My sister has health insurance but largely can’t afford to go to the doctor. Right when Obamacare kicked in, they changed her plan to where doctor’s visits used the deductible, when they previously didn’t.
I don’t think that is quite why Vermonts attempt wasn’t affordable. The real reason was that Vermonts attempt was a peculiarly American attempt, preserving the biggest cause of US high costs.
All other first world nations have a single national healthcare system. Regardless of which system they use, employer-financed insurance (Bismarck), one national healthcare system (Beveridge), a national insurance model or some hybrid. The standard is one national system, with one set of administration, and private healthcare filling in any gaps. (Except Canada on the last). Even places where they have chosen multiple private insurance operators, like Switzerland and the Netherlands, they don’t all use different administrative and billing systems as far as I know.
The US, however, have an unholy mess of different systems, with a massive duplication of effort, liaising and umpteen different systems for billing and credit-checking. As well as a number of government run healthcare systems operating separately. Medicare, Medicaid, IHA, VHA, Childerns etc.
When you try to plonk a UHC system on top of that, which is as far as I know what Vermont tried to do, you are not getting single payer. You are just adding one more layer to the mess.
To actually get single payer you’d need to replace all the government systems with one system, and use that funding.
You might not manage to get up to the level of care provided by other single payer systems for a while, but you should be able to improve the level of care Americans receive significantly.
Canada does not have a single national system. We have thirteen separate systems, one operated by each province and territory. Each of them is a single payer.
To receive federal funds, they must comply with the terms of the federal statute, the Canada Health Act.
Sweden also has a decentralized system. The real issue with Vermont is that as Grim Render said, they were trying to put it on top of everything else they had, which was a political necessity, since everyone would want to keep what they had. I figure Medicaid recipients don’t care, but everyone with good private insurance and Medicare would demand no changes.