Don't be afraid of single payer

January 01, 2015

Rutland Herald: In response to Enid K. Reiman’s letter, we are encouraged to know she recognizes the health care delivery system in the U.S. “needs to be fixed.” Without quoting figures everyone has heard, we know that we have the most expensive health care of all industrialized countries and that we provide a much lower percentage of our citizens with access to any health care. All those countries provided some form of a universal access plan, commonly referred to as “single payer,” although the mechanisms for doing this differ.

But what makes Ms. Reiman think Green Mountain Care won’t be portable, you won’t be able to get emergency care in another state? I have not seen the plan — how do you know this? Of course portable emergency care must be provided.

Ms. Reiman is correct that the insurance companies have created the fee-for-service model which is OK for private providers, but does not work inside institutions. Many people are working hard to transform this. In England, National Health Service providers are paid salaries, in other countries there are mixed plans. This will evolve once we get a handle on providing a health system (emphasis on system) rather than the for-profit business model which we have today with the profit-making insurance companies.

And to reassure her further, we know young health providers are at the gate to move to Vermont if we can create a true health delivery system which does not encumber them with yards of paperwork, many different insurance companies to answer to and to fight with to provide the health care they believe their patients need.

Dear Ms. Reiman, please consider sticking with those of us who do know single payer will be a vast improvement on what we have, who have lived in countries with universal, free access to health care, and who are working hard to see Vermont set up the first statewide health care system.