South Carolina Healthcare Voices

Governor Peter Shumlin of Vermont recently signed into law ambitious health care reform legislation that puts Vermont on course to implement a single-payer health care system. The law creates a Health Benefit Exchange, consistent with the federal Affordable Care Act, and anticipates using it as the administrative structure for a publicly funded program of health insurance coverage for all Vermonters. The Shumlin administration believes that a single-payer system offers the greatest promise for reducing administrative waste and hassle in our health care system, guaranteeing coverage to everyone in the state, and relieving employers of the increasingly crushing burden of health insurance costs.

Vermont’s plan would include many features common to single-payer systems around the world: a global budget for health care expenditures, guaranteed coverage that is not linked to employment, and a single system of provider payments and administrative rules. The health care delivery system would remain privately owned, however, and the state could contract with a private insurer to perform some functions required of the single payer. It is not yet clear how far the state can go toward establishing a complete single-payer system. Our administration is exploring the potential relationship between the single payer and federal programs such as Medicare and TriCare (the military’s health plan) and determining how self-insured employer plans will fit into the Vermont system. Other elements yet to be worked out include the specific sources of public financing and detailed specifications for covered benefits. We intend to develop these facets of the plan during the next 2 years and will request federal permission to have the single payer fully operational by 2017. (more…)