Sunday, May 29, 2011

Vermont Wins Single-Payer Debate; When Will Obama Concede?

Yep, it's done, and for once, working people and government in the public interest won.

Down With Tyranny:

Yesterday Gov. Peter Shumlin of Vermont signed a single-payer health care bill into law, the first of its kind in the U.S.

Legislators say the plan, approved by the Democratic controlled House and Senate this spring, aims to extend coverage to all 620,000 residents while containing soaring health care costs.

A key component establishes a state health benefits exchange, as mandated by new federal health care laws, that will offer coverage from private insurers, state-sponsored and multi-state plans. It also will include tax credits to make premiums affordable for uninsured Vermonters.

The exchange, called Green Mountain Care and managed by a five-member board, will set reimbursement rates for health care providers and streamline administration into a single, unified system.

Residents and small employers will be able to compare rates from the various plans and enroll for coverage of their choosing.

As designed, the goal is an eventual state-funded and operated single-payer system. ... Advocates of change say the existing fee-for-service care has a financial incentive to deliver more care, such as tests, with little attention to quality or better outcomes.

The single-payer concept was omitted from the federal health care overhaul championed by President Barack Obama, in part due to Republican criticism it meant excessive government control.

Progressives in Vermont, including Shumlin and U.S. Senator Bernie Sanders, an independent, have worked for years to modify the state's health care system.

...If the state secures one key federal waiver related to exchanges, Green Mountain Care could begin as early as 2014. Another waiver needed to implement the single-payer component under federal law would not be available until 2017.

Vermont's plan calls for the board to consider the likely costs of coverage, factor in potential savings from reforms and recommended sources of revenue. It is charged with delivering a financing plan to legislators by 2013.

If that plan's single-payer component is adopted, lawmakers would approve a budget annually.

Single-payer proponents say the present system is too expensive and excludes too many residents. Vermont has around 47,000 uninsured and 150,000 underinsured residents.
Meanwhile, President Obama and the Congressional Democrats who insisted on health care "reform" that handed trillions of taxpayer dollars to Big Insurance and Big Pharma, are about to get rolled by repugs demanding that dems cut Medicare, and cut their own 2012 electoral throats in the bargain.

Digby:

Ezra Klein systematically dismantles Paul Ryan's phony arguments in defense of his health care plan. It's an excellent post and one that shows just how dishonest the Republicans are. (There's no point in excerpting it, just read it.)

I only wish that Ezra had been as clear on Hardball today when Michael Smerconish was going on and on about the need to cut Medicare and Ezra replied that because Mitch McConnell is insisting on cuts in order to raise the debt ceiling, it will be done. That's probably technically true. But the fact is that the debt ceiling will be raised whether Mitch McConnell holds his breath and turns blue or not. He knows which side his campaign contributions are buttered on and so does everyone else. Medicare will only be cut because the Democrats allow it.

It's hard for me imagine that any good policy can come of this nonsense, but I'll leave it to the wonks to sort it our later. But on the politics it's very foolish. Right now you have a nice clean contrast and muddying it destroys the Dem advantage. But Ezra seems to be in the know so I guess at this point the only question seems to be how it will be cut. If that's the case, anyone want to bet on the return of the Obama Death Panel boogeyman in 2012?
If you wondered how the dems were going to snatch impossible defeat from certain victory in 2012, that's how.

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