Vermont Takes the Single-Payer Plunge


Oh, Vermont, you're so crazy. According to the Internet, (which, granted, may or may not be telling the truth in the strict sense) you once passed a law banning tying giraffes to telephone poles. You also gave America Sen. Bernie "Please-Call-Me-a-Successful-(Democratic)-Socialist!" Sanders, who, in December of 2009, tried to attach a 700-page single-payer health care bill to ObamaCare.

That didn't take, but Vermont's politicians aren't giving up on the dream, or the crazy. The state's legislators are now in the process of making it the first state in the nation to experiment with single-payer health care. In broad strokes, the plan is for the state to eventually fold everyone into a system in which all health care payments go through the government, which will transform itself, Megatron-style, into the state's one and only insurer and health care pay-master. One system, one government, one payer: Hence, single payer.

Will it work? No state has ever actually implemented a single-payer health system before, so there isn't much precedent. But back in the 1990s, California flirted with the idea of setting up a single payer system under the autocratic rule of a state-appointed health commissioner whose absolute control over the system's giant budget would have rivaled Dr. Doom's control over Latveria (albeit without the Doombots).

Unlike California's single-payer proposal, Vermont's law will pass: "Obviously, I intend to sign the bill," Gov. Pete Shumlin recently told the Burlington Free Press. But the law won't birth a full-fledged single payer system overnight: Mostly the plan is to slowly start the process of rolling people into a single system and figure out exactly how to make it work later. 

According to the law's backers, it will work this time. Somehow! Here's Wendell Potter, the perpetually aggreived ex-health insurance exec, talking up its benefits:

Vermont this week will be taking a giant leap in the other direction—toward universal coverage and greater cost control—when Gov. Peter Shumlin signs legislation putting the state on the path toward a single-payer health care system.

So, about that "cost control." Sounds good, and Potter isn't the only one to cite that as a reason to pass the law: Last year, Shulin indicated that he also believes the law will make health care cheap, cheap, cheap. You know, like Medicare, which after all only blows about $50 billion a year on fraud and improper payments. Anyway! 

How exactly would that work? The law has a plan—a sort of super-sized, super-powerful version of ObamaCare's Independent Payment Advisory Board (IPAB), the board of federal bureaucrats charged with holding down Medicare's spending—but the authors of the legislation left out some of the OMG-how-will-we-pay-for-this?!?! details.  Like, for example, the financing mechanisms. That's right; the law's authors didn't actually get to that part. Crazy? Maybe a bit. But not entirely. After all: There is a study group! They're totally working on it.