With the governor’s blessing, Vermont made history Thursday as the first state to enact a comprehensive single-payer health care system. There’s hope for the rest of us, as Amy Goodman pointed out: “Canada’s single-payer health care system started as an experiment in one province, Saskatchewan.”
In order to get Green Mountain Care (as the state’s new system is dubbed) off the ground, Vermont needs waivers from Congress and the Department of Health and Human Services. Firedoglake reports:
While the law puts Vermont on the path to achieving this goal [universal health care], there are still some major hurdles. By 2013 the state will need to decide on revenue sources to pay for some parts of it. An integral part of addressing the funding issue will be the need for multiple waivers from several federal laws that will allow the state to fold the administration and funding of federal insurance programs into Green Mountain Care.
Some of the potential waivers include:
Medicaid waiver
SCHIP waiver
Waiver to locally manage traditional Medicare
Medicare Part D waiver to include seniors in single drug formulary for the state
Waiver from some workers compensation laws
Waivers for multiple provision of the Affordable Care Act
It will take time to set up the new system. As AP explains, a new board will make key decisions about the public insurer:
Under a the law, a five-member board will be appointed by October to set up Green Mountain Care, as the state system is to be called. Among the board’s tasks will be to set up a payment system under which hospitals and other providers will be paid a set amount of money to provide health care to a set population, as opposed to the current system known as fee for service, which, for instance, pays doctors on a per-visit basis.
As alluded to before, Amy Goodman tells us in her latest column why the rest of the country might benefit from Vermont’s trailblazing:
Vermont has become an incubator for innovative public policy. Canada’s single-payer health care 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 health care law will start a similar, national transformation.
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.
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“Elected officials are not listening to their constituencies, they are,
as usual, advocating for their donors.” —mackTN, May 27 at
11:46 am
It is blaringly obvious that the 70% Majority Common Population,
the American Populace constituency, is NOT the constituency being
represented in Congress.
If insurance is going to be addressed in a meaningfully balanced
way, it will be necessary to unify the risk pool, so that risk for all
who are buying insurance and selling insurance is determined on
the basis of one single risk pool, and the risk and cost for
both buyers and sellers alike is spread out over that one
single risk pool; all else is a function of Hitleresque dialectic
and Hitleresque sophistry that serves the interests of the few at
the expense of the many——in a word usury.
“Elected officials are not listening to their constituencies, they are,
as usual, advocating for their donors.” —mackTN, May 27 at
11:46 am
It is blaringly obvious that the 70% Majority Common Population,
the American Populace constituency, is NOT the constituency being
represented in Congress.
If insurance is going to be addressed in a meaningfully balanced
way, it will be neessary to unify the risk pool, so that risk for all
who are buying insurance and selling insurance is determined on
the basis of one single risk pool, and the risk and cost for
both buyers and sellers alike is spread out over that one
single risk pool; all else is a function of Hitleresque dialectic
and Hitleresque sophistry that serves the interests of the few at
the expense of the many——in a word usury.
By Eugenia V. Pérez-Montijo, May 27, 2011 at 12:28 pm Link to this comment
(Unregistered commenter)
A Su Salud, Inc. (For Your Health), a Puerto Rican small, but seriously and passionately group of health workers and consumers advocates, committed to universal health for our archipielago, is deeply inspired by Vermont. HOORAY FOR VT! Congrats to its Health CAre for All leaders and officers.
Vermont has it right. The basic problem re health care is the cost of it and any
reform that does not address rapidly escalating costs will not work. Telling
workers under 55 that they’ll get a voucher to subsidize their premiums does
not address the increases in costs for care 10 years from now. We see that now
with the half-baked health insurance modifications passed a a couple of years
ago. Insurance companies and medical bills more than doubled for most
people, making health insurance really unaffordable. What will be the price for
seniors who are in their most expensive health care years?
Elected officials are not listening to their constituencies, they are, as usual,
advocating for their donors. Anything that would cut profits for the financially
generous health care industry is not something to consider, even if it means
devastating the people. It’s the same impetus behind taxpayer funded
bailouts—the people must pay even if it worsens their own condition.
