Vermont's new governor, Democrat Peter Shumlin. (Photo Courtesy of WikiMedia Commons)
News » March 18, 2011
Vermont’s Single-Payer Salvation
The Green Mountain State is poised to abolish most forms of private health insurance.
Three weeks after the House of Representatives voted to repeal last year’s landmark healthcare reform legislation, and one week after a federal judge ruled the bill’s insurance mandate unconstitutional, Vermont’s leaders decided to take matters into their own hands.
On February 8, newly inaugurated Democratic Gov. Peter Shumlin unveiled his plan for a publicly funded single-payer healthcare system, which was introduced into the state’s legislature. If enacted, which appears likely, it will be the first system of its kind in the United States and Vermont would become the first state to abolish most forms of private health insurance.
“In five years, I predict the United States will go through another major debate of how to reform the healthcare system,” Harvard School of Public Health Professor William Hsiao told the state’s legislators in January, noting his belief that the federal reform legislation passed in March 2010 will not solve the nation’s healthcare crisis. “The question for Vermont is, do you want to walk ahead of the United States? Do you want to be a model for the United States?”
Last year, lawmakers passed a bill to hire a team of consultants led by Hsiao–an economist who helped to develop universal healthcare plans in Taiwan and reform Medicare and Medicaid in the 1970s–to design a new healthcare system for the Green Mountain State. According to Hsiao’s research, about 32,000 people, or roughly five percent of the state’s population, would still be uninsured after federal reform measures take full effect in 2014. (Fifty seven thousand, or 9 percent, of Vermonters are currently uninsured.)
What Hsiao and his team ended up recommending to the state was a single-payer system that would ensure coverage for all residents. An independent public body would oversee the system and contract out administration of all claims. Private insurers could compete for this work, as they have done for years to administer the state’s Medicare program. The bill, currently in committee, would take an estimated three to six years to implement.
“I know what I’m going to present is not necessarily popular for everyone,” Hsiao said as he began his January presentation in Montpelier. “A health system is a complex system.” The annual savings that would be created by the system, however, do appear to be popular among lawmakers and public officials. Hsiao’s team estimates the single-payer system could save the state at least $580 million yearly, or $1.2 billion by 2019, and create 4,000 jobs because the burden of rising healthcare costs would be lifted from businesses.
On February 24, the Republican Mayor Christopher Louras, of Rutland, urged the state to adopt the single-payer legislation, noting that more than a third of the city’s $7 million annual payroll is consumed by healthcare costs. “The only way to fix the problem is to blow it up and start over,” Louras said.
The introduction of the healthcare bill comes in the first months of Democratic Gov. Peter Shumlin’s first term in office, which follows eight years of Republican rule under Gov. Jim Douglas. Shumlin supported a single-payer healthcare system during his campaign, calling Vermont’s current system “broken.” Anya Rader Wallack, the special assistant to Shumlin on healthcare, cited waste and “craziness” as factors troubling the state’s current healthcare system during testimony before Vermont House and Senate committees on February 8. Three private insurance carriers operate in Vermont, along with Medicare and Medicaid and various suppliers of workers’ compensation insurance, a structure Wallack called “misguided.”
Dr. Deborah Richter, president of Vermont for Single Payer, which has advocated for a new health system since 2003, says that “on the whole” the group supports Hsiao’s plan. “Estimates are that [Hsiao’s system] will not only be able to cover everybody, but for less money,” Richter says. “Vermont is uniquely poised to get this done.”
The state cannot “get this done,” however, unless it receives a waiver from the federal government to bypass the federal reform legislation. Shumlin thinks that won’t be a problem; Vermont’s entire congressional delegation–Sens. Bernie Sanders (I) and Patrick Leahy (D) and Rep. Peter Welch (D)–support the single-payer effort and introduced a measure to allow states to receive waivers from federal reform requirements as soon as 2014, as long as they cover as many uninsured people as federal law would. (They currently have to wait until 2017.) On February 28, President Barack Obama told state governors he would support the earlier date.
Hsiao seems optimistic. “I can say with full confidence that your broken system can be fixed,” Hsiao counseled Vermont lawmakers. “But we require you to…adopt the right solution.”
ABOUT THIS AUTHOR
Lauren Else is a Winter 2011 In These Times editorial intern.
