Thursday, April 28, 2011

Viva Vermont! First State to Pass Single Payer

Yes, I know, Vermont is culturally, politically, and socially very different than most states in this country, but it is worlds apart from the nonsense of the Oklahoma legislature spending taxpayer's time creating an official gospel song.  The great state of Vermont is now the first state in the US to pass a universal single payer health care bill.

Vermont Senate advances health care bill

The state Senate gave preliminary approval Monday to health care legislation that is a key part of Gov. Peter Shumlin's agenda.

The bill, a version of which already has been passed by the House, would put Vermont on a path toward what it calls a "universal and unified health system" and what the Democratic governor calls single-payer health care, with the objective of ensuring health insurance coverage for every resident.

The Senate legislation won initial approval on a 21-8 vote and is due for final action Tuesday. It calls for setting up a health care marketplace, called an exchange, in keeping with federal health care legislation. It also sets up a board that would review and approve designs for a publicly financed program available to all residents.

Differences between the House and Senate versions of the legislation would be worked out in a conference committee, and then the bill would go to the governor for his signature.

Sen. Claire Ayer, D-Addison and chairwoman of the Senate Health and Welfare Committee, began the Senate debate by reading a comment from a resident upset with the rising cost of health care. Someone identified only as Aunt Serena wrote to The Burlington Free Press about the difficulties of paying medical bills.
"The patient not only has to be sick and is full of aches and pains and other hardships ... (but also) has to scrabble to pay his taxes and his grocery and feed bills," Ayer read.

But Aunt Serena was a woman of optimism and determination.

"It will work out," Ayer read. "It will have to. We've got to face it and fix it."

The letter was written in 1929 and was dug up by state archivist Gregory Sanford, Ayer said.
"I think it's taken us a while to get here," she added.

The bill still leaves a long way to go. For example, it leaves until January 2013 -- after the next election -- the crucial question of how the new system will be paid for. Also to be decided later: what health services the benefit package will cover.

But Monday's vote, largely along party lines with Democrats in support, sets a course that could give Vermont a Canadian-style, publicly financed health care system by late in the decade.

Ayer said the legislation would get Vermont "off the track of escalating and out of control costs and develop a business plan that brings costs under control, covers all Vermonters (and) is financed by all participants in a sustainable fashion."

Critics of the legislation said it creates too much uncertainty for business by not saying up front how the system will be paid for, and they raised the specter of doctors and other health care providers fleeing Vermont in pursuit of a better living elsewhere.

Sen. Randy Brock, R-Franklin, said that at a recent forum in St. Albans that included doctors, "three of the five doctors told us point blank that if a single-payer health care system comes to pass they will seriously consider relocating elsewhere in the U.S."

The Green Mountain Care Board, a new state panel created by the bill, would review proposals from executive branch agencies on how the program would work and be financed. By January 2014, it would set up the exchange, required by the federal health care bill passed last year. The exchange later would become the framework for the single-payer system.

Some senators cautioned that previous forays into publicly financed health care have had problems.
Sen. Vincent Illuzzi, R-Essex-Orleans, pointed to Medicaid, which he said reimburses doctors and hospitals at just 60 percent of their cost of providing care. The state-subsidized Catamount Health Care Plan, a less ambitious public health care program passed five years ago, "has been declared financially unsustainable by the governor," Illuzzi said.

Supporters, though, were not deterred from what for many has been a lifelong goal.
"We're from Vermont," said Sen. Anthony Pollina, a Progressive from Washington County. "We're in one of the smartest states in the country, and we're in one of the healthiest states in the country, and we can figure this out."

Shumlin, in a statement released by his office, sounded similarly optimistic.

"Today the Legislature took a huge step toward making Vermont the first state ... in the nation to control skyrocketing health care costs and remove the burden of providing health care coverage from small business owners," he said. "This bill is good for Vermonters and Vermont businesses."


A state that prioritizes its own citizens before corporate donors.  Imagine that.  Well, if you live outside of Vermont you will have to keep dreaming because it is right now the only state legislature not completely in the pockets of large corporations in this country.

By the way, Vermont remains the only state in the union that decided not to straight jacket itself with a balanced budget requirement in its constitution.  The result?  A more fiscally responsible and prudent state.  I wonder how Texas, Oklahoma, and all of the red states are doing with their budgets?  Well, since you are wondering, for FY 2011 Vermont's deficit is $150 million (or $239.72 for every man, woman, and child in the state of Vermont).  By contrast, in good ole red state Texas, under a Republican governor and legislature (and much of everything else), the lone stars have tallied up a budget deficit for FY 2011 of $27 billion, coming to $1,073.75 for every man, women, and child in Texas.  In other words, in socialist Vermont (without any budgetary constraints that conservatives and their libertarian lemmings constantly pine for) its budget deficit (on a per capita basis) is almost 1/5 of what it is in Texas (and that is with a state that already has previously passed health care legislation to cover more Vermonters).   

I suppose if I ever get to live a second life, I should think about moving to Vermont.

Because of Vermont's size, to be sure, it is considered symbolic, but symbols have a way of steamrolling into much larger, more substantive movements and resulting policies.  Here is to hoping that Vermont is a harbinger of things to come.