New law designed to lead the state toward the nation’s first single-payer system

By Dave Gram for the AP

Vermont still has “a few challenges” ahead to meet its goal of a universal health care system this decade, Gov. Peter Shumlin said Thursday as he signed into law the bill designed to make the state the nation’s first with fully publicly funded health care.

More than 150 people, including legislators, administration officials, advocates who pushed for the bill and a handful of opponents gathered on the Statehouse steps as storm clouds threatened but gave way to humid sunshine.

“We gather here today to launch the first single-payer health care system in America, to do in Vermont what has taken too long — have a health care system that is the best in the world, that treats health care as a right and not a privilege, where health care follows the individual, isn’t required by an employer — that’s a huge jobs creator,” Shumlin said.

Among Vermont’s challenges: getting waivers from the federal government at a time when the U.S. House has come out strongly against the less ambitious federal health care bill passed last year.

The Vermont law also leaves for future debate whom the state would pay for its publicly financed health care system, what benefits would be covered and a host of other details to be figured out by a new state board in consultation with the Legislature and administration officials.

“This bill has a long, long, long way to go,” said Craig Fuller, managing director of the Employers’ Health Alliance, a Vermont-based group that tracks health reform for businesses.

But that didn’t stop supporters from celebrating Thursday.

“We’re going to hear all kinds of scare stories that this is a thoughtless experiment or that it is too bold,” said Dr. Deb Richter, a longtime advocate of a single-payer health care system. “But I would remind you that every other industrialized country is doing what we are trying to do. And they do it for far less money, they live longer and they get better-quality care.”

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.

“There is ample evidence that we can reduce cost growth without compromising health care quality, but it will take a new approach — we can’t simply cut provider fees,” a statement issued by Shumlin’s office said.

The law also calls on the state to set up a health care exchange — or simplified insurance marketplace — to comply with provisions of last year’s federal law and to serve as a stepping stone to the law’s longer-term goal of achieving a state-run system.

The bill signing drew a range of reactions from industry and advocacy groups.

The liberal blog Firedoglake.com and Physicians for a National Health Plan posted a petition online inviting people to ask the Obama administration to ensure Vermont gets the waivers it needs to implement its single-payer system. Backers say the waivers are crucial to Vermont’s efforts to get the maximum number of residents into the system.

David Oliker, president and CEO of MVP Health Care, one of the major insurers operating in the state, issued a statement saying opponents of the Vermont law continue to have questions and concerns, among them: how it will be paid for, how it will affect Vermont residents who work for out-of-state companies, and how it might affect doctors’ willingness to continue working in the state.

One of those who said she was glad to see the law taking effect was Jennifer Schneider, a 41-year-old Burlington woman who was diagnosed with late-stage ovarian cancer in 2009 and detailed her troubles getting insurance and understanding the coverage she got.

A person in that situation should be able to focus on fighting her illness, not her health insurer, Schneider said. “You shouldn’t have to worry about whether you’re covered,” she said.

34 Comments

  1. Jane on May 27, 2011 at 12:29 pm

    Fantastic! Let’s get this going in other states.



    • Richard Stephenson on June 14, 2011 at 12:24 am

      Bad idea. Instead of focusing on health insurance, why not put a system in place where all citizens of Vermont can go to see a doctor free of charge or at a subsidized rate. Make it a condition for new doctors to get licensed to work in these facilities for a certain period of time at certain reduced rates. Then all citizens would be able to see a doctor for minimal cost or pay for health care out of their own pocket using the existing system.

      Why do we need to drag the health care insurers into the picture?



    • JJ on September 24, 2011 at 8:58 am

      Congradulations Governor Shumlin! The other New England states need to follow Vermont’s new healthcare protocol.

      I reside in New Hampshire, and even though Governor Lynch’s wife is a medical doctor, neither one of them has addressed our dire need for universal healthcare.

      Case in point: I contracted Hepatitis C and diagnosed a few years ago. Due to under insurance and then no medical coverage, my viral infection progressed to advanced liver disease. I could not afford the expensive doctors, tests and treatment. Now, it’s too late for any treatment.

      I am dyeing because I live in a state and a country that does not provide universal healthcare; and prefer to back the large insurance corporations which currently control our USA Health System.



