Health Care Answers in Black and White

With receipt of a comprehensive report from health care system expert and economist William Hsiao, Vermont lawmakers now have all the reasons they need to push ahead with a single-payer system for the state that could prove an example for the United States. In addition, according to the report recommendations, a new system could save money, offer dependable insurance coverage and boost the economy.

While the health care dog and pony show continues in Washington, with Republican efforts to kill a flawed but fixable federal reform bill passed last year, Vermont sensibly approved funds for the study and analysis that resulted in a report by Mr. Hsiao and his team.

They looked at a completely government-run single-payer plan for health insurance, which would save Vermonters money but also would cost the most in taxes. Keeping the current multi-insurer system while creating an insurance exchange and new regulations was determined to save the least.

But a hybrid public-private system, which includes coverage for all residents yet allows private insurance plans — similar to supplemental insurance for seniors on Medicare — was the approach recommended. It would include medical and mental health care, prescription drug coverage, dental and eye care, and would have co-payments for outpatient care but not for preventative care.

People on Medicare would keep the same benefits they have today.

The cost savings in reduced and simplified paperwork with a public plan would be significant, the report found. Under the hybrid proposal, employers and employees would pay through payroll reductions about the same as with the current insurance system. The lowest income workers and their employers would be exempt from the deduction.

In addition, there would be an independent board to oversee the system, and its administration would be put out to bid every few years to private or quasi-government entities.

The funding for the recommended single-payer option for Vermont is feasible and the plan would cover all residents. Today, there are about 47,000 lacking insurance, most of whom end up seeking care in emergency rooms and add to the health care burden of all residents through financial losses at hospitals and other care facilities.

Of course, this report also is certain to set off a lobbying campaign by the insurance industry — not only in Vermont, but nationally. And whether or not state lawmakers believe it is a common sense approach may not matter. The opposition will be fierce and extremely well-funded.

And Congress and President Obama still would have to approve a waiver allowing Vermont to take this step and allow the state to proceed before the current date for waivers — 2017. Our congressional delegation is requesting a waiver for a 2015 launch date.

Bottom line here: We can do this — and on our own if the federal government can’t get its act together.

Many have long believed that a public-private system (exact details to be hammered out) makes the most sense, and will save the most money over our current system — the world’s most expensive. And ultimately, it would cover everyone, finally making health care the human right it should be.