IT’S OUTRAGEOUS. IT’S BUSINESS AS USUAL. IT’S GRAFT, CONFLICT OF
INTEREST, CORRUPTION.
rico, Martha got the point, it’s about a WE society where the tide lifts all boats together, rich or poor. Have you never given or donated to a cause? I believe we do have a universal food bank, where those that have enough give to those less fortunate. The problem is the pool of thoughtful, compassionate humans is dwindling because of a few greedy sharks that don’t know how to share, just take. I want people to have access to good health care, it’s in all our best interest. I believe the majority of health care providers also want health care to be available to everyone, not just the rich.
We’ve got to start somewhere, and Vermont is as good a place as any. The cost of our health care in America is out of sight, and it’s not because the doctors are taking the cash home, the middle man is robbing us blind for a no value service. This is really too simple to fix, but because the legislators have no interest in fixing the problem, it won’t get fixed. That’s not to say there isn’t a bucket full of work involved to get this system off the ground, but there won’t be billions going to a “health care insurance company” and Vermont will be allowed to bargain for drug cost. As long as the handful of people who are selected to turn this system up are honest, thoughtful citizens I think it will work. On the other hand, if you select criminals like Geitner, Paulson and Bernanke to “fix” your financial crisis, god help us!
The issue nonetheless remains, “Who will pay for it?” And that question has not yet been answered.
The Vermont State Health Care model is based upon one that was launched in Saskatchewan, Canada. It was so popular that it was adopted by the rest of the Canadian provinces.
If this movement (in America) follows the same pattern as Canada, then we will have, indeed, a (1) Public Health Care Option, (2) A single payer scheme, that is, funded entirely by the Federal Treasury, (3) that concentrates on both Preventive AND Remedial Care sectors and (4) that is as costly as other schemes in Europe. For an info-graphic view of per capita costs (provided by the OECD), go here.
Note that back in 2006, US HC cost per capita was around $7000. Note, for instance, Canada, where the per person cost is $3300 - or 52% less. Clearly, the Canadian Public Option HC service was less of a burden upon the Canadian Budget than ours was on our National Budget.
Which must be the end-point of any National Health System (NHS). Meaning what?
Meaning that:
* Like it or not, we must mandate prices for Health Care services, including pharmaceuticals.
* We should have an NHS that employs HC-practitioners at Civil Service rates, and to do so,
* We should fund this “corp” by assuming the cost of their education; where, upon graduation, they get to work for the NHS. (Of course, they can leave it to practice in private should they wish after a minimum period).
* America should embark upon a program of building new hospitals in areas that are under-served presently to assure coverage that reach ALL American citizens.
* And the states should oversee programs that include those private hospitals willing to work within the confines of a NHS at NHS-rates.
Health Care is NOT a business. It is a Public Service, meaning that it can and should be regulated. (Yes, many doctors will lose patients to the a lower-cost NHS. Such is life in a country with a basic sense of Moral Decency.)
MY POINT
IF all the above happens, we will have (finally, miraculously) a system that resembles one working in Europe for the past half a century - and is considered by most experts in the matter of National Health Systems as the standard for “World Class”.
Which is better Conservative NO Care or Obama
Care?
If we are going to have Obama Care as a term for Lite
Right Medical Coverage, we should also have Conservative
NO Care for Hard Right Medical Coverage.
Which is better Conservative NO Care or Obama
Care?
If we are going to have Obama Care as a term for Lite
Right Medical Coverage, we should also have Conservative
NO Care for Hard Right Medical Coverage.
I am all for single payer but we have to be realistic here. Do you think for a second that this administration which had the health industry lobbyists working hard writing “Obamacare” will allow all these waivers to go through, or do you feel the more likely scenario is obstruct, obfuscate, and delay- all to stop this bill?
I think the most serious trouble will come from dems and the administration, not the repubs- who if they were smart, would just sit back and watch the show.
It was the Hard-Right Republicans and the Lite-Right
Democrats in the Senate that voted out Medicare, and all
Moderates that can’t make up their mind whether they are Left or
Right, vote with the Hard-Right when the chips are down. And you
can add to that all Neo-Liberals, who are Conservatives——
Conservatives are the Hard-Right. Republicans DO NOT represent
the populace, the 70% majority population of the United States
and neither does the Middle Class Democrats represent the 70%
majority population of the United States.