    • leep on September 24, 2011 at 9:01 am

      Excellent accomplishment Vermont…your citizens will be the healthiest in the nation!



    • leep on September 24, 2011 at 9:04 am

      Excellent accomplishment Vermont…your citizens will be the healthiest in the nation!



  2. Ken Gale on May 27, 2011 at 12:32 pm

    Is there any indication that businesses are moving into Vermont or investigating moving into Vermont because they won’t have to pay a major expense of doing business?



  3. Dominique on May 27, 2011 at 12:37 pm

    GREAT! All of the states in America should have universal health care.



    • Francesca on May 27, 2011 at 4:48 pm

      I agree completely — Medicare for all!



  4. randy on May 27, 2011 at 12:53 pm

    It is finally a positive step in a country that has been headed back into the dark ages!!!



  5. irf on May 27, 2011 at 1:05 pm

    Wish you were our Governor/Georgia!
    God bless the USA!



  6. Alan on May 27, 2011 at 1:12 pm

    Hurray to the brave Vermonters! Let your state be a great test laboratory for the rest of the Union going single payer, national health care.



  7. Eve on May 27, 2011 at 2:03 pm

    Once again, Vermont leads the nation in progressive values.



  8. Demelza Costa on May 27, 2011 at 2:34 pm

    THIS is the most hopeful and Inspiring things i have watched in many weeks! FINALLY…..I feel that maybe I am NOT the only one who actually watched Michael Moor’s “SICKO”
    If ONLY we could hear our President saying these words. To HELL! with the fascist corporations whose Greed and power-lust has caused untold death and suffering in this country.
    If it can happen in one state, there is HOPE for others and then, Finally…..an Authentic, Sane, Functional HEALTH Care system for all of the People!!



  9. eddie1247 on May 27, 2011 at 4:35 pm

    Amazing and Vermont didn’t explode? According to all the nay sayers if a single payer system was implemented we were going to experience a cataclysm of biblical proportions.



  10. Sharon on May 27, 2011 at 5:31 pm

    Awesome!!! Vermonters are so lucky!!!



    • Sherry on May 28, 2011 at 3:49 pm

      Luck had nothing to do with it. What they have is the result of smart organization and hard work and relentlessness.



      • Katie on May 29, 2011 at 3:30 pm

        I agree with Sherry. Decades of organizing and educating brought Vermont to this place. Let’s keep fighting!



  11. Bill on May 27, 2011 at 6:24 pm

    Wish you were governor in Florida! Health care for all!



  12. Michele on May 27, 2011 at 6:32 pm

    Great news! Let’s hope the movement in CA can lead to the same thing. We can call it Golden State Care. Premiums on my health insurance went up 23%, and they will stop taking credit cards payments so they can charge a monthly administrative fee on top of it. Way to go Vermont! I will watch closely…



  13. Linda Thomas on May 27, 2011 at 7:40 pm

    Several areas in our society should not be left to the open market – police, fire dept., prisons, education, and health care. It is immoral for our health to be something a corporation can make money on. The bottom line for them is not our health, but their profits. Go Virginia – make it work for all our sakes.



  14. Richard Mason on May 27, 2011 at 7:44 pm

    Go Vermont! Here’s hoping the rest of the country will follow suit!



  15. Arliss Pereau on May 28, 2011 at 2:23 pm

    Thank you Vermont! Thank you Governor Shumlin! I have supported single-payer for a very long time. I heard the propaganda being spread against this kind of reform and it made me feel sick. We should have been allowed a chance to implement it nationally. Maybe the rest of us have a chance now, thanks to the courageous actions of Vermont people.



  16. Robert Landwehr on May 28, 2011 at 7:29 pm

    Congratulations VERMONT! But I am envious because we in California were hoping to lead the nation in adopting single payer. Our legislators voted twice for single payer several years ago, but our governor, horses-behind Arnold, vetoed the single payer bill twice. We hope with Governor Brown to follow you soon. Again–hooray for Vermont!



