Progress Pond

Vermont Moving Toward Single-Payer

Insane:

“Obamacare, as we know, is the crown jewel of socialism.” – Rep. Michele Bachmann (R-MN)

Sane:

VERMONT GOV. PETER SHUMLIN (D): Well, it’s my belief that it’s not an employer’s responsibility—and this might surprise you as a Democrat—but not an employer’s responsibility to provide health insurance to their employees, any more than we ask them to pay for their employees’ car insurance, life insurance or fire insurance on their home. What I want to design is a system where healthcare is a right, and the healthcare follows the individual. If we can take that burden off of the backs of our employers by using a broad-based funding mechanism, as in a payroll tax, other broad-based revenue sources, to replace the current dollars, we will be doing our employers a huge favor. I believe that the states that we currently lose jobs to—frankly, like New Hampshire to our east, who has no income tax—those small businesses will say, “Hey, wait a minute. If I can get rid of my biggest rising cost, which is health insurance to my employees, by moving to Vermont, that looks attractive.” So, I think it’s a jobs creator. We have to do it.

Gov. Shumlin was elected last year after running a campaign strong on single payer health care. Here’s what he wants to do.

So there are three things that we want our system to do. The first is, we’re wasting eight to 10 cents on the dollar in Vermont—frankly, in the rest of the country—chasing money around. No sane person would do that. We all know what we do. If we have insurance, we get the bill from our provider. Then the next envelope comes from the insurer. You wait for four or five of them to build up before you figure out what share you’re going to pay as an insured family and what share they’re going to pay. That is extraordinarily inefficient. We want to be the first state in the country that has the Green Mountain healthcare card. When you come out of your provider’s office, you pay your co-pay right there on the spot, just as you would never leave the grocery store without paying your bill there. That saves eight percent, we estimate, according to Dr. William Hsiao, right off the top. Then we want to use the same technology to have our health records on that card so that providers can actually know what the last provider did to you when you show up. That will get rid of the duplication and the waste in the system. And finally, we want to be the first state in the country that rewards providers for keeping you healthy as opposed the number of tests and procedures that they run you through, which happens to be the current system.

The hope is that Vermont will be more attractive to employers (because they will no longer be responsible for the soaring costs of health care) than New Hampshire is to them (because they can pay less to employees who don’t have to pay any state income tax). While New Hampshire businesses get slapped each year with rising costs, Vermont will increase its competitive edge annually and indefinitely until New Hampshire concludes that it must follow Vermont’s example and go to a single-payer system.

Gov. Shumlin also has something interesting to say about why it is possible to implement a single-payer system in Vermont, but not in other states.

Listen, here’s why we can do this in Vermont, why we have a better shot than perhaps anywhere else in America. Today is the anniversary of the Supreme Court decision that allows corporations to spend unlimited cash to influence our elections. What is different about Vermont is that our legislators are not in the pockets of special interests; they’re in the pockets of their constituents. Now, there’s a very simple reason for that. I was president of the Senate. My last campaign cost $2,500. My counterpart in New York’s campaign, the president of the Senate just across the lake, probably cost multiple millions of dollars. My point is, we have a citizen legislature in the state. We are not beholden to the special interests. We fight for our constituents in their best interest. And frankly, our insurance companies are smart enough to know that. So, I think that—you know, we all know that what’s destroying democracy is the extraordinary influence of corporate money. The folks that are making money off the system then elect the politicians that make the decisions about their economic future. So we have a real opportunity here, and I think our insurance companies are smart enough to see that we’re going to make progress, and they want to be the company that has the single payer.

I asked CabinGirl this morning if she’d be interested in a log cabin on the shore of Lake Champlain. It’s something to think about. If this bill passes and the jobs arrive as expected, it’s a conversation a lot of people will be having.

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