We the 70% Majority American Populace must STOP Backlash
Voting and figure out another way, because Backlash Voting only
sustains and sanctions their duopoly’s demolition of the 70%
Majority Common Population, the American Populace.
There are only TWO political parties. We must
demand more political parties.
It was the Hard-Right Republicans and the Lite-Right
Democrats in the Senate that voted out Medicare, and all
Moderates that can’t make up their mind whether they are Left or
Right, vote with the Hard-Right when the chips are down. And you
can add to that all Neo-Liberals, who are Conservatives——
Conservatives are the Hard-Right. Republicans DO NOT represent
the populace, the 70% majority population of the United States
and neither does the Middle Class Democrats represent the 70%
majority population of the United States.
We the 70% Majority American Populace must STOP Backlash
Voting and figure out another way, because Backlash Voting only
sustains and sanctions their duopoly’s demolition of the 70%
Majority Common Population, the American Populace.
There are only TWO political parties. We must
demand more political parties that are legislated
equal in every way with the Democratic Party and
the Republican Party.
There is hope for the rest of us in every day that Vermont sustains
their Single Payer Health Care System. I read somewhere that the
Feds have to OK their system to get it accomplished even after the
State OK’d it, if so, that may present a problem,
after all, look what happened to Medicare today in the Senate, they voted it out against the
peoples wishes.
Too Soon to Tell: The Case for Hope, Continued
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By MarthaA, May 27, 2011 at 1:20 pm Link to this comment
mackTN, May 27 at 11:46 am,
“Elected officials are not listening to their constituencies, they are,
as usual, advocating for their donors.” —mackTN, May 27 at
11:46 am
It is blaringly obvious that the 70% Majority Common Population,
the American Populace constituency, is NOT the constituency being
represented in Congress.
If insurance is going to be addressed in a meaningfully balanced
Report thisway, it will be necessary to unify the risk pool, so that risk for all
who are buying insurance and selling insurance is determined on
the basis of one single risk pool, and the risk and cost for
both buyers and sellers alike is spread out over that one
single risk pool; all else is a function of Hitleresque dialectic
and Hitleresque sophistry that serves the interests of the few at
the expense of the many——in a word usury.
By MarthaA, May 27, 2011 at 1:12 pm Link to this comment
mackTN, May 27 at 11:46 am,
“Elected officials are not listening to their constituencies, they are,
as usual, advocating for their donors.” —mackTN, May 27 at
11:46 am
It is blaringly obvious that the 70% Majority Common Population,
the American Populace constituency, is NOT the constituency being
represented in Congress.
If insurance is going to be addressed in a meaningfully balanced
Report thisway, it will be neessary to unify the risk pool, so that risk for all
who are buying insurance and selling insurance is determined on
the basis of one single risk pool, and the risk and cost for
both buyers and sellers alike is spread out over that one
single risk pool; all else is a function of Hitleresque dialectic
and Hitleresque sophistry that serves the interests of the few at
the expense of the many——in a word usury.
By Eugenia V. Pérez-Montijo, May 27, 2011 at 12:28 pm Link to this comment
(Unregistered commenter)
A Su Salud, Inc. (For Your Health), a Puerto Rican small, but seriously and passionately group of health workers and consumers advocates, committed to universal health for our archipielago, is deeply inspired by Vermont. HOORAY FOR VT! Congrats to its Health CAre for All leaders and officers.
Report thisBy mackTN, May 27, 2011 at 11:46 am Link to this comment
Vermont has it right. The basic problem re health care is the cost of it and any
reform that does not address rapidly escalating costs will not work. Telling
workers under 55 that they’ll get a voucher to subsidize their premiums does
not address the increases in costs for care 10 years from now. We see that now
with the half-baked health insurance modifications passed a a couple of years
ago. Insurance companies and medical bills more than doubled for most
people, making health insurance really unaffordable. What will be the price for
seniors who are in their most expensive health care years?
Elected officials are not listening to their constituencies, they are, as usual,
advocating for their donors. Anything that would cut profits for the financially
generous health care industry is not something to consider, even if it means
devastating the people. It’s the same impetus behind taxpayer funded
bailouts—the people must pay even if it worsens their own condition.
