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Wednesday, April 22, 2015

Single Payer: State v Federal

Does the demise of the Vermont Single Payer system signal that change is on the horizon on a national level for a more sweeping program? The medical costs of state workers' compensation programs have become so profitable for cottage industries that are directly and ancillary connected to the delivery of work related medical care that the system is our of balance. One has to look seriously at the comments by John E. McDonough in the NEJM.

"At some point, perhaps 5 to 15 years from now, as the size and scope of Medicare, Medicaid, and the ACA subsidy structure balloon far beyond today's larger-than-life levels, our political leaders may discover the inanity of running multiple complex systems to insure different classes of Americans. If advanced by the right leaders at the right time, the logic of consolidation may become glaringly evident and launch us on a new path. If such consolidation is to occur, like it or not, I believe it will happen federally and not in the states — and no time soon."

The Demise of Vermont's Single-Payer Plan
John E. McDonough, Dr.P.H., M.P.A.
N Engl J Med 2015; 372:1584-1585 April 23, 2015 DOI: 10.1056/NEJMp1501050