Vt. gov. hails health ruling, pushes bigger plan
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But the state's 2011 law calls for the exchange to be just a steppingstone toward the goal of having all Vermont residents covered by a public health insurance program, with just one entity — a single payer — sending money to doctors, hospitals and other providers.
Another key to Vermont's project is cost controls. The state wants to move away from the traditional "fee-for-service" model of paying for health care, in which the more of a procedure a health professional performs, the more he or she gets paid. Instead, various types of "global budget" are being considered, in which hospitals and medical practices would be paid a set amount for caring for a given populations, likely with bonuses for keeping people healthier.
State officials and Vermont's three-person congressional delegation in Washington have been pushing legislation that would move up the date in the Affordable Care Act when states can get waivers from some of its requirements, from 2017 to 2014. Vermont would use such a waiver — essentially a you-don't-have-to allowance — to move from the exchange to a single-payer system.
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As for the individual mandate, the much-discussed requirement in the federal law that every American must have health insurance or pay a penalty, that won't be an issue in Vermont, Shumlin said.
"We'll be the first state in the country where health care is a right and not a privilege and where you get health insurance because of your residency, not because of a mandate," he said.
http://www.sfgate.com/news/article/Vt-gov-hails-health-ruling-pushes-bigger-plan-3671616.php
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