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Amy Goodman writes: "Vermont is a land of proud firsts. This small New England state was the first to join the 13 colonies. Its constitution was the first to ban slavery. It was the first to establish the right to free education for all - public education. This week, Vermont will boast another first: the first state in the nation to offer single payer healthcare, which eliminates the costly insurance companies that many believe are the root cause of our spiralling healthcare costs."

A rally in Vermont for single-payer healthcare, 05/05/10. (photo: Jobs with Justice/flickr)
A rally in Vermont for single-payer healthcare, 05/05/10. (photo: Jobs with Justice/flickr)



Single Payer Healthcare: Vermont's Gentle Revolution

By Amy Goodman, Guardian UK

25 May 11

 

The green mountain state was the first to ban slavery, in 1777. Now, it's the first to pioneer a truly public healthcare system.

ermont is a land of proud firsts. This small New England state was the first to join the 13 colonies. Its constitution was the first to ban slavery. It was the first to establish the right to free education for all - public education.

This week, Vermont will boast another first: the first state in the nation to offer single payer healthcare, which eliminates the costly insurance companies that many believe are the root cause of our spiralling healthcare costs. In a single payer system, both private and public healthcare providers are allowed to operate, as they always have. But instead of the patient or the patient's private health insurance company paying the bill, the state does. It's basically Medicare for all - just lower the age of eligibility to the day you're born. The state, buying these healthcare services for the entire population, can negotiate favourable rates, and can eliminate the massive overhead that the for-profit insurers impose.

Vermont hired Harvard economist William Hsiao to come up with three alternatives to the current system. The single payer system, Hsiao wrote, "will produce savings of 24.3% of total health expenditure between 2015 and 2024". An analysis by Don McCanne, MD, of Physicians for a National Health Programme pointed out that:

"[T]hese plans would cover everyone without any increase in spending since the single payer efficiencies would be enough to pay for those currently uninsured or underinsured. So this is the really good news - single payer works."

Vermont Governor Peter Shumlin explained to me his intention to sign the bill into law:

"Here's our challenge. Our premiums go up 10, 15, 20% a year. This is true in the rest of the country as well. They are killing small business. They're killing middle-class Americans, who have been kicked in the teeth over the last several years. What our plan will do is create a single pool, get the insurance company profits, the pharmaceutical company profits, the other folks that are mining the system to make a lot of money on the backs of our illnesses, and ensure that we're using those dollars to make Vermonters healthy."

Speaking of healthy firsts, Vermont may become the first state to shutter a nuclear power plant. The Vermont legislature is the first to empower itself with the right to determine its nuclear future, to put environmental policy in the hands of the people.

Another Vermont first was the legalisation of same-sex civil unions. Then the state trumped itself and became the first legislature in the nation to legalise gay marriage. After being passed by the Vermont House and Senate, former Governor Jim Douglas vetoed the bill. The next day, 7 April 2009, the House and the Senate overrode the governor's veto, making the Vermont Freedom to Marry Act the law of the land.

Vermont has become an incubator for innovative public policy. Canada's single payer healthcare system started as an experiment in one province, Saskatchewan. It was pushed through in the early 1960s by Saskatchewan's premier, Tommy Douglas, considered by many to be the greatest Canadian. It was so successful, it was rapidly adopted by all of Canada. (Douglas is the grandfather of actor Kiefer Sutherland.) Perhaps Vermont's healthcare law will start a similar, national transformation.

The anthropologist Margaret Mead famously said:

"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

Just replace "group" with "state", and you've got Vermont.


Denis Moynihan contributed research to this column

e-max.it: your social media marketing partner
 

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+8 # AndreM5 2011-05-25 10:20
How is this different from Hawaii's (former) single-payer plan? The issue is less clear cut when the insurance company is also the provider, as it is for Kaiser, who is a big player in Hawaii.

The bottom line is to put the health insurance cos. out of business or at the worst make them not-for-profit.
 
 
+17 # Lexx 2011-05-25 10:58
Ah Vermont, my favourite Canadian state.
 
 
+27 # Barry Bobbitt 2011-05-25 11:24
Congratulations to the people and government of Vermont! A good step in the right direction with benefits for all. Maybe, just maybe some of the other states will follow this example...if they have any good sense....a rare commodity in most of our government.
 
 
+13 # Marna 2011-05-25 11:44
Great article! So very glad I was born and raised in Vermont. Weren't we also one of the first states (if not the first) to have mandatory bottle return? Single payer is the only way to go. Without the cost of insurance profit, it's a win/win all around; the providers can get fairly compensated and the users can maintain excellent health easily, at low cost, instead of saddling the system with serious health problems that grew because of lack of affordable care.
I love Vermont--thank you, Gov. Shumlin!
 
 
-5 # hsfrey 2011-05-25 11:46
The article is painfully short on details.

Will Vermonters pay premiums, or will it be paid through regular taxes?

Will there be a mandate that everyone buy health insurance?

Will there be services not covered? How will those be determined.

Will there be private insurance for those things not covered?

What will be done about the poor who can't afford even reasonable premiums?
 
 
+9 # PGreen 2011-05-25 19:01
Vermont has adopted a public insurance plan ("Green Mountain Care") for all state residents, which will be phased in over 4 years. The payment mechanism is likely to be a combination of business and individual taxes, though I wouldn't be surprised to also see a co-pay of some sort, as exists in most private plans. The finances have yet to be worked out in detail. Will the additional individual taxes for healthcare be progressive or flat? We shall see. This is groundbreaking stuff, and potentially superior to the Massachusetts system. I expect GMC to be far more cost effective than any private plan, with much lower administrative costs.
 
 
+21 # granny 2011-05-25 11:54
HOw many of us could fit in Vermont? Or how much of the country could Vermont annex?
 
 
+11 # mtnview 2011-05-25 15:15
Bernie Sanders, and now another reason to move to Vermont. Pretty soon there will be applications for new citizens, and the state will get to select who they want...... I hope they pick me!
 
 
+5 # americanexpat 2011-05-26 00:52
So glad we're planning a move to Vermont! I just hope natives of the great state don't think we came just for the health care! Either way, I am hoping this all works out; and hoping that more states follow. . . perhaps then the Federal Gov. will get a clue and do the right thing.
 
 
+3 # americanexpat 2011-05-26 00:57
Just a thought. . . perhaps Kiefer Sutherland could continue his grandfather's legacy--in the US?!
 
 
-3 # Kenwood 2011-05-26 08:39
Great! But what if the doctors move to New York?
 
 
+4 # Capn Canard 2011-05-26 10:13
What Vermont is doing is the only way to bring costs down. Leave it to a small state to actually do something big for it's people. It reminds me of the disaster that is Central America. FYI, Costa Rica has national healthcare and a strong Middle Class. CR has flown under the radar, even though the first elected leader of CR was a SOCIALIST. While Honduras, Nicaragua, El Salvador, Guatemala, and Panama have no Middle Class or Nationalized Healthcare these nations were all left to be dictated by the whims of United Fruit and other North American capitalists, hence Banana republics, and all the wars and killing that has followed for over 100 years. The free market is not so free nor is it safe. It is a Friedrich Hayek, and consequently Milton Friedman, dream come true. Disaster capitalism, as described in Naomi Klein's "Shock Doctrine"
 

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