Vermont Signs Single-Payer Health Care into Law:

Total posts: [96]
1 2 3 4
76 Enkufka28th May 2011 03:40:29 PM from Bay of White fish
Wandering Student ಠ_ಠ
well that has more to do with keeping the patient steady in times of emergency. though I can't tell if you're being sarcastic...
Very big Daydream Believer.

"That's not knowledge, that's a crapshoot!" -Al Murray

"Welcome to QI" -Stephen Fry
77 HungryJoe28th May 2011 03:43:45 PM from Under the Tree
If I'm going into cardiac arrest, horsedrawn carriage is not my preferred mode of transportation, and not just for the rough ride.
Charlie Tunoku is a lover and a fighter.
Have you seen roads after a New England winter?

They'd be in for a bumpy ride either way.

79 Enkufka28th May 2011 03:44:55 PM from Bay of White fish
Wandering Student ಠ_ಠ
And now I have no clue how we got to this point...
Very big Daydream Believer.

"That's not knowledge, that's a crapshoot!" -Al Murray

"Welcome to QI" -Stephen Fry
80 HungryJoe28th May 2011 03:49:54 PM from Under the Tree
^^I live in New England. So, yes.

A. VT has a lot of expirence keeping their main roads clear, as a skier I've spent quite some time on them.

B. The main danger is ice or snow too deep to drive through, both of which are more dangerous and harder to negotiate via horse. Plus the distances are so great the paitent will die from any time critical condition even with the horses in an incredibly dangerous full gallop.

^Good point.

Anyway, this whole thing has to do with paying for the use of existing services more than creating new ones.

edited 28th May '11 3:50:39 PM by HungryJoe

Charlie Tunoku is a lover and a fighter.
Hey, it's better than the libertarian diatribe we had going.

But anyway, I think they're going to have to negotiate with nearby urban areas for certain things.

82 Enkufka28th May 2011 04:25:03 PM from Bay of White fish
Wandering Student ಠ_ಠ
^ this is likely, but I think what will likely happen is people will go to hospitals better equipped than their own for care, such as Fletcher-Allen in Burlington, for long term care or surgery for non-immediately life threatening conditions. More immediate concerns, such as an inflamed appendix or trauma surgery or something else would have to be handled by local hospitals, possibly with surgeons brought in via car or helicopter.

Basically, what it does now, only cheaper and possibly more efficient.
Very big Daydream Believer.

"That's not knowledge, that's a crapshoot!" -Al Murray

"Welcome to QI" -Stephen Fry
I wonder if they can get remote surgery machines. I've seen some testing with them, not for certain stuff, but for many things, it's not like the doctor isn't using a camera anyway.

edited 28th May '11 4:33:40 PM by blueharp

84 HungryJoe28th May 2011 04:36:14 PM from Under the Tree
Those would seem like a good idea, but only if they come down in price so that flying a surgeon out is more expensive.

Remember, even if people are willing to have tax hikes, it doesn't mean they want every new and shiny piece of tech out there on the bill. That's how the Pentagon and School Districts get screwed up in the budget department.

edited 28th May '11 4:36:33 PM by HungryJoe

Charlie Tunoku is a lover and a fighter.
I wish it were only shiny tech that was wrong.

But those are general problems everywhere, not Vermont-specific.

I wonder if they'll be able to negotiate prices on drugs like Canada does?

edited 28th May '11 4:46:06 PM by blueharp

86 CaissasDeathAngel29th May 2011 03:23:51 PM from Dumfries, SW Scotland , Relationship Status: Pining for the fjords
House Lewis: Sanity is Relative
Transport should still be viable with air-ambulances and the like if need-be. That works in Britain, and is quite regularly used since in the Scottish highlands, if there are any hospitals in an area at all, they're often inadequate for complicated stuff like major surgery. Thus the patient needs to be helicoptered to Glasgow or Edinburgh. The terrain is rough, ragged, mountainy and there's many on islands with only a basic doctor's office in their local area, but it's still managed.

Granted, I don't know what kind of distance you're talking about in VT, just a couple of hundred miles in Scotland. The air-ambulances also serve as mountain rescue services frequently, so perhaps if there's any kind of service like that in VT it could be expanded so vehicles could be co-opted for that sort of use?
My name is Addy. Please call me that instead of my username.
87 HungryJoe29th May 2011 06:57:36 PM from Under the Tree
Yeah, I really don't think emergency care is an issue.
Charlie Tunoku is a lover and a fighter.
88 Enkufka29th May 2011 07:21:51 PM from Bay of White fish
Wandering Student ಠ_ಠ
So the only difference will be that everyone who wants to be covered by VT will be?
Very big Daydream Believer.

