Tag Archives: Vermont

Vermont Goes for Real Deal in Health Reform: Single Payer

Can you hear Blue Cross screaming in the distance? Vermont is about to hit the road toward a real (if modified) single-payer health care–Medicare, but for everyone. Cut out the middlemen, save some money, cover more people.

Can you hear Blue Cross screaming in the distance? Vermont is about to hit the road toward a real (if modified) single-payer health care–Medicare, but for everyone. Cut out the middlemen, save some money, cover more people.

In Washington, insurance companies are deploying their lobbying might to chip apart the gargantuan federal health reform–at least the parts that won't turn them a bigger profit. States governed by "kill all government" leaders are trying overturn the whole reform law in federal courts. But Vermont has turned its back on the catfight.

It won't be easy. Vermont has to persuade the federal government to hand over, in cash, the amount that it would otherwise cost to enable the privatized health reform passed by Congress last year. It still has to figure out how much single-payer will cost, how and how much its citizens and employers will pay and how the state will directly reimburse doctors and hospitals. (Large self-insured employers that choose to stay with private plan administrators may do so). But the state wll also shed a lot of expensive insurance baggage.

From a Kaiser Health Foundation report on the Vermont legislation:

Supporters of the change … point to statistics showing that health spending more than doubled in Vermont between 1992 and 2009. [Gov. Peter] Shumlin's office has estimated the state would save $500 million in the first year of a single-payer plan.

That would come from reduced insurance marketing and administrative costs. Hospitals and physicians also lose time and money in filling out claims information for every private health plan they bill.

Not to mention all the hours billed by backroom administrators and lawyers to stop patients from getting care. And all the trees and electrons that will be saved when doctors' offices can quit spending as much time on paperwork as they do on patient care.

As Gov. Shumlin signs the single-payer legislation Thursday, insurance companies will be gearing up paint Shumlin as a mad socialist intent on letting government killy granny. But the state has a strong reformist record, and already stretches its Medicaid dollars to cover more of its population than other states.

A New York Times story on the physician who's credited with getting the single-payer ball rolling in Vermont also contains the anecdotes that should sustain the push to get it done:

Dr. Richter said she embraced the idea of a single-payer system as a young doctor in Buffalo, where many of her patients put off crucial treatments because they were uninsured. As a medical student, she saw a patient with a life-threatening heart infection caused by an infected tooth that had gone untreated because he lacked dental insurance.

“He was in the hospital for six weeks, and I was like, ‘This makes no sense,’ ” she said. …

Once, she presented [to the Vermont Legislature] a printout of all the insurance companies her small practice in Cambridge had billed over five years.

“It was like 190 pages long,” she said. “Here we were, this tiny rural clinic having to bill all these different addresses. And all of them have different rules and reimbursements; I mean, it’s ridiculous.”

While insurance companies tremble at the idea of even a small, green and civil state actually instituting a Medicare-for-all system, Vermont's concept is also taking hits from the left. Hard-nosed advocates for absolute single-payer, including Physicians for a National Health Program, call the plan "well short of the single-payer reform needed.” They object to letting the largest employers keep using private companies to administer benefits. That's about the best example I've ever seen of letting the perfect be the enemy of the (very) good.

Other states including Oregon would also like to take the federal money and try to do more with it at less cost than private insurance. Oregon Sen. Ron Wyden has introduced a bill to allow states to ask for waivers that would fund alternative systems now, rather than in 2017 when the existing federal law would free up money for state plans.

Vermont, however, is a step ahead. It has a real single-payer plan and a backup plan–go along with the federal reforms while doing all the planning. Then whenever the state can break loose the federal money, it will be ready to break loose from the insurance industry. That's what's causing Blue Cross such unbearable pain.


Posted by Judy Dugan, research director for Consumer Watchdog, a nonpartisan, nonprofit organization dedicated to providing an effective voice for taxpayers and consumers in an era when special interests dominate public discourse, government and politics. Visit us on Facebook and Twitter.