IT’S OUTRAGEOUS. IT’S BUSINESS AS USUAL. IT’S GRAFT, CONFLICT OF
Report thisINTEREST, CORRUPTION.
By SteveP, May 27, 2011 at 8:53 am Link to this comment
rico, Martha got the point, it’s about a WE society where the tide lifts all boats together, rich or poor. Have you never given or donated to a cause? I believe we do have a universal food bank, where those that have enough give to those less fortunate. The problem is the pool of thoughtful, compassionate humans is dwindling because of a few greedy sharks that don’t know how to share, just take. I want people to have access to good health care, it’s in all our best interest. I believe the majority of health care providers also want health care to be available to everyone, not just the rich.
Report thisBy MarthaA, May 27, 2011 at 8:26 am Link to this comment
Lafayette, May 27 at 12:02 am,
Thanks, those who are aware must continue to expand the base of
Report thisawareness, which is all that can be done, everything else is just
blather.
By CJ, May 27, 2011 at 8:26 am Link to this comment
For once no complaint. A HUGE congratulations to the sane state of Vermont.
Report thisGood on ‘em.
By MarthaA, May 27, 2011 at 8:21 am Link to this comment
rico, suave, May 27 at 7:42 am,
The answer is that we need a “unity of societal balance,” don’t you
Report thisagree?
By rico, suave, May 27, 2011 at 7:42 am Link to this comment
Martha:
And, all people in the US need food. What’s the relevance of your comment? Do we need a Universal Grocery Store, funded by the state?
Report thisBy SteveP, May 27, 2011 at 5:50 am Link to this comment
We’ve got to start somewhere, and Vermont is as good a place as any. The cost of our health care in America is out of sight, and it’s not because the doctors are taking the cash home, the middle man is robbing us blind for a no value service. This is really too simple to fix, but because the legislators have no interest in fixing the problem, it won’t get fixed. That’s not to say there isn’t a bucket full of work involved to get this system off the ground, but there won’t be billions going to a “health care insurance company” and Vermont will be allowed to bargain for drug cost. As long as the handful of people who are selected to turn this system up are honest, thoughtful citizens I think it will work. On the other hand, if you select criminals like Geitner, Paulson and Bernanke to “fix” your financial crisis, god help us!
Report thisBy PatrickHenry, May 27, 2011 at 3:23 am Link to this comment
Its nice to know there is one state which has values which transend profits.
Bernie Sanders represents this state and it shows.
Report thisBy Lafayette, May 27, 2011 at 12:02 am Link to this comment
Yes, you’ve put your finger on politics in general throughout the US.
To damn many conservatives who are living in a past that, itself, never existed.
Nostalgia aint what it used to be.
Report thisBy Lafayette, May 26, 2011 at 11:02 pm Link to this comment
THE BIG IF
The issue nonetheless remains, “Who will pay for it?” And that question has not yet been answered.
The Vermont State Health Care model is based upon one that was launched in Saskatchewan, Canada. It was so popular that it was adopted by the rest of the Canadian provinces.
So, more about Canadian HC here.
If this movement (in America) follows the same pattern as Canada, then we will have, indeed, a (1) Public Health Care Option, (2) A single payer scheme, that is, funded entirely by the Federal Treasury, (3) that concentrates on both Preventive AND Remedial Care sectors and (4) that is as costly as other schemes in Europe. For an info-graphic view of per capita costs (provided by the OECD), go here.
Note that back in 2006, US HC cost per capita was around $7000. Note, for instance, Canada, where the per person cost is $3300 - or 52% less. Clearly, the Canadian Public Option HC service was less of a burden upon the Canadian Budget than ours was on our National Budget.
Which must be the end-point of any National Health System (NHS). Meaning what?
Meaning that:
* Like it or not, we must mandate prices for Health Care services, including pharmaceuticals.
* We should have an NHS that employs HC-practitioners at Civil Service rates, and to do so,
* We should fund this “corp” by assuming the cost of their education; where, upon graduation, they get to work for the NHS. (Of course, they can leave it to practice in private should they wish after a minimum period).
* America should embark upon a program of building new hospitals in areas that are under-served presently to assure coverage that reach ALL American citizens.
* And the states should oversee programs that include those private hospitals willing to work within the confines of a NHS at NHS-rates.
