Update On Vermont, As It Moves Toward Single Payer System

Vermont moves ahead with its unique, publicly-financed insurance program” credit=”Amy the Nurse/flickr

Kaiser Health News revisits Vermont, which approved a single-payer health system last year, but has yet to figure out some critical details — like how to pay for it. In the meantime the state is working to build a new health exchange — a requirement of the new federal health law — that will serve as a foundation of the future, publicly-financed insurance program.

KHN’s Jessica Marcy reports:

Gov. Peter Shumlin’s administration this week offered a bill to the legislature that lays out a plan for building the exchange, a type of marketplace for individuals and small groups to buy health insurance. The proposal would combine the small group and individual health insurance markets, would bar the sale of health insurance to individuals and small employers outside of the exchange and would define a small employer to be 100 employees or fewer instead of 50, which had been under consideration. The bill also seeks to clarify how the state should integrate Medicaid, the state-federal health program for the poor and disabled, into the exchange.

Under the new system, an independent five-member panel called the Green Mountain Board will also be in charge of reviewing hospital budgets and defining final Certificate of Need as well as making health insurance rate decisions. That board is also working on a transition to a single-payer health system. Continue reading

Daily Rounds: Uncured Price Problem; Height Reflects Health; Rating Online Health Managers; Mass. As Model?; State Insurance Exchanges Key

The price problem that health-care reform failed to cure “We spend fewer per capita days in the hospital compared with other advanced countries, we see the doctor less frequently, and we swallow fewer pills,” said Jon Kingsdale, who oversaw the implementation of Massachusetts’s 2006 health-care law. “We just pay a lot more for each of those units than other countries.” (The Washington Post)

Measuring A Country’s Health By Its Height : NPR “From the day we’re born, height equals health. Babies are measured to make sure they’re thriving. But doctors aren’t the only people who look to height as a sign of health. Economists like John Komlos of the University of Munich in Germany use height to measure the health of entire countries. “Height is like holding a mirror to society’s well-being,” Komlos says. And, it turns out, by that standard, the United States isn’t measuring up.” (

Evaluating Online Services for Tracking Your Health – “In the end, we found that each PHR offers a remarkable value for a free application, but none of the three emerged as a clear winner. Microsoft HealthVault gets high marks for portability, but it has no features for printing. WebMD Health Manager has all of its health evaluation features built in, so you don’t have to connect to external applications, but it lacks the ability to export information in some key industry formats. So does Google Health (it says it may add this later), but it does export data to online health applications. (Wall Street Journal)

Healthcare reform model polls poorly with Massachusetts doctors – The Hill’s Healthwatch The Massachusetts Medical Society surveyed 1,000 practicing doctors in its annual Physician Workforce Survey and found only 14 percent recommended Massachusetts’s 2006 overhaul as a model for the nation. (

Health Care Overhaul Depends on States’ Insurance Exchanges – “Massachusetts and Utah provide a glimpse of the future, and they offer radically different models for other states. The battle over health care is shifting to the states, and the design of insurance exchanges will be one of the most pressing issues for state legislators when they convene early next year.” (The New York Times)