Vermont Approves Single-Payer Health Care: ‘Everybody in, nobody out’
by Salvatore Aversa
The Affordable Care Act continues to plow ahead, despite Republican
attempts to fight it at every turn. What is unfolding in front of us
is nothing short of spectacular. The problems with healthcare.gov are
slowly being resolved which is helping more and more people sign up
for affordable healthcare, many for the first time in their life. The
law provides so much more than that, including standards for even the
lowest level plans, protections for young adults 26 and younger, and
the elimination of pre-existing plans. Of course, you will not hear
the success stories on the news, because those stories are not nearly
as sexy as the “Obama Lied” slogan they are so fond of.
The biggest downside of the ACA is the reliance on the private
insurance industry. It does not have to be this way, however. There
is yet another provision in the Affordable Care Act that can open the
door for states to institute their own single-payer healthcare system.
Other states have a public option, especially for those below a
certain income level, but no state had instituted a true single-payer
system. All of this has changed thanks to President Obama and the
Affordable Care Act.
Vermont—Home of Ben and Jerry’s, Maple Syrup, Bernie Sanders and the
first state to pass marriage equality. Now, Vermont will be known for
something that will impact every resident in the state.
The ACA provided states with federal funds to institute a Medicaid
expansion. The states chose to expand the program also were able to
set up their own state exchanges, which were relatively free from the
problems the federal site had. Vermont decided to take it a step
further by setting up their very own single payer system.
The slogan of the program: Everybody in, nobody out.
The program will be fully operational by 2017, and will be funded
through Medicare, Medicaid, federal money for the ACA given to
Vermont, and a slight increase in taxes. In exchange, there will be
no more premiums, deductibles, copay’s, hospital bills or anything
else aimed at making insurance companies a profit. Further, all
hospitals and healthcare providers will now be nonprofit.
This system will provide an instant boost the state economy. On the
one side, you have workers that no longer have to worry about paying
medical costs or a monthly premium and are able to use that money for
other things. On the other side, you have the burden of paying
insurance taken off of the employers side, who will be able to use the
saved money to provide a better wage and/or reinvest in their company
through updated infrastructure and added jobs. It is a win-win
To make sure that it is done right the first time, Vermont brought in
a specialist who knows a thing or two about setting up a single-payer
Dr. William Hsaio, the Harvard health care economist who helped craft
health systems in seven countries, was Vermont’s adviser. He estimates
that Vermont will save 25 percent per capita over the current system
in administrative costs and other savings.
Many like to say that the United States has the best healthcare system
in the world. The problem is we don’t. Not even close. In fact, the
only way you can get the best healthcare in the world, is if you are
willing and able to pay for it. The United States can and must do
better for its people.
Costs have to be held down — there is no reason why the U.S. has to
pay twice the amount per capita as the next most costly system in the
world (Norway’s), and still not cover millions of its citizens. A
Harvard Medical School study states that 45,000 Americans die each
year from treatable diseases because they cannot afford to get
45,000 Americans die every single year because they cannot afford
treatment, are you ready for that? That is 15 times the amount of
people that died during the September 11, 2001, attacks, or perhaps
for you Righty’s out there you would rather see it put this way,
11,250 times the amount of people that died in the Benghazi attack.
That equals 5 Americans that die every hour, of every day, of every
year because of a preventable illness that was not taken care of due
to lack of access and means.
Even once the Affordable Care Act wrinkles are ironed out, which they
will be, and every America is covered, which will happen, that will
not change the fact that all of this is being driven by a for-profit
system by companies that only care about their bottom line. Despite
rules in the ACA which prevent insurance companies from absolutely
gouging their customers, insurance companies are not exactly know for
their ethical behavior.
A single-payer system would all but eliminate anybody dying
unnecessarily due to lack of access to healthcare. Our Declaration of
Independence states, “We hold these truths to be self-evident, that
all men are created equal, that they are endowed by their Creator with
certain unalienable Rights, that among these are Life, Liberty and the
pursuit ofHappiness.” How can somebody have life and happiness,
without their health? Despite the glaring hypocrisy of rich, white
males who owned slaves stating all men are created equal, we have come
a long way from 1776. Yet when it comes to the very basic need, we
are left to the whim of a business. Single-payer is inevitable, and
the ACA is a giant step in that direction. We need must hold our
officials to a higher standard which will get us there faster. 40,000
people a year is absolutely unacceptable. Vermont saw the writings on
the wall. Will the rest of us?