Single Payer - Vermont, who else?

[JackieLikesVariety]

Yet another healthcare insurance question: I know Vermont is in the process of implementing single payer for the entire state (although it will take a few years).

I'd like to relocate to a place that does this but - frankly - somewhere with better weather.

What other states might be next? I hear California keeps trying, anywhere else?

thanks!

[t-bonham@scc.net]

Based on the history from Canada, the next states are likely to be Maine or New Hampshire.

In Canada, this was first started in on province. Then nearby businesses noted the economic benefit & fixed costs of this, and the good effect on their employees. So businesses started relocating to that province (especially ones right along the border). The provinces next door noticed how well the neighboring single-payer plan was working, and that they were losing businesses to that province, and started plans of their own. Eventually, most of the provinces had their own plans, but with differences between. So the Federal government decided to take over the system, make them more standardized, and try to get even more efficiency via volume purchases, etc.

So that would seem to indicate the neighboring states would be the first to follow. But I'm not sure it would work that way. For example, the states in that area are much smaller & closer together than Canadian provinces.

[JackieLikesVariety]

good point, I didn't even consider geographic proximity but that makes sense.

I was thinking more over-all liberal politics.

between the question of health care (and insurance, more specifically) and global climate change deciding where I want to age is a bit of a crap shoot.

*rolls dice*

[Ludovic]

Originally Posted by t-bonham@scc.net

So businesses started relocating to that province (especially ones right along the border).

Yep. I bet Wal-Mart just can't wait to move into Vermont!

But seriously, what businesses? Does Vermont even have the infrastructure necessary to support a growth in relocatable businesses, let alone the zoning permissiveness?

But in general, I agree with this assessment except for the smallness and peculiarity of Vermont. If single-payer were in a larger state I'd agree that this effect would take place.

[JackieLikesVariety]

I bet Wal-Mart just can't wait to move into Vermont

if there isn't a walmart already that's one more reason to move there.

as for infrastructure - if we aren't talking about making cars or something, what do you mean? because if it's paved roads and electricity I'm thinking you are being a little hard on Vermont.

not that I know anything about it. Except I seem to recall Newhart supposedly took place there but the opening shots were filmed in New Hampshire.

[fiddlesticks]

Montana is another state with serious movement towards one.

[Ludovic]

Originally Posted by JackieLikesVariety

if there isn't a walmart already that's one more reason to move there.

as for infrastructure - if we aren't talking about making cars or something, what do you mean? because if it's paved roads and electricity I'm thinking you are being a little hard on Vermont.

For all I know they might have lots of empty factory and/or office space. But their population is so low that unless they make more of it, surrounding states might not even notice if business move there. And from what I know, it's more difficult to create business space in Vermont due to their zoning requirements, although that might not be true everywhere in Vermont.

[JackieLikesVariety]

Originally Posted by fiddlesticks

Montana is another state with serious movement towards one.

aha! thanks, googling MT and SP got me to wikipedia (hadn't thought to look there!) and info on MN, CA, IL, PA, as well as MT.

so there's that. also, the MT link states the gov likes what he sees in Saskatchewan so it does spread geographically. huh.

[Hari Seldon]

You see if you live in VT or MT, you can see Canada from your front porch.

Seriously, I would expect MA next. They are already partway there, are not in the throes of the tea party and maybe can begin to see how advantageous it would be to skip the middleman (the insurance companies). If that happens, MA is where I head. I have a son living in Boston.

When I first moved to Montreal, 44 years ago, it had government-run hospitalization but no government run medical care. That came after the federal government mandated it in 1971. The doctors went on strike, then the Quebec separatists kidnapped a couple of people (murdered one of them) demanding independence. This drove the doctor's strike off the news headlines it just, as far as I recall, ended. Now my family doctor (originally American, BTW) wouldn't want to practice any other way. He's not wealthy, but clearly comfortable.

[skdo23]

Originally Posted by JackieLikesVariety

if there isn't a walmart already that's one more reason to move there.

as for infrastructure - if we aren't talking about making cars or something, what do you mean? because if it's paved roads and electricity I'm thinking you are being a little hard on Vermont.

not that I know anything about it. Except I seem to recall Newhart supposedly took place there but the opening shots were filmed in New Hampshire.

There are already three Walmarts in VT, unfortunately. While I'm not sure about all of the opening scenes from Newhart, the exterior shots of the Stratford Inn are actually of an inn in Middlebury, VT, which is on Vermont's western border with NY (actually the border bisects Lake Champlain, but Middlebury is on the shore) whereas, the frequent references to Dartmouth place the show's setting in the White River Junction area, which is on Vermont's eastern border.

