As Vermont Moves Toward Single Payer System, Some Worry

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Vital Signs: Vermont Charts A New Course For Health Care

(Host) Next week, the full Senate is expected to consider the Governor’s plan to restructure the state’s health care system.

Although the bill doesn’t commit Vermont to a single payer system, supporters say it does put the state on the path to such an approach.

And, as VPR’s Bob Kinzel reports, that has some lawmakers concerned.

(Kinzel) At the beginning of the session, lawmakers got a report from international consultant Dr. William Hsaio, that concluded that the state could save a half billion dollars a year by switching to a single payer health care system.

The savings would largely be the result of streamlining the administrative system that’s used to process health care forms and developing a new payment system.

Speaking on VPR’s Vermont Edition, House Health Care chairman Mark Larson said these savings are essential to expand coverage to all Vermonters.

(Larson) "We can save enough money to be able to cover 47,000 Vermonters who currently don’t have any insurance, improve the coverage for about 160,000 Vermonters who are underinsured, who have very limited benefits or high cost sharing and then still be able to achieve significant overall systemic cost savings beyond that."

(Kinzel) But Franklin senator Randy Brock is very skeptical about these claims for savings.

(Brock) "Every time government intervenes and sets estimates of what things cost the Medicaid program, the Medicare program the classic examples, those estimates are wildly understated and years later we wind up with programs that are close to bankruptcy."

(Kinzel) Instead, Brock wants to introduce more competition in the health insurance marketplace. He says Vermont has too many health care mandates and he’s convinced that additional competition will help lower costs.

(Brock) "Just the mere presence of pricing and pricing transparency also tends to lower prices, because as one provider looks at prices and compares them to what another provider is charging, that market effect is the same market effect that you see with every other commodity. It tends to depress pricing."

(Kinzel) But Larson says the competitive model doesn’t always work and he drew upon some personal experience to make his point.

(Larson) "When a family member of mine got ill this week we were certainly not in any position to be able to start choosing which doctor, provider or emergency room to take her to. Our goal is to get her the best care that we could as fast as we could.  And the fact of the matter is that most of our dollars in the health care system are going into care that people don’t really have the ability to shop around for."

(Kinzel) The real debate over Vermont adopting a single payer approach isn’t expected to take place until the 2013 session.

For VPR News, I’m Bob Kinzel in Montpelier.

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