Single payer: The clear choice

Tuesday February 19, 2013

Robin Lunge

As we see more and more of our dollars going toward the rising costs of health care, it is critically important that we continue our efforts to control costs while providing better care for all Vermonters. The governor remains committed to this goal and we are working tirelessly toward achieving this much-needed reform by 2017.

Recently, we released a study that once again shows the clear benefits of moving Vermonters to a single-payer health insurance system. Once this plan is in place, we will save over a half billion dollars per year compared to the current costs of our system.

We propose investing these savings in providing better health-insurance coverage. Under the plan: All Vermonters will be covered. Currently more than 40,000 Vermonters are uninsured. Under our universal Green Mountain Care plan all Vermont residents will be covered, regardless of income or employment status. Vermonters will no longer need to worry about losing their coverage if they lose or change jobs, and all of us will have access to high-quality health care.

Health coverage will be comprehensive and affordable. Currently, some of us shoulder as much as half of our health care costs because our insurance is not comprehensive or requires high, unaffordable out-of-pocket payments. Green Mountain Care will ensure all of us can afford high-quality and comprehensive care.

Seniors will also benefit. Currently Medicare beneficiaries face a heavy burden of out-of-pocket costs and most seniors purchase supplemental insurance in order to have reasonable out-of-pocket costs. Under Green Mountain Care, Vermont seniors would have supplemental medical and drug coverage. Seniors will also keep the option of purchasing private supplemental coverage if they prefer.

Better coverage for more Vermonters at a lower cost - that is why we are moving as quickly as we can to achieve this goal. The report we just issued shows the unmistakable value, both financial and human, of a single-payer system.

We will achieve cost savings by: Separating health coverage from employment. By de-linking health insurance from employment and simplifying coverage, employers will get out from under unsustainable health insurance cost trends and the tremendous burden of administering health insurance. Employers will be able to focus instead on their businesses, growing jobs and economic opportunity for all of us.

Consolidating to a single system. We will save on administrative expenses by consolidating to a single system, and by reducing the administrative burden insurers place on doctors and other health care providers through paperwork requirements.

Reducing waste and improving outcomes. By containing costs, we will reduce waste and inefficiency, emphasize prevention, and achieve better outcomes for patients. Under the leadership of the Green Mountain Care Board, this transformation is already under way and will be integral to making our health care system financially sustainable.

None of us will be surprised to hear that health care currently costs on average nearly fifteen percent of our household incomes, and Vermont employers and individuals will pay $2.2 billion toward health insurance in 2017. The new report shows that we can save about a half a billion dollars every year by adopting a single-payer health care system.

Many people ask: How will we actually pay for this new system? As our report describes in detail, all of us now pay for our health care system, either in direct and concrete ways like premiums, or through the hidden costs of higher prices throughout our economy driven by the inefficiencies in our current system and the need to pay for those who are now uninsured. Green Mountain Care will be financed by replacing and streamlining these costs, including the hidden costs now paid by every Vermonter - individuals and employers alike.

Under current federal law, we cannot implement the single payer system in Vermont until 2017. But that delay gives us a great opportunity to continue to drive down costs in the current system. It also gives us ample time to talk with our employers, our legislators, and all Vermonters regarding the benefits of the new system and the best way to design the new financing system to replace how we currently pay for health care in Vermont. We will only accept an outcome that is fair, equitable, and affordable, and that supports better health for our citizens and greater economic growth for our state. Vermonters deserve nothing less.

Robin Lunge is director of health care reform for the State of Vermont.


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