"That's not knowledge, that's a crapshoot!" -Al Murray

"Welcome to QI" -Stephen Fry
89 BestOf30th May 2011 05:53:29 PM from Finland , Relationship Status: Falling within your bell curve
[up][up][up]Slightly off-topic, but I just wanna know: since you seem to have an ambulance and rescue helicopter force, which is a great thing BTW, do you know if military helicopters are ever used like that?

In Finland, the helicopters that our defence forces have are also required to carry out rescue and ambulance duties if the local rescue services can't handle it, and they have trained crew in place for it.

Is it the same in Scotland?

Also: wouldn't that be a very good idea in the US, too? (Actually, I'm almost certain that there is such a system in place in the US.)
Quod gratis asseritur, gratis negatur.
I know the Air Force can sometimes be used for emergency transport, and I'm sure the National Guard gets called in from time to time.

91 HungryJoe30th May 2011 07:13:50 PM from Under the Tree
I don't think it's a big thing though.

Most places that need air-ambulences have their own.

In coastal areas the Coast Guard does a lot of that work, but Vermont is landlocked.
Charlie Tunoku is a lover and a fighter.
So I am somewhat confused by the article about what exactly they're implementing because it doesn't actually look like single-payer at all. They seem to miss the point of it; having a single freaking payer.

It appears to be both a healthcare mandate combined with a co-op shop for private insurance. That may reduce rates somewhat (since group buying power can get you that) but it's not exactly single payer. The phase-in implementation is what I'm especially interested in. Is the prevalent thought that they would have a government-run insurance competing against all the others and that it would eventually grow to dominate the market?

You know how it normally works is that you have a combo of three things (to be most similar to America's current healthcare system)

  • A single customer; the people of the state of Vermont. Therefore you only have one price for all your services since you only have one customer to sell to and one person to negotiate the prices.
  • A pay cap. Doctors/surgeons in single-payer systems with privately delivered healthcare typically have salary caps on healthcare workers. This prevents them from prescribing pointless things because eventually they run themselves out of business. It makes them prioritise and cheapen costs but it does result in them turning away people if they think they can't afford it. Also limits on litigation to protect healthcare workers and reduce legal costs.
  • Creeping restrictions on private healthcare. This tends to happen because you don't want the healthcare worker salaries to be eroded by private healthcare services. Voters usually push for this because they don't like healthcare quality to degree for everyone but the top 1% in society.

edited 31st May '11 1:14:53 PM by breadloaf

93 storyyeller31st May 2011 01:45:58 PM from Appleloosa , Relationship Status: RelationshipOutOfBoundsException: 1
More like giant cherries
It has to be phased in over time. It's not something you can just set up overnight.
Eh, you can. Saskatchewan (a province in Canada) did just that. Socialists went into power, they put in public healthcare. Hilariously during the anti-communist years too, though I'm not sure if it was during the red scare (I think it was somewhat afterwards). It saved so much money that all other provinces followed suit and then eventually the Federal government bought into it around a decade and a half later.
Aw dagnabbit, I was so hoping my home state of California would get this done first. At least somebody's fired the first shot in this war, it took 15 years for the province-by-province fights to hit a federal victory in Canada, let's see if we Americans can win it faster.

96 Lanceleoghauni4th Jun 2011 03:24:11 PM from Z or R Twice , Relationship Status: In my bunk
On Massachusetts' Bankruptcy: It's less to do with insurance being mandatory, and more to the massive fuckup that is the Big Dig. Really, That thing was so mismanaged that it's Hemorrhaging money. Also, It's one of the healthiest states as a result of Medical Reform It's a year ago, but I don't expect too much has changes since then. Hell, Every State in New England is in the top ten. (Admittedly Rhode Island is tenth)

Just for clarity.

edited 4th Jun '11 3:35:03 PM by Lanceleoghauni

"Coffee! Coffeecoffeecoffee! Coffee! Not as strong as Meth-amphetamine, but it lets you keep your teeth!"
The system doesn't know you right now, so no post button for you.
You need to Get Known to get one of those.

Total posts: 96
1 2 3 4