Vermont has long had a two-pronged approach to building a single-payer health care system. First, they would figure out what they would want the system to look like. Then, they would figure out how to pay for it.This has always been the HUGE hurdle that any single payer system would have to jump. Its true that - in the end - such a system would likely save money. But simply comparing costs in the U.S. to countries with single payer systems is not adequate. First of all, it has been proven that health care procedures are WAY more expensive here than they are in other countries. That's part of where the discrepancy comes from. Single payer wouldn't fix that.
The state passed legislation outlining how the single-payer system would work in 2011. And ever since, the state has been trying to figure out how to pay for a system that covers everybody. Most estimates suggest that the single payer system would cost $2 billion each year. For a state that only collects $2.7 billion in revenue, that is a large sum of money.
What Shumlin appears to be saying today is that the "time is not right" to move forward on the financing of the single-payer system. And that means putting the whole effort aside, with no clear moment when the debate would be reopened.
Secondly, switching to single payer means that costs are shifted - not that they simply go away. Vermont found that, when implemented in 2017, those costs would equal an 11.5% income tax on all residents. Trying to design a system of who pays for what inevitably would create big winners and big losers. That means a lot of chaos and an awful lot of noise from the losers.
So...single payer advocates are going to have to address how that transition should happen. Vermont just showed that if you don't do that, it is never going to happen.