Funding single payer
As Vermont paves way to reform, hurdles remain
Vermont is officially on a path toward creating the nation’s first statewide publicly funded single-payer system. Last week, Gov. Peter Shumlin signed the widely watched legislation, which still faces a number of challenges, including whether the federal government will grant waivers Vermont needs to implement a single-payer system earlier than 2017, and how the system—called Green Mountain Care—will be funded (May 16, p. 6).
“My administration has to come up with a plan to pay for it,” Shumlin said in an interview.
Also at issue is the state health insurance exchange that Vermont is expected to offer in 2014 as a result of the Patient Protection and Affordable Care Act.
Shumlin, a Democrat, said his administration views the federal healthcare law “as a bridge” that will allow the state to achieve cost containment in billing, electronic medical records and shifting the fee-forservice system to one that rewards outcomes.
“The federal bill gives us the ability to invest in the technology for our providers,” Shumlin said. “The federal bill is a partner to us in getting this done.”
Federal funding could be used to invest in infrastructure and technology that would ensure more efficient billing methods and a Green Mountain Care card that provides access to the resident’s electronic health record, he said, adding that preventive care is another area in which the state can achieve savings.
In the meantime, the soon-to-be appointed five-member panel will hammer out the system’s details, including financing. Two financing plans are slated to be sent to state House and Senate committees in 2013.
The Vermont Association of Hospitals and Health Systems and the Vermont Medical Society have remained neutral on the