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Vermont

The straight scoop about the status:
an important first step along what has been and is a long, tough road toward the possibility of having a state-version of single-payer health care by 2017. At that time it would not be a "strict single-payer", as noted in two places within this web page.

Our warmest and heartiest congratulations regarding the progress!
to Dr. Deb Richter, to Vermont Governor Peter Shumlin, to the Vermont Workers Center and to everyone else who has contributed to this first major step of progress.

 


Summary

In Vermont in early May 2011 an important step of progress was made towards the possibility of a state-based single-payer system by 2017.

There has been much excitement about that first step of progress. So much excitement that some Americans think that Vermont already has single-payer, but it does not, as documented below.

What follows is the straight scoop about the status.

 

Vermont Senator: unknown if Vermont will ever have single-payer

Listen to the WCAX video "Legislative countdown: Health care", also titled "Paying for Single Payer". Reporter Kristin Carlson interviewed Senator Claire Ayer of Addison County, Vermont, on the same day on which the current legislation was signed on May 3, 2011.

Within the first few minutes of the interview:

"... a lot of what we are doing is setting up the stage for decision-making ..."

"It might be five years or more ... before the state has a single-payer system."

"Definitely years down the road ..."

"It's a huge project ... " "... three to five or six years to get there".

The Senator discusses that the legislation does not define how the system will be financed.

At the end of the video (at about 5 minutes):

At the end of the video the Senator is asked whether or not Vermont will ever see single-payer. She replied with "There can't really be a single-payer system until there's a single payer." Then she implied that it's a complete unknown as to when Vermont will ever have a "strict single-payer" system. Listen to the video for her description of the complexity involved due to the surrounding states not having single-payer even if Vermont successfully passes such a law.

 

Dr. Deb Richter: law does not allow for strict single-payer, as per The New York Times

The NY Times, May 21, 2011: Within this article Vermont Governor Shumlin described Dr. Richter as the backbone of the grassroots effort that led to the progress that has been made. Dr. Richter is VERY pleased about the progress, as we all should be. However, Dr. Richter's input to The New York Times clarifies the current and future status.

Excerpts of the article: (bolding added)

... much remains to be worked out — so much that even under the
        most optimistic projections the plan might not take effect until 2017. ...

... Most significantly, Mr. Shumlin still has to figure out how much it will cost and how to pay for it, possibly through a new payroll tax. Whether he will still be in charge by 2017 is among the complicating factors. (There is no financing mechanism defined in the legislation.)

"If we had the exact same Legislature and the same governor we could get it done,” Dr. Richter said. “It’s a big if, because the opposition has a ton more money to convince people that the governor is evil and this is socialized medicine and all kinds of other scary stuff.” (Dr. Richter is one of the most highly respected single-payer activists in the United States. She tells it like it is, such as this quote about the opposition. Read more about the opposition at the Media web page.)

The opposition will probably include insurance companies, drug makers and some employers who say there are too many unknowns. Many doctors, too, are wary of the change and what it might mean for their income. Dr. Richter said she believed a “slim majority” of the state’s 1,700 licensed physicians were supportive.

... Some supporters of single-payer health care say Vermont’s law does not go far enough, mostly because it would allow at least a handful of private insurers to stay in the market indefinitely. Self-insured businesses like IBM, the state’s largest employer, could continue providing health coverage to workers under the law, though they would have to help finance the new system, possibly through a payroll tax.

Physicians for a National Health Program is among the critics, saying the law “falls well short of the single-payer reform needed.” Allowing private insurers to remain in the state will prevent meaningful savings, the group says.

Dr. Richter acknowledges that the law will not allow for “strict single-payer,” ...

Source: The New York Times, May 21, 2011.

Bolding was added to the above excerpts.

From website of PNHP, Physicians for a National Health Program:

PNHP article April 7, 2011: Vermont health bill mislabeled 'single payer'

Healthcare Finance News, May 16, 2011: "Single Payer in Vermont? Well, Not Exactly"

"The (new law) provides for the creation of the legal framework of a public insurance program, to be called Green Mountain Care, but includes no funding mechanism, defines no benefit standards, is vague on the future roles of private insurers, and is silent on exactly how existing federal programs are to be incorporated."

"(... big obstacles ... are likely to be at the federal level ...) The Accountable Care Act allows states to opt out of federal reform starting in 2017, but not before. (Although an earlier date has been proposed, it has limited support). The pooling of federal funds envisioned by Vermont’s single payer advocates would require negotiations with Medicare, Medicaid, TRICARE, and Public Health administrators, all in the face of opposition from lobbyists for insurers, providers, and businesses who fear the impacts of a single payer structure on their revenues and profits. And who would be willing to guess whether or not in 2013 the administration in Washington DC is favorable towards any kind of health care reform?"

Additional information

Vermont News provided by PNHP regarding their path to a possible state-version single-payer system.

 


 

Additional Excerpts from The New York Times Article that was originally published at:
        http://www.nytimes.com/2011/05/22/us/22vermont.html
A Doctor’s Push for Single-Payer Health Care for All Finds Traction in Vermont
By ABBY GOODNOUGH  Published: May 21, 2011

MONTPELIER, Vt. — "Many people move to Vermont in search of a slower pace; Dr. Deb Richter came in 1999 to work obsessively toward a far-fetched goal ... to (have Vermont) become the first state to adopt a single-payer health care system ..."  “We wouldn’t be where we are without Deb,” (Vermont Governor) Shumlin said in an interview. “She’s made this her passion. And like anyone that’s making significant social change, she has qualities of persuasiveness and leadership and good judgment that are hard to find.” "... "Dr. Richter has given about 400 talks on the single-payer concept, tutored lawmakers in the State House cafeteria and testified before the Legislature more times than she can remember." ... "Dr. Richter acknowledges that the law will not allow for “strict single-payer,” but said it still promised “health care for everybody, for less cost. This is not the top of the mountain, but it’s the first time anyone has headed up the mountain,” she said. “No other place in the country has gotten this far."

 



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