Perspective:

The Governor of Vermont recently signed into law health care reform legislation that will allow Vermont to implement a single-payer health care system. The law creates a Health Benefit Exchange, consistent with the federal Affordable Care Act, and anticipates using it as the administrative structure for a publicly funded program of health insurance coverage for all Vermonters. Vermont’s plan would include a global budget for health care expenditures, guaranteed coverage that is not linked to employment, optimal health care payment and delivery systems, and a single system of provider payments and administrative rules. It will be worth monitoring Vermont’s development of its single-payer system as a model for guaranteeing coverage for all citizens, reducing administrative waste, and simplifying insurance for both patients and providers. There will be many lessons to be learned from the implementation of this program.