  17. ahmed c k kutty MD on May 28, 2011 at 8:05 pm

    Congrats t Deb Richter,and fellow PNLHers of Vermont; you are on the way to becoming Saskatchewan with many differences including world in 2001 is not what we had 1962. Yet it is a very uplifting event in this nation’s political history.Jennifer Schneder’s experience of getting coverage for treating her ovarian cancer is reminiscent of candidate Obama narrating the story of Ann Stanley Dunham, his mother having to argue and fight for coverage in her deathbed with cancer of the ovary. I woulk like his reelection campaign to replay that speech and ask for our suport and vote promising his full support to get the job of ‘Medicare for all’ done for good in his 2nd term.



  18. Tom on May 29, 2011 at 11:40 am

    You know the Republicans will fight this tooth and nail.. They are a wholly owned subsidiary of the health insurance industry..Maybe once and for all this country can join the rest of the world with Universal healthcare.



  19. Penny Small on May 29, 2011 at 12:15 pm

    This was the most uplifting thing I have seen in a long time. Finally seeing a government that is truly working for the people! I hope that my beloved President takes note, not to mention our Senate and House. They are supposed to be working FOR THE PEOPLE! The People elected them, NOT the corporate interests! My hat is off to the elected officials in Vermont for actually doing the job they were elected to do… I also was equally moved by the 2nd video clearly showing that future doctors DO want to help their patients and would go to Vermont to practice… NO ONE LEFT OUT! They do NOT want insurance companies telling them how to practice! What they can and cannot do in the best interest of their patients!!!!! Thank you VERMONT! You have given us some hope in what seems like a truly hopeless situation!



  20. Bill Slabe on May 29, 2011 at 1:01 pm

    Thank goodness for all the work that the people of VERMONT did and “THANKS” for your fortitude and “GUTS” to get SINGLE PAYER HEALTH CARE signed into law! HOORAY for all you good folks!!!!



  21. Val on May 30, 2011 at 9:40 am

    one down 49 to go



  22. Kristin Catasso on May 31, 2011 at 1:17 pm

    YES!!!! Way to go Vermont on bringing back some renewed faith in the United States by providing your citizens the RIGHT to Health and well being; not a privilege for a few. Until we as a country acknowledge that our people are of value and put their health and well being first we will never amount to anything. Thank you Vermont for stepping up to the plate!



  23. business review on May 31, 2011 at 10:15 pm

    With the passage of federal health reform states face numerous implementation issues.Fortunately state examples exist for many of the national reform components which may provide useful lessons as states continue to move forward.Below is information about several reform components with links to NCSL and other resources… States have also used the Childrens Health Insurance Program CHIP to extend coverage to more children and to pregnant women. Insurance exchanges or connectors link people and small businesses to health insurance options.



  24. Luke on June 2, 2011 at 1:30 am

    Now if only the rest of the country would start being so rational… :)



  25. leftover on June 2, 2011 at 5:20 am

    Is this “Single Payer” legislation? Or is this “Public Option” legislation?

    Vermont health bill mislabeled ‘single payer’: doctors group (http://www.pnhp.org/news/2011/april/vermont-health-bill-mislabeled-single-payer-doctors-group)
    Vermont’s Bill: Is it Single-Payer Health Care? (http://www.pnhp.org/news/2011/april/vermonts-bill-is-it-single-payer-health-care)

    Just because PNHP supports Vermont taking a step in the right direction and supports Vermont’s call to the Obama Administration to allow the state to implement actual healthcare reform doesn’t make this Single Payer legislation.

    And if Firedog Lake is involved, you can bet there’s a bait-and-switch con in there somewhere. (http://www.pnhp.org/search/google/public%20option%20bait%20and%20switch?query=public%20option%20bait%20and%20switch&cx=015249405663905105964%3Aebn8t4lcngk&cof=FORID%3A11&sitesearch=)

    Support true Single Payer legislation and national healthcare reform.
    The Expanded & Improved Medicare For All Act (H.R. 676)
    (http://www.pnhp.org/publications/united-states-national-health-care-act-hr-676)



    • Luke on June 3, 2011 at 12:22 am

      Yes, the goal of this bill is to eventually implement single payer, basically a state-run medicare-for-all type of system. They need federal waivers to opt out of some federal requirements which is why it will take until 2014 or 2017 to implement this, but it is true single payer. The articles you cited are out of date.



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