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Reader Comments
Finally perhaps, a majority of people with the intelligence and will to address real issues. Bravo!
Posted by wesgordon on Mar 24, 2011 at 3:11 PM
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Posted by ofice2010 on Apr 26, 2011 at 8:27 PM
Well, This is good news out of the US, a rare thing I’m sorry to report. I was under the impression that states could go their own way. This article seems to imply that they can’t, at least not easily. Certainly, with this turn of events, we now see why, beyond the basic idea that supporting democracy is good (‘real’ choice for people who, in one place, may have their own reasons for doing things differently than fellow citizens elsewhere), it would be a good thing for states to have some independence. Politicians just might come to right conclusions, from a democratic standpoint, and decide to do the right thing, namely the thing that offers socialism for all, rather than just for a hypocritical minority that tells others that socialism is a sin.
Otherwise, I have always felt that it’s unrealistic to expect a socialistic program like universal, single payer healthcare to survive within an uber capialist system. I don’t expect it to survive here in Canada and I don’t expect it to survive in America. Uncaring capitalists are under pressure by their monstrous system to demonstrate fealty, regularly (and it’s easy to choose to ‘not’ rock the boat when there’s a real danger in a social safety net-shredded system that you will be tossed over, since the monster doesn’t care whether you’ve fed it), by going along with the built-in mechanisms that ensure the system’s own continued existence. A Republican who supported single payer healthcare surprised the heck out me. I can’t believe it - literally. But, We’ll see.
Lawmakers who are down with the fascism-supportive doctrinal system, with outcomes like Citizens United, and more, ensure that the big heavy boat of socialism for a minority will only get bigger and harder to turn around - if folks ever find the energy and time to even grapple with all the problems that comprise the Big problem that is that big boat.
The answer: I’m not an expert. But I am a citizen (of Canada, which is mostly a sentiment, thanks to a succession of continentalist, ‘capitalist’ leaders here who sold their souls and sold out fellow Canadians) and I have been paying attention and I do have a non academc, but good, understanding of what’s going on. I try to shame my fellow ‘citizens’ into caring. Our capitalist-designed society dumbs people down because it is threatened by caring, engaged citizens. I can’t prescribe, or offer detailed, specific solutions, because I wouldn’t know how to, but also because I think the real need is first just get people to care. Solutions (and yours may look different than mine) flow from caring.
Two. It’s clear that we do have fascism and that’s it’s ramping up. Madison Wisconsin makes it very clear that fascists, otherwise known as glory seeking, macho capitalists (who like to push until things break), will go all the way. It’s human nature to trust and we just can’t believe that people who we don’t know would seek to harm us. But that’s a conclusion we draw, to our detriment, when we ignore all available info. There ‘is’ a Devil and he has his agenda and it involves us and it’s… not good. So, We need to recognize that demon-inspired fascist elites have chosen to society build by exploiting. It makes them seem tougher in their own and each others’ eyes when they can get ahead by taking from others rather than working with them.
Of course, They also need to work with others to do that. That’s why they are really socialists. They just don’t believe in socialism for all. And we must comprehend that, and the corporatocracy which those fascist elites preside over and the need, therefore, to attack that. We need to form explicitly anti-corporatocracy, anti-fascist parties and force them into our unfree electoral marketplace. We must corrupt fake democracy. That will be revolutionary and unwanted by power and powers’ servants, but that’s all that we can do - in the absence of Armageddon, which I also expect. But in the meantime…
Posted by Arby on May 11, 2011 at 6:15 PM
A good indicator for economical decrease can also be the number of families that sign for a home insurance. Since this is so well known as being a basic premise of life safety, we can tell the thoroughness of cutting expense among the population by the fact that some of them are giving it up. After all, the importance of home insurance, health insurance, car insurance quotes, stands for a major importance role in anyone`s life.
Posted by Elliad on Dec 26, 2011 at 7:08 PM
These budget cuts diminish our chances as college students to benefit from accommodation conditions that used to come by default, I guess. Things were much easier for us years ago, but this is how it works now. Either you afford it, or not. Which is why I come to think of a better option, like entering the colleges in Idaho. Lots of people of my age have taken this opportunity. Needless to say you can have at least a part time job meanwhile, that can cover some of your expenses.
Posted by Elliad on Jan 24, 2012 at 10:44 AM
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