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How Vermont is doing implementing single payer
A DUer mockingly asked "How Vermont doing with installing its single-payer system ... surely it's operational by now!"
Three years ago, Peter Shumlin, the governor of Vermont, signed a bill creating Green Mountain Care: a single-payer system in which, if all goes according to plan, the state will regulate doctors’ fees and cover Vermonters’ medical bills. Mr. Shumlin is a Democrat, and the bill’s passage is a credit to his party. Yet a small upstart spent years building support for reform and nudging the Democrats left: the Vermont Progressive Party. The Progressives owe much of their success to the oddities of Vermont politics. But their example offers hope that the most frustrating dimensions of our political culture can change, despite obstacles with deep roots in American history.
Green Mountain Care won’t begin until at least 2017, but Vermont liberals are optimistic. “Americans want to see a model that works,” Senator Bernie Sanders told The Atlantic in December. (Mr. Sanders is an independent, but a longtime ally of the Progressives.) “If Vermont can be that model it will have a profound impact on discourse in this country.”
Before you dismiss that prospect as wishful thinking, consider: That’s how national health care happened in Canada. A third party’s provincial experiment paved the way for national reform. In 1946, the social-democratic government of Saskatchewan passed a law providing free hospital care to most residents. The model spread to other provinces, and in 1957 the federal government adopted a cost-sharing measure that evolved into today’s universal single-payer system.
....
The Vermont Progressives have only eight seats in the State Legislature, but they played a decisive role in the 2010 gubernatorial election. They promised not to play spoiler if the Democratic candidate supported single-payer health care. “Shumlin was very clear on his stance, and it pulled him through a narrow primary — a lot of Progressives were volunteers on that — and then he narrowly won,” Chris Pearson, a Progressive state representative from Burlington, told me. “He kept his promise.”
....
Yet the main lesson that Americans can learn from Canada is that political cultures can change. In 1950 Canada was, in many respects, a more conservative country than America, and each step of reform was hard-won. But as Canadians watched new policies produce results, skeptics became supporters. “Many policies that emerged in postwar Canada have changed Canadians’ conception of their relationship to the state,” Professor Maioni told me. “Policies feed political culture.” If the Vermont experiment works, other states will follow. American pragmatism will trump ideology.
NY Times
Green Mountain Care won’t begin until at least 2017, but Vermont liberals are optimistic. “Americans want to see a model that works,” Senator Bernie Sanders told The Atlantic in December. (Mr. Sanders is an independent, but a longtime ally of the Progressives.) “If Vermont can be that model it will have a profound impact on discourse in this country.”
Before you dismiss that prospect as wishful thinking, consider: That’s how national health care happened in Canada. A third party’s provincial experiment paved the way for national reform. In 1946, the social-democratic government of Saskatchewan passed a law providing free hospital care to most residents. The model spread to other provinces, and in 1957 the federal government adopted a cost-sharing measure that evolved into today’s universal single-payer system.
....
The Vermont Progressives have only eight seats in the State Legislature, but they played a decisive role in the 2010 gubernatorial election. They promised not to play spoiler if the Democratic candidate supported single-payer health care. “Shumlin was very clear on his stance, and it pulled him through a narrow primary — a lot of Progressives were volunteers on that — and then he narrowly won,” Chris Pearson, a Progressive state representative from Burlington, told me. “He kept his promise.”
....
Yet the main lesson that Americans can learn from Canada is that political cultures can change. In 1950 Canada was, in many respects, a more conservative country than America, and each step of reform was hard-won. But as Canadians watched new policies produce results, skeptics became supporters. “Many policies that emerged in postwar Canada have changed Canadians’ conception of their relationship to the state,” Professor Maioni told me. “Policies feed political culture.” If the Vermont experiment works, other states will follow. American pragmatism will trump ideology.
NY Times
Lawmaker Pushes Alternative To Single-Payer System
Lawmakers won’t see a plan to finance single-payer health care until 2015. But even as the Legislature tries to speed toward a Saturday adjournment, the issue of health care funding continues to loom large. And some lawmakers are ramping up efforts to create an alternative to single-payer.
At the beginning of the year, a group of mostly Republican lawmakers went to a legislative analyst and posed a question: Is there a way for Vermont to abandon single-payer, but still achieve all the health care benefits that Governor Peter Shumlin has promised to deliver to residents of the state?
....
As was reported first by VTDigger.org, Galbraith says the Shumlin plan would use a combination of a 5-percent payroll tax, a 2-percent tax on fuel gross receipts, and a mandatory premium that would be equivalent to a 9-percent income tax on people making $50,000 per year and above, with a maximum cap.
....
Browning says her plan doesn’t ensure health insurance as a right of Vermont residency, something Shumlin has insisted is an essential component of any health care reform initiative. But she says that according to the administration’s own projections, the number of uninsured Vermonters will soon drop below 15,000, thanks in large part to increased Medicaid eligibility as a result of the federal Affordable Care Act. And she says it doesn’t make sense to upend a system that works for many Vermonters when policy makers could take a more surgical approach to finding and enrolling the uninsured.
“To my mind this is a modest reliable alternative path for health reform that builds upon what we’ve already got and uses what’s already going right,” Browning says.
Vermont Public Radio
Lawmakers won’t see a plan to finance single-payer health care until 2015. But even as the Legislature tries to speed toward a Saturday adjournment, the issue of health care funding continues to loom large. And some lawmakers are ramping up efforts to create an alternative to single-payer.
At the beginning of the year, a group of mostly Republican lawmakers went to a legislative analyst and posed a question: Is there a way for Vermont to abandon single-payer, but still achieve all the health care benefits that Governor Peter Shumlin has promised to deliver to residents of the state?
