Vermont health bill mislabeled 'single payer' says Physicians for a National Health Program

Vermont health bill mislabeled 'single payer': doctors' group
Physicians for a National Health Program says draft legislation gives wide berth to private insurers, falls far short of single-payer reform

FOR IMMEDIATE RELEASE
April 7, 2011
Contact:
Garrett Adams, M.D., president PNHP
David Himmelstein, M.D., co-founder PNHP
Andrew Coates, M.D., board member PNHP
Mark Almberg, communications director, (312) 782-6006, mark@pnhp.org

The following statement was released today by the national board of Physicians for a National Health Program.

Health reform legislation initiated by Vermont Governor Peter Shumlin was recently passed by that state’s House of Representatives and awaits action in the Senate.

Many journalists and commentators have portrayed this bill as fully embracing the single-payer approach to reform. We write to clarify the views of Physicians for a National Health Program on the Vermont legislation.

We appreciate the enthusiasm for progressive health reform shown by Gov. Shumlin and the many dedicated single-payer supporters in Vermont. However, it is important to note that the bill passed by the Vermont House falls well short of the single-payer reform needed to resolve the health care crisis in that state and the nation. Indeed, as the bill moved through the House the term “single payer” was entirely removed, and restrictions on the role of private insurers were loosened.

In its present form, the legislation lays out in considerable detail a structure to implement Vermont's version of the federal reform passed in March of 2010, which would expand coverage by private insurers and Medicaid. However, it offers only a vague outline of the additional reform promised by the governor and Legislature at such time when states will be allowed to experiment with alternatives to the federal program in 2017 (or 2014, if the effort to move up the date succeeds).

The Vermont plan promises a public program open to all residents of the state in 2017, but even then it would allow a continuing role for private insurance. This would negate many of the administrative savings that could be attained by a true single-payer program, and opens the way for the continuation of multi-tiered care.

Within the public program, the plan would continue to lump together payments for operating and capital costs, allowing hospitals and the newly established Accountable Care Organizations (ACOs) to use funds not spent on care for institutional expansion. Meanwhile, those with operating losses would shrink or close even if they were meeting vital health needs. This would perpetuate incentives for hospitals and ACOs to cherry-pick profitable patients and services, and hobble the health planning needed to assure rational investments in new facilities and high-technology care.

Under the legislation, many patients would continue to face co-payments that obstruct access to care, and the bill makes no mention of expanding coverage of long-term care. The legislation fails to proscribe the participation of for-profit hospitals and other providers (e.g. ACOs and dialysis clinics), which research has shown deliver inferior care at inflated prices.

Finally, the bill offers no concrete funding plan or structure for the public program that it promises.

We applaud the sentiments expressed by the governor and legislative leaders and remain hopeful that the legislation’s rhetorical commitment to further reform will become a reality. We urge the Vermont Senate to address the shortcomings in the House bill.

Much work, including efforts to enact federal enabling legislation – and continued advocacy by single-payer supporters – will be needed in the years ahead to achieve Vermont’s goal of universal access to high quality, affordable care.

*******
Physicians for a National Health Program (www.pnhp.org) is an organization of 18,000 doctors who support single-payer national health insurance, an improved Medicare for all. A March 26 rally at the Vermont Statehouse organized by medical and other health-professional students from PNHP and the American Medical Student Association drew over 200 attendees in support of single-payer health reform.

http://www.pnhp.org/news/2011/april/vermont-health-bill-mislabeled-single-payer-doctors-group

I haven't read the Vermont legislation so I have to depend on reliable sources like the physicians group for information.

Any failure of a plan that is short of single payer but tabbed as single payer will be used against arguments for single payer by its enemies.

That's exactly how I understood the legislation.


The waivers come with federal funding. Still, why will it take years? By that time Vermont's plan will be implemented.

That just allows those who don't want universal care in any form, public or private, time to sabotage everything.

that it promises.

is about, read this:

http://www.washingtonpost.com/blogs/ezra-klein/post/vermont-closing-in-on-single-payer/2011/05/09/AFvtBmZG_blog.html

I depend a lot on your posts concerning the Vermont proposal.

Nothing at all!

The article points out in the very beginning that "This bill is more of a framework. For example, they left out all the financing."

So tell me "cali" .... how can this be considered a single-payer bill when there is absolutely no requirement for government funding of a robust public option and the private insurance industry remains a huge part of the proposed plan!

An authentic single-payer Medicare for All plan does not include the private health insurance industry as a component.

You didn't know that?

In any case, the Vermont bill does not in its present form replace the health insurance industry with even a strong public option, much less a single-payer plan. It doesn't even say how a new Vermont health care plan will be financed!

everyone to VT! Brrrrr.

It's really "Affordable Insurance". As we all know, just because you can afford insurance, doesn't mean you can afford care.

On a related note:

Does anyone here realize that almost all corporations can completely avoid virtually ALL of the Patient Protection and Affordable Care Act (Obamacare) regulations and mandates?

Right now, companies can "grandfather" their crappy health plans, and thus avoid adhering to the regulations and mandates. If a company has a self-funded plan that excludes things like maternity coverage, chemotherapy, mental health, etc., it can keep this plan under the PPACA rules. If you are on a health plan at work that has huge deductibles, limited coverage, and even yearly maximums to coverage, and that company elects to grandfather, you are out of luck.

My company grandfathers and self-insures (and it is a big company). I have 2 autistic kids that get NO treatment, physical therapy, speech therapy, etc. through the plan. When I asked HR about the PPACA "essential health benefits" they told me: "we are grandfathered: PPACA doesn't apply to us."

Thousands of companies have been slashing benefits and increasing deductibles and copays in order to "lock in" crummy insurance for their employees. Only individuals without insurance through work can elect to go into the new insurance exchanges, so millions of Americans will end up underinsured, lacking basic health benefits.

The PPACA is having the exact opposite effect than what was intended: Americans are now getting worse care, incurring greater healthcare costs, and are locked into bad health plans.

I want to personally thank Mr. Obama and congress for throwing the entire middle class under the bus on healthcare.

We need single-payer health care, not a welfare bailout for the serial-killer insurance agencies.

Each day, 273 people die due to lack of health care in the U.S.; that's 100,000 preventable deaths per year. This is not only a moral issue, but a national security issue that we're so vulnerable given that our health care delivery system is so fragmented and dysfunctional.

"Employer-based health insurance has always been a bad idea. Your life should not depend on who you work for." -- T. McKeon

"Any proposal that sticks with our current dependence on for-profit private insurers ... will not be sustainable. And the new law will not get us to universal coverage ...." -- T.R. Reid, The Healing of America

"Despite the present hyperbole by its supporters, this latest effort will end up as just another failed reform effort littering the landscape of the last century." --John Geyman, M.D., Hijacked! The Road to Single Payer in the Aftermath of Stolen Health Care Reform