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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