QUICK OVERVIEW OF H.100/S.88, Vermont Single-Payer Healthcare Bills

These bills "propose to establish the goal of universal access to essential health care services in Vermont through a publicly financed, integrated, regional health care delivery system; provide mechanism for cost containment in the system; and provide a framework, schedule and process to achieve that goal."



The bill begins with findings, in five parts, as follows.


1. The healthcare infrastructure (and services) are public goods that are threatened in the current healthcare system. In particular, economic incentives distort the provision of quality care, and multiple payers create excessive administrative waste.


2. The current healthcare system cannot contain costs and is therefore unsustainable.


3. The costs of the current healthcare system are unfairly distributed.


4. The current healthcare system is not accessible to all who need care.


5. The quality of healthcare in Vermont could be improved by a better system.



The bill creates a new plan, VermontCare, (analogous to Medicare) to pay for essential healthcare services in Vermont. It would utilize the existing network of healthcare providers (doctors & hospitals) but would eliminate private insurance for essential healthcare services and replace the current multiple payers with a single public fund financed by a system of broad-based taxes. Insurance premiums (and, therefore, deductibles) and out-of-pocket payments ("co-pays") would be eliminated. All residents of Vermont would be eligible for VermontCare, simply by virtue of residence. The bill would merge three existing government divisions into a new department, Health Care Administration, and create a new three-member board, the Vermont Health Care Board, each with specific mandates, guidelines and timelines for designing, implementing and managing theservices included in VermontCare. (Specifically: the Board would propose [to the general assembly] a package of essential health services to be covered by VermontCare and subsequently act in a quasi-judicial capacity to hear complaints and amend established reimbursement rates. The Department of Health Care Administration would administer payments and establish a drug formulary, which would be used to negotiate discounts from manufacturers and establish uniform state-wide prescription practices, along with several other administrative duties related to VermontCare.)

The bill also calls on the general assembly to create regional community health boards to assess, prioritize and define community health needs, as well as to develop budget recommendations and provide regional oversight and evaluation regarding the delivery of care in their regions. Under VermontCare, providers would be compensated based on best practices and healthcare outcomes rather than for individual services. Hospitals would negotiate annual "global" budgets instead of being paid for individual services.

H.100 sponsors: Michael Obuchowski, Bill Botzow, Alison Clarkson, David Deen, Michael Fisher, Patsy French, Mary Hooper, William Lippert, Terrence Macaig, Michael Mrowicki, Betty Nuovo, Carolyn Partridge, Paul Poirier, Ernest Shand, David Sharpe, Ira Trombley, John Zenie, David Zuckerman

S.88 sponsors: Ed Flanagan, Timothy Ashe, Claire Ayer, John Campbell, Matthew Choate, Ann Cummings, Harold Giard, Robert Hartwell, Sara Kittell, Virginia "Ginny" Lyons, Mark MacDonald, Peter Shumlin, Robert Starr, Jeanette White, Richard McCormack