[Kevbo]

A large group of physicians in Grand Junction, CO have banded together to form a de-facto single payer system. Seems to be working.

[JackieLikesVariety]

Originally Posted by Kevbo

A large group of physicians in Grand Junction, CO have banded together to form a de-facto single payer system. Seems to be working.

thank you, I am glad to hear that.

*ponders* you couldn't ask for a better climate...

[Dewey Finn]

Originally Posted by Kevbo

A large group of physicians in Grand Junction, CO have banded together to form a de-facto single payer system. Seems to be working.

My guess is that what these physicians have created is a medical group practice, which is a group of physicians and other medical professionals. These are very common in the US. I very much doubt that they are creating a single-payer system. If I'm wrong, I apologize, but I'd love to see a cite.

[Jas09]

No, it really is single payer. A non-profit middle-man pools all the money from Medicare, Medicaid, and private insurance and pays out for all treatments at the same rate regardless of what coverage the patient has. Cite: http://www.forbes.com/sites/rickunga...-proven-wrong/

[Dewey Finn]

I don't see how that's a single-payer plan. The article says, "Another key feature to their plan involved the physicians’ wish that patients on Medicare and Medicaid- government programs that pay doctors less than private insurers- not be treated differently than those with private insurance." So some patients are covered by Medicare and Medicaid while others have private insurance.

[Jas09]

Right, but from the physician's point of view they all get paid by one payer (the non-profit). A single payer, if you will.

The idea is that neither the provider nor the consumer is making price-based decisions regarding care or treatment.

I agree it's not identical to a true single-payer government system, but it's an attempt to get the effects (not delaying care, not cherry-picking patients based on coverage) within the existing framework.

[bouv]

Originally Posted by skdo23

There are already three Walmarts in VT, unfortunately.

Soon to be a fourth. The proposed Wal-Mart is St.Albans finally got the ultimate approval from the Supreme Court after an almost 20-year legal battle.

[Diceman]

Originally Posted by JackieLikesVariety

What other states might be next? I hear California keeps trying, anywhere else?

I wouldn't hold my breath for California. These days, that state doesn't have two nickels to rub together.

[JackieLikesVariety]

Originally Posted by Jas09

No, it really is single payer. A non-profit middle-man pools all the money from Medicare, Medicaid, and private insurance and pays out for all treatments at the same rate regardless of what coverage the patient has. Cite: http://www.forbes.com/sites/rickunga...-proven-wrong/

I read the link and still don't get it.

all I know for sure is Grand Junction, CO seems to have an excellent weather - and that makes me want to move there.

[Kevbo]

Originally Posted by JackieLikesVariety

I read the link and still don't get it.

all I know for sure is Grand Junction, CO seems to have an excellent weather - and that makes me want to move there.

It can be pretty hot in the summer.

They also have good fruit orchards and vineyards. Great hunting and fishing on Grand Mesa, just an hour outside of town. Job market can be iffy...I think it is currently doing OK due to natural gas fracking boom. It is on my list of places to retire to.

[greenslime1951]

Oregon doesn't have single payer per se, but everyone who wants health insurance can get it: there is a state-mandated risk pool, which offers standard health insurance at no more than 125% of the state average rate, regardless of personal medical history. In fact, in order to get into this program, you have to have been turned down for medical insurance.

Oregon is pretty liberal, and I, personally, really like the weather. It doesn't rain as much as everyone thinks, and it's rarely below freezing in the winter--the weather then is a lot nicer than many places further south. And of course, the summer is glorious.

In general, Oregon's tax and public services structure is geared toward the "little guy" (and to some extent, screwing the "big guy," which is why we have a hostile business climate and high unemployment).

[JackieLikesVariety]

Originally Posted by greenslime1951

Oregon doesn't have single payer per se, but everyone who wants health insurance can get it: there is a state-mandated risk pool, which offers standard health insurance at no more than 125% of the state average rate, regardless of personal medical history. In fact, in order to get into this program, you have to have been turned down for medical insurance.

Oregon is pretty liberal, and I, personally, really like the weather. It doesn't rain as much as everyone thinks, and it's rarely below freezing in the winter--the weather then is a lot nicer than many places further south. And of course, the summer is glorious.

In general, Oregon's tax and public services structure is geared toward the "little guy" (and to some extent, screwing the "big guy," which is why we have a hostile business climate and high unemployment).

I like ALL of that - thanks for sharing. you live in the Willamette Valley?