Vermont Poised to Become First State to Enact Single-Payer Healthcare

Vermont made history last week by becoming the first state in the nation to offer universal, single-payer healthcare when Gov. Peter Shumlin signed its healthcare reform bill into law. The Vermont plan, called the Patient Protection and Affordable Care Act, will attempt to stem rising medical care prices and provide universal coverage. We speak with Dr. Deb Richter, president of Vermont Health Care for All. She moved from Buffalo, New York, to Vermont in 1999 to advocate for a universal, single-payer healthcare system in the state. Gov. Shumlin calls her the “backbone” of the grassroots effort that helped persuade the Democratic-led state legislature to pass the bill this spring.

Earlier this year, Governor Shumlin explained to Democracy Now! why the state needs the change.

GOV. PETER SHUMLIN: Here’s our challenge. Our premiums go up 10, 15, 20 percent a year. This is true in the rest of the country, as well. They are killing small business. They’re killing middle-class Americans, who have been kicked in the teeth over the last several years. What our plan will do is create a single pool, get the insurance company profits, the pharmaceutical company profits, the other folks that are mining the system to make a lot of money on the backs of our illnesses, and ensure that we’re using those dollars to make Vermonters healthy.

JUAN GONZALEZ: Governor Shumlin has appointed a five-member board to determine payment rates for doctors and what benefits to cover. Given all the details that need to be worked out, the plan may not go into effect until 2017.

AMY GOODMAN: To discuss the signing of the bill into law and the details of the plan, we’re going to the capital of Vermont, Montpelier, where we’re joined by Dr. Deb Richter. She’s the president of Vermont Health Care for All. Dr. Richter moved from Buffalo, New York, to Vermont 12 years ago to advocate for universal, single-payer healthcare in Vermont. Governor Shumlin calls her the "backbone" of the grassroots effort that helped persuade the Democratic legislature to pass the bill this spring.

Dr. Richter, welcome to Democracy Now! This is an enormous day for you. You’re going from your house to the Capitol for the signing. Can you explain what this bill actually does?

DR. DEB RICHTER: Well, this bill really establishes a framework for a true healthcare system, which is lacking anywhere in the United States. And what it will do is put in place a board that will oversee the healthcare system, and the board will be nominated in July. And we’ll start working in October to look at how we can reduce cost in our system. And that will be sort of the first phase. And most Vermonters won’t feel too much then, except probable a slowing of the rate of increase of their premiums.

And then the second phase, if we can’t get a change in federal law, is we will build the exchange according to federal law. But we will heavily regulate the insurance companies within that exchange and try to also streamline the payments to providers by making them uniform, calling them "all payer rates." So that’s sort of the second phase.

And then the third phase, if we get the waivers that we need in 2017, we hope to have a publicly financed single-payer healthcare—as close to a single-payer healthcare system as we can get.

JUAN GONZALEZ: And why the long wait, Dr. Richter, until 2017 for a full implementation? Is there any concern on your part that a change in the political climate, new people elected in Vermont, might attempt to roll that back in that period of time?

DR. DEB RICHTER: Well, we are not—we are not naive enough to think that we are not going to have significant challenges trying to get this bill in place. Our problem is really the federal law put restrictions on states that they couldn’t apply for waivers until 2017. What we’re hoping is that we can roll that back to 2014 and get our system in place before then.