The little state that could ... and should


On Thursday, the Vermont House of Representatives voted in favor of establishing a single-payer health care system in the Green Mountain State.

If the Senate approves it and the governor signs off on it -- which they probably will -- Vermont will lead the nation in providing a system that could go a long way to solving many of the nation’s health care system woes.

There are many details yet to be worked out, which is why the legislation passed by the House of Representatives calls for a five-member committee to study and propose how a single-payer plan could be implemented and operated.

Of course, there is strong opposition to switching to single payer, not the least of which comes from Ethan Allen Institute, which bills itself as a free-market think tank.

John McClaughry, President of the institute, contends that advocates for a single-payer system rely on three arguments -- that health care is a human right and that there is evident dissatisfaction with the operation and financing current system.

The third reason, he stated, "is political and rarely stated."

"It will put the government in control of all employers, medical providers, insurers (if any), and patients. ... That will mean many more jobs for (unionized) government bureaucrats. It will require unionization of doctors and other professionals who will have to bargain with the public body over their compensation and working conditions. It will mean more campaign contributions and votes for politicians who will work to rig the system in favor of their particular group of ‘stakeholders.’"

While we don’t agree that single-payer advocates subscribe to his third argument, we do believe that the first two are too true to be denied.

Opponents say they don’t want the government running our health care system.

The truth: Other universal health care systems are not controlled by bureaucrats but instead by a public trust.

In the U.S., the system is run by insurance companies, who preapprove service, a nightmare for many of us who need care.

(More than half the family bankruptcies in the United States are attributable to medical expenses. Seventy-five percent of those bankruptcies were filed by people with health insurance.)

Death rates in for-profit hospitals are higher than in nonprofits, according to a study in the Canadian Medical Association Journal, which concluded the reason is for-profit hospitals must cut corners "in order to achieve a profit margin for investors, as well as to pay high salaries for administrators."

The biggest bogeyman lurking in the shadows, according to opponents to single payer, is that it is socialized medicine.

But the Connecticut Coalition for Universal Health Care believes otherwise.

"Health care providers would be in a fee for service practice, and would not be employees of the government, which would be socialized medicine," wrote the Connecticut Coalition.

If you want the perfect example of socialized medicine, look at the Veterans Administration’s network of hospitals, paid for by the government and managed by government employees.

Many veterans feel they get better service through the VA than through for-profit hospitals.

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Then there are the reactionaries who believe single-payer health care is just a code phrase for "death panels" in which bureaucrats ration services and decide who is most deserving of health care.

The Reformer does believe care is already rationed in the United States, but it’s based on an ability to pay.

According to a study from Statistics Canada, "Income inequality is strongly associated with mortality in the United States ...."

We’ll interpret that for you: If you’re poor, you are more likely to die young than if you are well off.

The barefaced truth is the United States is the only industrialized nation that doesn’t have a tax-supported health care system. And no one can argue that we have the most expensive health care system on the planet.

But as an example of the myopia of Americans, many of us believe the nation also has the best health outcomes in the world.

The numbers belie this delusion.

Let’s consider the case of our much-maligned northern neighbor, which has a system that McClaughry calls a "very apparent failure ...."

Canada has an infant mortality rate of 4.7 per thousand, 23rd out of 225 countries.

The United States has a rate of 7 per thousand, 43rd in the rankings. (Shockingly, in 2001, black infants were dying at a rate of 14.2 per thousand).

"Outcome studies on a variety of diseases, such as coronary artery disease, and renal failure show the United States to rank below Canada and a wide variety of industrialized nations," according to the Connecticut Coalition.

Other numbers:

-- The United States ranks 20th in life expectancy for women down from 1st in 1945 and 13th in 1960

-- The United States ranks 21st in life expectancy for men down from 1st in 1945 and 17th in 1960.

-- The United States spends at least 40 percent more per capita on health care than any other industrialized country with universal health care and 50 to 100 percent more on administration than single payer systems

-- The U.S. has an oversupply of medical equipment and surgeons but patients in universal health care have more doctor visits and hospital days than in the United States, according to the coalition.

All this information is the reason the Reformer believes some sort of single-payer health care system should be put in place in the United States.

We hope Vermont can become a guiding light to the rest of the nation and prove that universal health care is the solution to many of the ills that ail our system today.


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