The recent Avalere report, commissioned mainly by affiliated business groups, predictably disputes some savings that will be realized by Vermont’s Act 48 single-payer health care plan. However, before opponents of single-payer start victory laps, some questionable aspects of the report should addressed.
The report overlooks that today hospitals and doctors in private practice write off over a hundred million dollars a year in care when patients can’t pay their medical bills, which means that everyone else pays more. Added on to this are collection fees. Single-payer eliminates such losses.
Every Vermonter will be a paying patient and charged the same based on an upgrade of Medicare reimbursement rates. This leveling of the medical paying field should lower non-medical administrative costs such as billing departments. Even today, many hospitals flourish on mostly Medicare patients. See the Brill article in Time magazine.
The sponsors of the Avalere report include those who have vested interests directly or indirectly in the current health insurance system, such as Blue Cross and Blue Shield of Vermont, the Vermont Business Roundtable, the Vermont Chamber of Commerce, Fletcher Allen, Vermont Association of Hospitals, and the Vermont Medical Society. Incidentally, another sponsor of Avalere, Vermont Partners for Health Care Reform, testified that they question the accuracy of the report and want an independent study.
Five other reports, Lewin in 2001, Thorpe in 2006, Hsiao in 2011, BISHCA (now Vermont Department of Financial Regulation) and UMass in 2012 all contradict the Avalere report concerning savings from single-payer.
Finally, reports supporting single-payer should be redundant by now as the evidence of savings in the last 50-plus years are visible worldwide from developed countries, all of whom have universal health care, including single-payer, with better results at less cost than our fragmented and inefficient system.
JERRY KILCOURSE
Montpelier