Coming in 2017: Vermont's single-payer system|
The Advisory ...
AP: The little state is leading the way on health care
reform
October 29, 2013
Vermont is on
track to launch the nation's first universal health care system in 2017, which
state officials have promised will offer access to and coverage for
"high-quality, medically necessary health services" for all
residents.
Meet the physician who was 'backbone' of Vermont's
single-payer plan
The status of the
state's single-payer plan
Green Mountain Care (GMC), which was approved and signed into law
in 2011, will:
·
Provide a pre-determined package of coverage benefits to
each state resident;
·
Shift providers from the traditional fee-for-service system
to one that bundles payments; and
·
Be funded in part through $1.6 billion in new taxes on state
residents.
The 2011 law
created a five-member oversight board that already has launched four pilot
projects with the goal of reducing health care costs statewide. For example,
one payment bundling program combines costs into a single set price for
services that commonly are provided together, such as anesthesia, surgery, and
follow-up physical therapy for a knee replacement.
Study: A single-payer system would save $592B annually
GMC is not
designed to provide coverage to federal employees in the state or those with
self-insured employers who assume the risk of their own coverage and are
governed by federal law. It also might not serve residents who obtain coverage
from employers with headquarters in other states, according to Vermont Association of Hospitals and Health Systems Vice President Jill Olson.
HHS has yet to approve
a waiver allowing Vermont
to use federal funds to finance GMC. State Health Director Robin Lunge says a
decision likely will be finalized late in the Obama administration's final
term. The state previously has obtained similar waivers allowing it to make
changes to its Medicaid program.
Additionally, Vermont must secure
legislative approval for a state financing plan, which has yet to be developed.
AP: The little
state with a big plan
According to the Associated
Press, Vermont
is uniquely situated for a universal health care system because the state:
·
Is considered to be the most liberal state, with Democrats
holding the governorship and both houses of the Legislature;
·
Has a tradition of activism for such a program, with
residents frequently holding rallies to promote universal health care;
·
Is small—with a population of about 626,000 and a total of
15 not-for-profit hospitals—which makes it a manageable setting to test a
universal health care project; and
·
Already is close to achieving a key goal of a universal
health care program, with 91% of the total state population insured.
Montana: The next single-payer system?
Observers raise
some concerns
However, America's Health Insurance Plans (AHIP) is warning that the
state's 2011 law could limit consumer options and might not be sustainable.
"The plan
could disrupt coverage consumers and employers like and rely on today, limit
patients' access to the vital support and assistance health plans provide, and
put Vermont taxpayers on the hook for the costs of an unsustainable health care
system," AHIP spokesperson Robert Zirkelbach
says.
Some observers
also have questioned the expected cost savings of eliminating multiple
insurance companies and their different coverage and billing styles (AP/U-T San Diego, 10/26; Gram, AP/Yahoo! News,
10/26).