We Don’t Have Gay Marriage Because Of A Dysfunctional Political System

Today, the Vermont legislature overrode a gubernatorial veto and voted to allow same-sex couples to marry.  They become the first state to legalize gay marriage through the legislative process rather than the courts.  Of course, California passed a gay marriage bill twice, in 2005 and 2007, only to see the Governor veto the legislation both times.  And then… nothing.

Now, the bill never passed by a margin approaching a 2/3 vote in either chamber, so you might question the efficacy of an override vote.  However, that only makes sense if you aren’t aware that the California legislature NEVER overrides vetoes.  This actually came up last year, when the Governor vetoed the initial FY2009 budget and the legislature threatened to override.  Instead they ceded to the Governor’s demands.  Indeed, California has never overridden a budget veto in the history of the legislature, and the legislature pretty much never overrides vetoes of any other kind, even if the measures pass both houses with overwhelming margins.  The last override in California?  THIRTY YEARS AGO.

Part of this is due to the unnecessary forced bottlenecks in the legislative process, where practically everything passes right at the end of a legislative session, and the Governor vetoes after the session ends, which means that the legislature is out of session at the time they could override a veto.  But another part concerns an insidious professional courtesy mixed with threats, where the Governor in recent years has implicitly vowed to veto all kinds of bills if he’s ever overridden on one.

The overall point is that California’s government does not operate like a functioning political body.  The veto override, a major tool for a legislature to impose their will on a Governor, doesn’t exist.  The majority vote, when a Governor agrees with the thrust of the legislation, with respect to the budget and taxes, doesn’t exist.  And so ordinary functions of political bodies are closed off to California, by self-imposed means.  This highlights once again why we have an ungovernable political structure that needs to be radically changed.

Vermont Rules! Blog post from Marc Solomon

Like clockwork, I woke up at 6 AM Pacific time, knowing the Vermont legislature would soon be voting to override Governor Jim Douglas’s veto of the marriage equality bill. I turned on my computer, went to the Burlington Free Press website, and have been glued to it since then. After the first vote–the Senate veto override vote–I left a message for Peter Shumlin, the President of the Vermont Senate who has become a good friend and tremendous ally over the past two years.

For the last year-plus, MassEquality—the organization I just left—has been working extremely closely with the other New England states to win full marriage equality. Last year, much of the focus was on protecting the court win in Connecticut. Since mid-2008, in partnership with the amazing leaders at Vermont Freedom to Marry (it is truly an amazing organization), I've worked very hard towards this day. Days of meetings in Vermont, meetings and conference calls with Senate President Peter Shumlin and the past and present House speakers, phone banks and volunteer canvasses into Vermont, and for the past couple of months, almost daily check-ins.

While Vermont is a small state, the symbolism of the first state with civil unions saying, very clearly, that CU is not good enough, that only marriage is… is huge.

We knew there was a chance, but never expected, Governor Douglas to veto the bill. We thought he’d allow it to become law without his signature (which you can do in Vermont). And we also thought that we would be in grave trouble if he did veto the bill.

But today, Vermont proved, once again, what we all know–that marriage equality makes a tremendous difference for gay and lesbian couples and families, and those who love and care about them. And for the rest of society, it's not a big deal. In fact, I am positive if you were to poll Vermonters today, a strong majority would say they are proud to be the first state to have passed marriage through their legislature and enacted into law.

For us in California, this shows that anything short of marriage—whether it is called civil unions, domestic partnerships or anything else—doesn't suffice. Full equality is marriage, plain and simple. The people of Vermont, acting through their elected officials—more than two-thirds of them—get it. It's our job to make sure that a majority of the people of California get it too! It will happen here, sooner rather than later. We just have a lot of hard work to do making that case to a majority of Californians.

Iowa, Vermont—what a week! Now on to New Hampshire, Maine, New York and New Jersey! And of course, our own state of California.

Let Freedom Ring!

Marc Solomon
Marriage Director
Equality California

–Reposted from the California Ripple Effect