Health Care is NOT a business. It is a Public Service, meaning that it can and should be regulated. (Yes, many doctors will lose patients to the a lower-cost NHS. Such is life in a country with a basic sense of Moral Decency.)
MY POINT
IF all the above happens, we will have (finally, miraculously) a system that resembles one working in Europe for the past half a century - and is considered by most experts in the matter of National Health Systems as the standard for “World Class”.
Report thisBy MarthaA, May 26, 2011 at 8:16 pm Link to this comment
Which is better Conservative NO Care or Obama
Care?
If we are going to have Obama Care as a term for Lite
Report thisRight Medical Coverage, we should also have Conservative
NO Care for Hard Right Medical Coverage.
By MarthaA, May 26, 2011 at 8:13 pm Link to this comment
Which is better Conservative NO Care or Obama
Care?
If we are going to have Obama Care as a term for Lite
Report thisRight Medical Coverage, we should also have Conservative
NO Care for Hard Right Medical Coverage.
By MarthaA, May 26, 2011 at 8:04 pm Link to this comment
morongobill, May 26 at 7:04 pm,
It’s the conservatives on both sides that are the problem.
Report thisBy morongobill, May 26, 2011 at 7:04 pm Link to this comment
I am all for single payer but we have to be realistic here. Do you think for a second that this administration which had the health industry lobbyists working hard writing “Obamacare” will allow all these waivers to go through, or do you feel the more likely scenario is obstruct, obfuscate, and delay- all to stop this bill?
I think the most serious trouble will come from dems and the administration, not the repubs- who if they were smart, would just sit back and watch the show.
Report thisBy MarthaA, May 26, 2011 at 6:59 pm Link to this comment
rico, suave, May 26 at 6:36 pm,
Yes, all people in the United States need health care.
Report thisBy rico, suave, May 26, 2011 at 6:36 pm Link to this comment
Good for Vermont! 99% white-bread, flint-hard stoics who all know each other.
Do you really think you can export this to California, let alone the entire US?
Fifty states, fifty solutions.
Report thisBy MarthaA, May 26, 2011 at 6:32 pm Link to this comment
Addendum to last post:
It was the Hard-Right Republicans and the Lite-Right
Democrats in the Senate that voted out Medicare, and all
Moderates that can’t make up their mind whether they are Left or
Right, vote with the Hard-Right when the chips are down. And you
can add to that all Neo-Liberals, who are Conservatives——
Conservatives are the Hard-Right. Republicans DO NOT represent
the populace, the 70% majority population of the United States
and neither does the Middle Class Democrats represent the 70%
majority population of the United States.
We the 70% Majority American Populace must STOP Backlash
Voting and figure out another way, because Backlash Voting only
sustains and sanctions their duopoly’s demolition of the 70%
Majority Common Population, the American Populace.
There are only TWO political parties. We must
Report thisdemand more political parties.
By MarthaA, May 26, 2011 at 6:28 pm Link to this comment
Addendum to last post:
It was the Hard-Right Republicans and the Lite-Right
Democrats in the Senate that voted out Medicare, and all
Moderates that can’t make up their mind whether they are Left or
Right, vote with the Hard-Right when the chips are down. And you
can add to that all Neo-Liberals, who are Conservatives——
Conservatives are the Hard-Right. Republicans DO NOT represent
the populace, the 70% majority population of the United States
and neither does the Middle Class Democrats represent the 70%
majority population of the United States.
We the 70% Majority American Populace must STOP Backlash
Voting and figure out another way, because Backlash Voting only
sustains and sanctions their duopoly’s demolition of the 70%
Majority Common Population, the American Populace.
There are only TWO political parties. We must
Report thisdemand more political parties that are legislated
equal in every way with the Democratic Party and
the Republican Party.
By MarthaA, May 26, 2011 at 5:55 pm Link to this comment
There is hope for the rest of us in every day that Vermont sustains
their Single Payer Health Care System. I read somewhere that the
Feds have to OK their system to get it accomplished even after the
State OK’d it, if so, that may present a problem,
after all, look what happened to Medicare today in the Senate, they voted it out against the
peoples wishes.
http://www.alternet.org/newsandviews/article/599016/senate_gop_votes_to_end_medicare,_despite_constituents’_wishes/#paragraph5
Report this