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

Vermont Health Care for All President Dr. Deb Richter discusses why a universal, single-payer healthcare system was needed in the state.

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So those are the things that I think resonated with people. I think people who had gone to the doctor 30 years ago and didn’t see all those people behind the counter just pushing paper, it’s something that they all felt. And we’re seeing this. More and more in the middle class is now experiencing what the poorer folks used to experience in terms of access. And I think that now that we have probably a majority of the population experiencing problems, this is something that’s resonating. And I do believe that that’s one of the major reasons that we got this legislation passed this year.

AMY GOODMAN: Dr. Richter, can you explain more who exactly is going to pay for this? Of course, that’s the argument that’s used all over the country. This is what we most understand as Medicare, but you just drop the age of eligibility to zero, to when—the day you’re born.

DR. DEB RICHTER: Well, I’d like to point out that we always ask this question: how are we going to pay for it? I think we should remind people that they’re paying—every penny of the healthcare dollar is coming from Americans. Right now we’re paying—60 percent of it is financed through taxes, 20 percent out of pocket, and 20 percent for private insurance premiums. That’s all coming from us. We either give up higher wages, or we pay higher prices for goods, or we give up paving our roads. All of those things go into financing the healthcare system now.

What this bill will do—and we do not have a financing mechanism set up yet. We did have Dr. William Hsiao, who suggested an 11 percent payroll tax on employers and a three percent payroll tax on the employees could finance a very robust benefit package for all Vermonters. At the time, the Governor felt that we really needed to look into whether that was the best way. But it is—we have committed to broad-based taxes to finance the healthcare system, much like you described, a Medicare for all, which would be—you’d get it at birth rather than waiting 'til you're 65. More than likely, this will be some combination of a payroll tax, perhaps some income tax, perhaps some other taxes, but that will then be in place of premiums and out-of-pocket payments. So, we should keep in mind that what this does is it dedicates financing for the healthcare that we expect to be there for us.

AMY GOODMAN: I should just clarify something. When you said Dr. Hsiao, this very interesting Harvard economist who Vermont hired, who addressed a rare session, a joint session, of the Vermont legislature, with all three—the whole delegation from Congress, the two senators and the Congress member there, as well as the Governor, to lay out what the proposals are. Juan?

JUAN GONZALEZ: Yeah, I’d like to ask you about the response of the doctors of the state. And there’s obviously public support for it, but what about the medical community? What’s been their response to your efforts and to the new plan?

DR. DEB RICHTER: Well, we’ve had some opposition, but there was a public hearing for providers. This was—included hospitals. And what we found was, two to one were in favor of single payer. And that’s particularly true in the primary care specialty. Eighty percent, roughly 80 percent nationally and in other state polls have shown that primary care, 80 percent of them are in favor. And we—our American Academy of Family Physicians Vermont chapter endorsed it. Our Vermont Psychiatric Association endorsed it.

 
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