....
As was reported first by VTDigger.org, Galbraith says the Shumlin plan would use a combination of a 5-percent payroll tax, a 2-percent tax on fuel gross receipts, and a mandatory premium that would be equivalent to a 9-percent income tax on people making $50,000 per year and above, with a maximum cap.
....
Browning says her plan doesn’t ensure health insurance as a right of Vermont residency, something Shumlin has insisted is an essential component of any health care reform initiative. But she says that according to the administration’s own projections, the number of uninsured Vermonters will soon drop below 15,000, thanks in large part to increased Medicaid eligibility as a result of the federal Affordable Care Act. And she says it doesn’t make sense to upend a system that works for many Vermonters when policy makers could take a more surgical approach to finding and enrolling the uninsured.
“To my mind this is a modest reliable alternative path for health reform that builds upon what we’ve already got and uses what’s already going right,” Browning says.
Vermont Public Radio
New Oversight Panel To Vet Single-Payer Plan
The legislative session may have ended. But that doesn’t mean lawmakers’ work is complete. And six of the most influential legislators in Montpelier will be spending part of their summer and fall preparing for the push next year for a single-payer health plan.
In the waning days of the legislative session, leaders in the House and Senate added a small provision to the budget. The language calls for the formation of what will be known as the Health Care Reform Oversight Committee. The panel will be composed of the chairwomen and chairmen of some of the most powerful committees in Montpelier.
....
Ashe says lawmakers will need to vet every aspect of the administration’s plan, and be mindful of how various financing mechanisms might jar different segments of the economy. For instance, Ashe says only a fraction of Vermont’s small employers actually provide health insurance benefits to their workers.
....
Ashe says the Health Care Reform Committee will serve as a kind of repository for information that will be analyzed and then disseminated to the Legislature as a whole. And if the Shumlin Administration has any hope of seeing its financing plan approved next year – the timeline favored by Gov. Peter Shumlin – then Ashe says the reform committee will need to see a preview of the financing plan before the beginning of the next session.
Vermont Public Radio
The legislative session may have ended. But that doesn’t mean lawmakers’ work is complete. And six of the most influential legislators in Montpelier will be spending part of their summer and fall preparing for the push next year for a single-payer health plan.
In the waning days of the legislative session, leaders in the House and Senate added a small provision to the budget. The language calls for the formation of what will be known as the Health Care Reform Oversight Committee. The panel will be composed of the chairwomen and chairmen of some of the most powerful committees in Montpelier.
....
Ashe says lawmakers will need to vet every aspect of the administration’s plan, and be mindful of how various financing mechanisms might jar different segments of the economy. For instance, Ashe says only a fraction of Vermont’s small employers actually provide health insurance benefits to their workers.
....
Ashe says the Health Care Reform Committee will serve as a kind of repository for information that will be analyzed and then disseminated to the Legislature as a whole. And if the Shumlin Administration has any hope of seeing its financing plan approved next year – the timeline favored by Gov. Peter Shumlin – then Ashe says the reform committee will need to see a preview of the financing plan before the beginning of the next session.
Vermont Public Radio
Single-Payer Advocates Hit Capitol With New Sense Of Reality
Advocates for a single-payer “Medicare for all” health system are fanning out across Capitol Hill this week, lobbying members of Congress.
....
“This is tough stuff,” Sen. Bernie Sanders, D-Vt., told a roundtable of advocates he convened in the Dirksen Senate Office Building. “Single-payer health care bills – it ain’t going to take place here in Washington. I suspect it’s going to take place, as it did in Canada, with a state [Saskatchewan] going forward. I hope it will be my state.”
Indeed, Vermont in 2011 passed legislation that would make it the first state to create its own single-payer system, called “Green Mountain Care.” The experiment is set to launch in 2017, the first year that’s allowed under the Affordable Care Act. But key decisions about exactly how the plan would work, in particular how it would be financed, have yet to be made.
....
For the moment, however, the single-payer advocates recognize that their mission is to convince a public that is clearly unhappy with the status quo in health care that a single-payer system is a potential option.
“The most important thing is to show people that change is possible,” said Gerald Friedman, an economics professor from the University of Massachusetts-Amherst. “That’s the role that Vermont has had – showing that it’s possible to get something done.”
Washington Post
Advocates for a single-payer “Medicare for all” health system are fanning out across Capitol Hill this week, lobbying members of Congress.
....
“This is tough stuff,” Sen. Bernie Sanders, D-Vt., told a roundtable of advocates he convened in the Dirksen Senate Office Building. “Single-payer health care bills – it ain’t going to take place here in Washington. I suspect it’s going to take place, as it did in Canada, with a state [Saskatchewan] going forward. I hope it will be my state.”
Indeed, Vermont in 2011 passed legislation that would make it the first state to create its own single-payer system, called “Green Mountain Care.” The experiment is set to launch in 2017, the first year that’s allowed under the Affordable Care Act. But key decisions about exactly how the plan would work, in particular how it would be financed, have yet to be made.
....
For the moment, however, the single-payer advocates recognize that their mission is to convince a public that is clearly unhappy with the status quo in health care that a single-payer system is a potential option.
“The most important thing is to show people that change is possible,” said Gerald Friedman, an economics professor from the University of Massachusetts-Amherst. “That’s the role that Vermont has had – showing that it’s possible to get something done.”
Washington Post
That's how Vermont is doing with their Single Payer plan. Forging ahead while Republicans and some Democrats are gumming up the tracks.
11 replies
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Nice people, good environment, and now sensible health coverage. Could it get any better? 
