In 2011 Vermont passed a bill creating Green Mountain Care, the first State run health insurance. Its passage ushered in a new chapter in the health-insurance debate. Asking for the first time in a long time, why is health insurance connect to employment?
From Vermont.gov:
"Green Mountain Care will use the federally-mandated Health Benefit Exchange infrastructure as a springboard, but it will be a completely new type of system. The goals of Act 48 are to:
for a super wonky video:From Vermont.gov:
"Green Mountain Care will use the federally-mandated Health Benefit Exchange infrastructure as a springboard, but it will be a completely new type of system. The goals of Act 48 are to:
- Improve the health of Vermonters
- Reduce the rate of growth of Vermont’s health care costs
- Enhance the quality of care and experience of patients and providers
- Recruit high-quality health care professionals to practice in Vermont
- Simplify and streamline administrative and claims processes to reduce overhead and enhance efficiency"
Basically, Vermont is breaking the link between employment and health-insurance. It is a great opportunity to see what American Single Payer Health might look.
Their big question is how to you raise the $2B needed to pay for it. They know that Vermonters pay well over $2.3B/yr in insurance premium, yet they are afraid to ask Vermonters to pay some type of similar insurance premium/subsidy to a government run insurance program.
One of leaders behind the bill explained how much more cost effective it would be for a company of the size of Vermont to self-insure and how every actuary and consultant would advise the move. Ironically, many health business executives shutter at the thought of a single-payer system. Mainly due to the economy of scale that adjust the cost-benefit scale away from illness and towards health. When the system is large enough and payed for in a closed loop, an increase in population health means decrease in overall health spending.
As we enter the next generation of the fights in health-equity, Vermont might prove to be a great lab. The bill, in the very least, brings into clear view some of the hypocrisy of the current system.
A great video explaining the current debate:
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