Old Well: UNC Chapel Hill Campus

Tuesday, May 31, 2011

Single Payer Health Tax

 Last Thursday, or May 26, the governor of Vermont signed a bill allowing groundwork for the first single tax payer health plan in the nation. It would establish universal health care for  all Vermonters.  The bill would not only provide coverage, but help put a lid on soaring health costs.  As Democratic governor Peter Shumlin put it, “We must control the growth in health care costs that are putting families at economic risk and making it harder for smaller employers to do business.”  I say, “Go for it!”  No wonder Vermont’s been my favorite state for a good long time, apart from all that cold and snow, that is.

Actually, the single tax payer approach was originally a facet  of President Obama’s approach way back in 2003 when he was a state senator in Illinois.  More precisely, he favored an expansion of  Medicare to cover all Americans. Unfortunately, in 2009 the President did a U-Turn in the face of the health insurance lobby and Republican opposition to a bill they saw as further government encroachment on the private sector.  We got health care reform, but with the insurance industry still driving the buggy.

Vermont’s initiative still faces an up-hill challenge.  Starting modestly, it would be set-up as a state health benefits exchange managed by a five member board responsible for setting reimbursement rates and ultimately melded into a single, streamlined system.  This requires two federal waivers: one to begin the exchange; the other, to implement the single payer system in 2017.

And then there are the matters of funding and cost savings.  Will it result in higher payroll taxes?  Will it save costs over the present system, including the Health Reform offering?

On the other hand, proponents argue that it could save Vermont $580 million annually and $1.9 billion by 2019.

At the national level, even with Health Reform, millions of Americans will be uncovered and the for-profit insurance industry still in charge of prices and treatment decisions.  On the other hand, with the single payer approach, health insurance corporations like Aetna, CIGNA, United, Anthem and Humana would have to say “bye-bye,” replaced by one insurance pool.  Medicare, which serves senior citizens so well, would be expanded to include all.  Everybody gets in!  Doing so would save $350 billion annually in administrative costs, waste and profits, money that could be used to pay for the expansion.  Like social security, every new baby gets a medical insurance card, giving access to any doctor or hospital in the country.

Hats off to little Vermont!  Let’s hope and work to make the move to a single payer system a reality at the national level as well.  A good first step:  join Public Citizen at www.citizen.org