Vermont Gets Single-Payer System, but More Hard Work Lies Ahead

Legislators in Vermont approved by a vote of 94 to 49 a bill intended to create a single-payer health care system in that state.

Both chambers of the Vermont legislature approved versions of the bill that originated in the Vermont House of Representatives as "an act relating to a single-payer and unified health system." A House–Senate conference committee produced a final version that was approved May 5.

Gov. Peter Shumlin (D) has championed the bill and at press time was expected to sign it into law. The Vermont Psychiatric Association (VPA) has also supported the bill (Psychiatric News, May 6).

"The VPA took an early and active role in support of this bill," said Vermont psychiatrist and APA Trustee David Fassler, M.D. "Psychiatrists contacted legislators, met with the governor, wrote letters to the local papers, attended rallies, and testified frequently at legislative hearings. Although passage of the bill is a significant accomplishment, much of the difficult and challenging work remains ahead. The VPA plans to remain actively involved throughout the process."

The bill will create three new organizations to help control health care costs and increase health insurance coverage: a new Green Mountain Care Board to oversee cost-containment strategies, the Vermont Health Benefit Exchange as required under the Affordable Care Act for helping to achieve universal insurance coverage, and the evolution by 2017 of the Health Benefit Exchange into Green Mountain Care as the state's single-payer plan.

The proposal was designed by Harvard economist William Hsiao, Ph.D., who was involved with the development of Taiwan's new single-payer health care system that covers everyone and includes comprehensive benefits. Hsiao was commissioned by the legislature to conduct a detailed examination of the health care system in Vermont and to make recommendations for a reformed system.

Hsiao's report is posted at <www.leg.state.vt.us/jfo/healthcare/FINAL%20VT%20Hsiao%20Written%20Statment%20for%20Jan1911_1.pdf>.