As a number of states seek to find alternatives to PPACA, Vermont unveiled a plan on Tuesday that would effectively shut down the state's private insurance market in favor of one large, publicly funded pool. The bill draws inspiration from similar single-payer health plans in the United Kingdom, Canada, and Taiwan.
Gov. Peter Shumlin, who was elected last November, has said from the start that reforming Vermont's health care program was a top priority, citing increasing health care costs that, over the past few years, have grown at more than 12 times the growth of Vermont's economy. Under this new proposal, all Vermont residents would receive health care paid for by the state.
The single-payer precedent
According to Kaiser Health News, Shumlin's bill has roots in a number of other single-payer plans that have been broached over the years, including a proposal by former Vermont governor Howard Dean, who tried and failed to launch a statewide single-payer plan in 1994. The idea was also put forth during last year's Congressional debates over the Affordable Care Act, but was dismissed both as too controversial and potentially too cost-prohibitive.
In Vermont, for the moment, there is some amount of support for the bill – perhaps because Democrats overwhelmingly control both houses. In fact, prior to the bill's proposal, the legislature had retained several experts to help advise on elements of the plan, including Harvard economist William Hsiao, who helped build Taiwan's single-payer system.
Yet there is still much persuading to be done. Republicans across the state seek answers to some difficult questions, and small business owners in particular struggle to see how this bill will benefit them and how it will work in practice.
Lt. Gov. Phil Scott, a Republican, said that he had received letters from concerned residents even before Shumlin's bill was released.
