National Nurses United

National Nurse magazine September 2011

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t A s if ben and jerry 's ice cream, powdery light snow, and fresh maple syrup weren't enough to make Vermont a place we'd all like to experience more often, the Green Mountain state has made history by beginning the hard work of creating a progressively financed, single standard of high- quality care for all Vermonters. While states from coast to coast are figuring out how to implement the new federal healthcare reform bill, also known as the Patient Protection and Affordable Care Act of 2010 (PPACA), Vermont has taken a giant leap beyond merely expanding insurance coverage offered through the state exchange model required by the new law and committed to establishing a single-payer system. Vermont's Governor Peter Shumlin signed H.#202 into law on May 26, 2011. The new law provides building blocks for more state reform in Vermont and the eventual implementation of a single- payer method of financing healthcare in the state. Most immediately, the law established a board with the following duties, among others: "Oversee the development and implementation, and evaluate the effectiveness, of healthcare payment and delivery system reforms designed to control the rate of growth in healthcare costs and main- tain health care quality in Vermont, including (control over) payment reform pilot projects." The board is set to begin work Oct. 1, 2011. Another exciting aspect of the Vermont work is the state's com- mitment to stemming the tide of ever-increasing healthcare costs while at the same time extending high-quality care to all. H202 also will "implement methodologies for achieving payment reform and containing costs, which may include the creation of healthcare pro- fessional cost-containment targets, global payments, bundled pay- ments, global budgets, risk-adjusted capitated payments, or other Moving Mountains Vermont forges a path toward state-based s uniform payment methods and amounts for integrated delivery sys- tems, healthcare professionals, or other provider arrangements." Just as passage of this legislation required the joint efforts of multiple citizen advocacy groups from a broad range of perspectives, its passage also required the cooperation and support of many elected officials— including Vermont's federal Congressional delegation. "Vermont's enact- ment of historic health reform takes a big step for Vermont toward creating the first universal access, single-payer health coverage system in the country and recognizes healthcare as a human right. It has long been my view states can lead the way for the nation by providing better care for more people at lower cost," said U.S. Senator Bernie Sanders. Nurses in Vermont were, of course, also among the most vocal spokespeople in favor of passing Green Mountain Care. "As nurses we see the effects of our broken healthcare system every single day," said Jennifer Henry, RN in testimony to the Senate Health and Welfare Committee, according to a blog by the Vermont Workers' Center, the group which spearheaded the community's "Healthcare is a Human Right" single-payer campaign. "How many more stories of pain and suffering must be told before real change occurs? ... We need a Medicare-for-all-style system in Vermont. It is possible and we are working to make it happen for Vermont. For a small state, Vermont has often been a leader. We have the will, we have the courage, we have the strength and now we must work together to make it happen." Sandy Eaton, a Massachusetts RN and leader in that state's sin- gle-payer movement, said that the main lesson to come out of Ver- mont's recent success in passing H.#202 was that "it was basic, hardcore, door-to-door organizing of working people that got sin- gle-payer on the agenda for the state." It's a model that Eaton and his colleagues are following for Massachusetts, and one that single- payer supporters in other states must adopt. Vermont_REV 2 10/11/11 9:23 PM Page 16

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