system

An unlikely experiment is underway in one of the few American states where conservatives were unable to convince majorities of the populace to view government leadership as the Devil’s preferred path to socialism, if not Stalinism. Vermont, a bastion of good sense in this benighted era of irrationality, is one of, if not the, best of the states. The newly-elected governor, Peter Shumlin, wants to overhaul the state’s medical system. His plan for doing so is nothing less than the boogeyman to the Tea Party types, namely, single payer. Watch out for death panels! The governor’s goal is nothing less than a public option for the entire state. Best of all, there is no role in single payer as the governor sees it for the rapacious insurance companies. Michael Moore must be besides himself with joy.
Of course, a waiver from the federal government to implement a single payer plan will be required. The new governor believes that “the waiver is the easy part. The hard part is designing a single payer health care system that works and that delivers quality health care, gets insurers off our providers’ backs and has a reimbursement system that makes sense.” He adds, I believe if we design that system, we can sell it.”
The new governor sees the shift to single payer as an economic necessity as well as a move that will boost quality of life. A plot line showing a steep upward trajectory of rising costs convinced him that a single payer plan is essential. He has stated that such a big step is needed for the well-being of government itself, as well as companies and the citizens of Vermont.
The governor argues that costs will increase a billion dollars in the next year in Vermont. The average family will pay $7,000 more. This is on top of $32,000 paid now. This hurts the state economy and increases property taxes.
The governor campaigned on single payer, so the ambitious redesign plan comes as no surprise to voters. Key features include:
* Health benefits managed directly through citizens, not employers.
* Reimbursement related to outcomes, not pay for treatment/fee for service.
* Reliance placed on upgraded standards of uniform medical records and payments.
* Plans for implementing a single payer system and other options are shaped by the state legislature. The head of this study, a Harvard Economics Professor, made his own position clear in a New York Times interview: “You can have universal coverage and good quality health care while still managing to control costs. But you have to have a single-payer system to do it.” (See Anne Underwood, “Health Care Abroad,” The Business of Health Care, NY Times, November 3, 2009.)
In Vermont, unlike my own hapless state of Florida, Democrats control the executive and legislative branches. This makes prospects for a single payer system more likely than in most other states, if not any other state.
My chief wellness adviser in Vermont, Dr. Judd Allen, reported this week that the governor’s election and the drive to adopt a single payer health system in Vermont, “is perhaps one of the few bright spots in the election results. I worked very hard in Shumlin’s campaign and we only won by a few thousand votes. It is a big deal. I’ve written our governor-elect about helping with the transition.”
If the governor puts Dr. Allen on the case, look for Vermont to become a national model for the future of American medical system reform.
Be well and look on the bright side, even if you don’t have the good fortune to live in Vermont.…