment and retention.

• Hospitals also could see revenue losses based on the reimbursement scheme the administration used to explore future financing for a single-payer system.

• Health insurers already have reduced administrative expenses to a point where the projected savings of switching to a government-run system could result in negligible savings.

• Doctors still would have costs for processing insurance for out-of-state patients and those whose employers continue to offer insurance.

Please note the abundant qualifiers. “could see significant reductions… which might affect recruitment…” “could see revenue losses…” “could result in negligible savings.”

It’s all those “coulds” that add up to the extra $300-600 million. Doesn’t sound very definite to me. In fact, it might be a sign that there was, indeed, a thumb on the scale. And well, whaddya know, buried in VTDigger’s account is a big greasy thumbprint:

Vermont Partners for Health Care Reform commissioned Avalere to comb through the financing plan for “assumptions”- in other words, potential fallacies…

Oh, so it wasn’t an objective evaluation of single-payer; it was a single-minded search for flaws. Er, things that could be flaws. And, of course, they found a few.

Gov. Shumlin’s director of health care reform, Robin Lunge, was unfazed by the report, and offered a very detailed response. I won’t repeat her points here; go read ’em on Digger if you want more.

The real goal of this little dog-and-pony show is to try to slow momentum toward a single-payer system. One of the report’s authors, Bob Atlas, used the dreaded words “bold experiment” in relation to single-payer — words certain to make lawmakers dive under their desks. And, tellingly, he noted that

“The current plan may not be the only path or the most painless path to the outcomes you are looking for.”

In short, single-payer is a dangerous thing, and if you decide to chicken out, you can still declare victory.

I beg to differ. Single-payer is exactly where I want to go. That’s the point. I’d hate it if this report gives jittery lawmakers a pretext for dumping universal health care.

And now we must, sadly, turn our attention to our friends at WGOP — I mean, WCAX-TV. Its report strips away all those pesky “coulds” and presents the outside study as plain old fact, under the headline “Single-payer to cost Vt. more than first thought.”

WCAX also misrepresents the group that commissioned the report:

Consultants independently hired by the state’s hospitals… told legislators the cost is more likely to fall between $1.9 billion and $2.2 billion.

Hmm, “the state’s hospitals.” So neat, so clean. Conveniently omitting the Chamber of Commerce, the Vermont Business Roundtable, and the state’s largest health insurance company.

WCAX downplayed Lunge’s coherent, detailed critique of the report by saying that she “quibbles with some of the new report’s methodology.” Quibbles, eh? Makes it sound like she objected to the font size or paragraph spacing.

Oh, WCAX, the spirit of Marselis Parsons is strong with you.

Anyway, color me unimpressed by the report. I hope it goes away as quickly as it arrived.