One of the issues in this year's campaign was Peter Shumlin's call for a single payer health care system. There was a lot of skirmishing, with Peter arguing that single payer is the best way to structure health care financing and Dubie arguing that, regardless of its merits, single payer is off the table because it isn't allowed under the Affordable Care Act.
Peter's response was that we can ask for a waiver, and they'll probably grant it. Not bad, but it depends on getting the waiver, and getting it years before the law says we can ask for it.
Today we learn that things may be changing. Scott Brown, the new Senator from Massachusetts whose qualifications are apparently limited to the fact that he owns a truck and has, in the past, had the ability to make women salivate,is working with Oregon Senator Ron Wyden to "fix" the Affordable Care Act.
According to Ezra Klein in today's Washington Post:
The Wyden/Brown legislation would allow states to propose their alternatives now and start implementing them in 2014, rather than wasting time and money setting up a federal structure that they don’t plan to use.
Also, according to Klein, even Orin Hatch supports this idea.
And who benefits from this idea? Here's Klein again:
One state that wants to prove it is Sanders’s Vermont. “As a single-payer advocate,” he says, “I believe that at the end of the day, if a state goes forward and passes an effective single-payer program, it will demonstrate that you can provide quality health care to every man, woman and child in a more cost effective way. So I wanted to make sure that states have that option.” Vermont’s governor-elect, Peter Shumlin, is on the same page. “Vermont needs a single-payer system,” he said during the campaign.
These are early days and there's a lot that could go wrong with this proposal.
Still, if Peter Shumlin, working with Bernie Sanders (exactly what he said he’d do in his campaign) can get some traction for a waiver to try a single payer system in Vermont, this will be not only a huge benefit for the people of Vermont, but a tremendous accomplishment for our new governor.
…I’d been talking with Bernie’s folks long ago and they said there would be a waiver date pushback in the summer. You know, when the Dems still had a supermajority. So I’m not overly optimistic that there will be anything done in the next Congress, with Brown and Hatch on board or not. And even if the new Scott/Wyden alliance gets their proposal through, 2014 is still 2 years after our legislature is supposed to implement single-payer.
But Obama reportedly called Shummy and promised he’d get all of the necessary waivers (3 by my count, including Medicaid, ERISA and ACA). I suspect the Exec can do a lot of things with or without Congress’ being on board.
Regardless, if a State were to try implementing single-payer, it would have more merit to push the Feds than any of those misguided AG suits about the individual mandate.
Do these waivers need congressional approval? If so, I highly doubt that the new tea partiers would even think of granting waivers for single-payer. But, if not, and this act goes through, it will be a gigantic accomplishment for Shumlin. I can imagine how the insurance companies are going to fight back on this one.
Obviously, the legislative prospects may be somewhat daunting, particularly now. Yet — and perhaps this is unrealistically hopeful, too — I cannot help but think that our Rube Goldberg medical insurance scheme will someday soon topple from its own complexity (never mind its injustice!). Yesterday, I was in a health care provider’s office speaking with an employee whom I have known for years. This individual has just completed her chemotherapy and radiation treatments for breast cancer. Diagnosed early in 2010, my friend first had to overcome the shock of the news … but then, as she recounted yesterday, she began to plot out her treatments so that they would end during the year in which she has already met her deductible. In other words, she had to balance, in one hand, the stark choices she had to make about her treatment, and in the other hand, she had to figure out her coverage schedule in order to minimize her out-of-pocket expenditures. She was smart and informed, but nonetheless, this kind of system is CRAZY!!
My wife, until recently, worked in surgical oncology. She was infuriated when two patients would present themselves with the same condition: One would get the drug that was needed because their insurance company covered it; the other, whose company did not cover it, would not receive that drug. So, here we see the tangible and life-affecting consequences of a medical system run by a lot of people with, not green scrubs but, green eye shades.
Here is another source in addition to Ezra Klein:
http://wonkroom.thinkprogress….
When Margaret Thatcher wreaked her havoc in Britain, she was fond of saying, as she wielded her hatchet, that “There is no alternative” or, as it has come to be known, TINA. What the Wyden bill represents is the possibility that there truly is an alternative (call it TTIAA!) That’s one thing about which I will be greatful this Thanksgiving.
If we had a federal single payer system. Imagine if someone proposed the complexity of the system we have now. Imagine how the arguments would go… sure, the death panels would be private – but can you imagine the tea parties giving up their simple, cheap(er) care?