On Thursday May 26, 2011, Vermont moved one step further toward establishing a single payer healthcare system after Governor Peter Shumlin signed a bill designed to provide universal coverage to all of its 620,000 residents. Vermont currently has 47,000 medically uninsured residents and 150,000 underinsured residents. In March, the bill passed in the state House of Representatives by a 92-49 vote, and in April the bill was passed by the state Senate by a 21 to 9 vote. The bill aims to somewhat preserve the role of private insurers while establishing a single large state run healthcare plan. A key component of the bill will establish a state health benefits exchange, as require by the new federal health care law. The exchange will be called Green Mountain Care and will establish the reimbursement rates for health care providers and attempt to converge administration into a single system. One of the main goals of the new single payer healthcare system will be to contain costs compared to the current fee for service system. Healthcare spending in the state has been about $5 billion annually, and has risen by 6-8% in recent years. Vermont will attempt to obtain federal funding for the health benefits exchange so that the program can begin in early 2014. Some health care experts are estimating that the new system could save $580 million per year and up to $1.9 billion by 2019. Governor Shumlin applauded the legislation for allowing Vermont to “become the first state in the country to make the first substantive step to deliver a health care system where health care will be a right and not a privilege”. In theory, the program appears to be superior to our current system, but there are several obstacles in the way of Vermont’s proposed single payer healthcare plan. Under the current federal Affordable Care Act, such a system would not be permitted and Vermont would have to obtain a waiver from the federal government. Waivers were initially not going to be offered until 2017, but may be able to be obtained as early as 2014 as pledged by President Barack Obama. In addition, the state Senate and House of Representatives in Vermont are currently Democratically controlled, but the party control may shift in upcoming elections. Republicans are predominantly against a single payer healthcare system. There are currently 25 states that have filed a challenge to President Barack Obama’s 2010 national healthcare overhaul, and have claimed that it is unconstitutional to require citizens to obtain healthcare insurance. Health insurance companies are likely to develop a strong lobbying effort against the proposed single payer healthcare system. Many Americans believe that a universal healthcare system will provide inferior healthcare and result in long waits for surgeries and appointments with specialists. Lastly, the funding for the proposed single payer healthcare system is not definitively established and currently appears to rely largely on federal funds that may not be guaranteed. It will be interesting to see if Vermont is able to establish a single payer healthcare system, and whether it can be expanded to a national level.
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