Keeping an Eye on Vermont
I just spent a few days in Chiould increase to pay for the plan (about 13% combo new income and payroll) got leaked ancago at a conference for state legislators new to health policy. Many fascinating developments in states, none more so than in Vermont where enactment of a single payer (tax financed) health care system is a front burner issue supported by many members of the Democratic House and Senate majorities.
A little history: back in 1992 when Howard Dean was governor, Vermont decided to create a universal health care system, setting up a commission to figure out financing. In 1994, the Commission’s estimate of how much taxes wd plastered on the front page of the Burlington Free Press. That day, the reform process died.
They’re trying again, this time learning from episode one’s collapse. The bill would set up a governing structure and leave the treacherous chore of defining a benefit package and tax rates (to replace insurance premiums) to two commissions with the Legislature ratifying next year in an up or down vote. The new system would start in 2007. Benefits would be structured similar to those in Oregon’s now-defunct Health Plan, ranking services in order of priority, and linking the budget to the number of services that could be provided. A key obstacle is Republican Governor Jim Douglas who criticizes the plan and estimates the combo of new income and payroll taxes now needed at 20 percent. The Legislature wraps its session in late April, so this will play out quickly.
Back in the early ‘90s, many folks said Vermont was a good place to try such a huge experiment because of its size and compactness. They’re traveling down a difficult and controversial road and deserve our attention and respect for tackling this issue.