Vermont governor signs single-payer health law

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vermont gov. peter shumlin on thursday signed into law a bill establishing a single-payer health care plan for the state, making vermont the first state to do so.

shumlin lauded the legislation as an "economic and fiscal imperative" -- as well as a moral one.

"this law recognizes an economic and fiscal imperative - that we must control the growth in health care costs that are putting families at economic risk and making it harder for small employers to do business," he said in a thursday statement. "we have a moral imperative to fix this problem, with 47,000 vermonters uninsured and another 150,000 underinsured and worried about how to afford keeping their families healthy."...

http://www.cbsnews.com/8301-503544_162-20066495-503544.html

Specializes in Critical Care,Recovery, ED.

Essentially we are talking about how to finance health care for the indigent, whom we as a society are morally and legally required to provide. Financing health care to minimize the costs of this indigent care can either be individually through our own personal resources, collectively through some form of governmental program, or a combination of the the two.

Currently we have a combination of the two and its my belief that most people feel that this is not working as well as it could. With some opting for as much individual choice as possible with the benefits accruing to the individual in an uneven and haphazard manner. While others seeing the advantage to society as a whole to a unified approach and the benefits accruing to society as a whole. A nationwide consensus on which approach to provide this care has not been reached and we will muddle along with a combination. Eventually consensus will be reached and through our elected representatives it will be done. Experiments like VT and MA will go a long way in determining the consensus that society has to reach.

Complicating the whole issue is the questions of profits in the health insurance industry. Since most are publicly traded companies and have shareholders to answer to their motive is to decrease what they pay out to health care providers and maximize what income they can get out of those paying premiums. Since health insurance companies have an exemption from anti-trust laws they aren't subject to the market forces that other for profit companies are. On an historical note health insurance companies were almost exclusively non profit during the industries infancy and that is when they convinced the US Congress to grant them the anti-trust exemption shortly after World War II. During the 1980's the non profits began morphing into for profit and publicly traded companies.

Specializes in Psych , Peds ,Nicu.
on the other hand, in my private insurance, i am paying for me ( no you are not ! , your premium is paid to cover the risk that you and all other policy holders will incur a liability [ of a bill], those premiums are put into a collective pool from which claims are paid . if you don't make a claim in a year for example you do not get a refund , or a statement that shows a positive account balance nor is the total sum of your premiums available as some of those funds will have been used to pay other insured policy holders claims ., and my co-workers are paying for themselves. true, our employer pays into it, but with money that would otherwise go into my pocket directly (as in per diem employees.) ( i know in our case perdiem recieve a 15% premium for not taking benefits , but that is ofset by losing accrual of pto , 14% in the case of some employees , healthcare costs a lot more than the 1% of their pay differential remaining ) ,so, it's money i earn, and decide to use to insure myself as much as i can. and, i get to choose from a range of benefits. like ppo or hmo. i can use an md in the plan or outside the plan. i can choose to take the dental and eye benefits or not if you choose not to be covered ,who other than the taxpayer is the guaranor of last resort to pay your bill .. i can be part of my spouse's plan or use my own, or be covered by both.

vis., 5 very smart people making all the decisions about how to do something incredibly complex for a huge number of people, all of whom are individuals and each of whom has individual needs that vary over time. are you out of your mind? they would have to be god (in 5 persons, not 3) to have that much wisdom. what incredible blind faith. abundant and overwhelming evidence from human history richly illustrates how bad an idea this is. so you would rather rely upon the one individual who is working to the corporate rule book ( upon which you have no direct input ) ,who then makes his decision upon how your approval or denial of payment will effect the profitability of his employer ?

now those 5 wise men were adam smith, edmund burke, milton friedman, friedrich hyek and ronald reagan... hmmm... nah. not even then.

frankly i don't know if the political appointees would be any wiser than the corporate appointees ( employees ) , but i do know they would not have to consider the effects of their healthcare decisions have upon the profitability and returns for share and bondholders .i also know that as a voter i will have an opportunity to try to have them voted out at a future date . i know market forces are supposed to work to improve the healthcare insurance products , but if that was working out , we wouldn't have a healthcare insurance crisis .

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