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Vermont's bill, in fact, falls short of universal, high-quality, affordable coverage by permitting multiple private insurers, able to game the system through "multi-tiered care, rising costs and needless waste."
Moreover, enormous administrative costs remain instead of eliminating them altogether under a single-payer system, removing the middleman so state officials can negotiate reduced prices for drugs and other health services.
Among other limitations, Vermont's bill establishes a state healthcare exchange called Green Mountain Care, managed by a five-member board. It interfaces with providers on reimbursement rates under a system leaving them largely in control, a serious flaw needing correcting. Otherwise they'll game the system to their advantage.
According to PNHP co-founder Dr. David Himmelstein:
Vermont's law "leave(s) the door open for burdensome co-pays, deductibles and other out-of-pocket expenses that deter people from seeking timely care. (Moreover), to the extent the law permits, large for-profit institutional providers (may) allocate their profits as they see fit, (denying) the system (of) the ability to do effective health planning."
As a result, much more work needs to be done to make universal coverage a reality.
On Democracy Now, Dr. Deb Richter, president of Vermont Health Care for All and past PNHP president, explained the bill's shortcomings and need to change federal law. The goal, she stressed, is true universal coverage. Everyone in, no one out in a system excluding private insurers except for those choosing that option.
In fact, Vermont for Single Payer: Everybody In, Nobody Out's Statement of Principles is as follows:
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