- Associated Press - Wednesday, May 11, 2011

MONTPELIER, Vt. (AP) – Accustomed to being the first to dip its toe into hot-button issues, Vermont is preparing to provide public health care to all residents regardless of income, moving toward a government-run system that will take it as close to Canada philosophically as it is geographically.

Gov. Peter Shumlin, a Democrat, is expected to sign legislation this month marking the first step on the path to phasing out most private insurance. The effort puts Vermont well in front of last year’s federal health care overhaul.

The ultimate goal, Mr. Shumlin said recently, is a Canadian-style system “where health care is a right and not a privilege.”

But it’s not yet clear how Vermont - the first state to ban slavery in its constitution and to give marriagelike rights to same-sex couples - will achieve universal health care. The legislation places responsibility for the details of the new system, including how to pay for it, in the hands of a powerful new state board.

Vermont’s turn toward universal care comes as more than two dozen states have gone in the opposite direction, suing to overturn the federal law. The U.S. House last week voted to strip federal funding from key parts of it, though that move is expected to die in the Senate.

While the federal law requires people to have health insurance and offers subsidies to help low- and moderate-income people buy it, Vermont would go further. It would change the way doctors and hospitals are paid and streamline the processing of insurance claims.

The federal law was modeled in part on Massachusetts’ groundbreaking 2006 system that required all residents to have health insurance; unlike the Vermont plan, the Massachusetts program does not provide health care to all but does offer subsidized insurance to those can’t otherwise afford it.

The Vermont bill sets up a five-member board which, in consultation with the executive branch and legislature, is to answer the big unanswered questions in this year’s bill. Those include how the system will be paid for - some have suggested a payroll tax on employers and workers; what benefits will be covered; what copays and deductibles it would include; and other details.

“Vermont is leading the way in having an authentic discussion about what a universal health care system would look like in the state,” said Katie Robbins of Healthcare NOW. The Philadelphia-based group supports single-payer health care, under which everyone gets coverage from the same government-run system, similar to what military personnel have now.

Despite the growing opposition to the federal law, Vermont, where liberal Democrats control the governor’s office and both houses of the General Assembly, is undaunted in moving in the direction of Canada, which pays for its health care system through taxes.

And supporters say the state has built-in advantages. Vermont, with a population of about 620,000, is often ranked as one of the healthiest states. It is well below the national average for infant mortality, childhood obesity, AIDS diagnoses and a range of other indicators of poor health, according to figures kept by the Kaiser Family Foundation.



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