Hamilton E. Davis

Hamilton E. Davis is a longtime journalist, who has written for the Providence Journal and the Burlington Free Press.

The consultant hired by the Vermont Legislature to advise lawmakers on health care reform has developed a concept that differs significantly from the single-payer plan now being pursued by the administration of Gov. Peter Shumlin.

Angela Evancie / VPR

When Gov. Peter Shumlin launched his single payer health care initiative in 2011, the effort promised to be the policy equivalent of a moon mission, one of the most far-reaching and complex reform projects ever undertaken at the state level. It would be very hard, yet still doable. And critically important, given that the health care system both in Vermont and in the U.S. is simply not financially sustainable.

Angela Evancie / VPR

From the opening days of Gov. Peter Shumlin’s single payer health care initiative, House Speaker Shap Smith has been a rock-solid supporter of the campaign. In 2011, he delivered Act 48, arguably the most far-sighted health care reform blueprint in the country, by lining up his huge Democratic house majority behind it.

Christophe Boisson / Thinkstock

One of the key arguments by opponents of Gov. Peter Shumlin’s single payer health reform initiative is that it mirrors the single payer system in Canada, which they say has serious problems. The opponents have a point about Canada’s problems, but they are entirely wrong about Canada’s relevance to Vermont. You could fairly call the Vermont design the “un-Canada.”

Angela Evancie / VPR

As lawmakers begin to focus on how to pay for Gov. Peter Shumlin's single payer health plan, they want to know if the plan will work as promised to control costs and provide universal coverage.

In this analysis we examine the challenges ahead, including the legal thresholds that must be cleared for single payer to proceed and the conflicting financial projections.

Part 1: The Legal Threshold

Toby Talbot / AP

The Vermont health care exchange came out of the starting blocks this fall limping badly and it’s not clear yet how long it will take Gov. Peter Shumlin’s bureaucrats to get it back on track. It’s not too early, however, to try to assess the effect the troubled launch will have on state politics in 2014 and on the fate of the Shumlin reform initiative out into the future.

Anya Rader Wallack

When Gov. Peter Shumlin launched his single payer health initiative two years ago, he set up a three-part structure to deal with the various problems that have to be solved to get to his goal.

The Green Mountain Care Board has tied up the loose ends on its second year of work, finalizing the budgets for the state’s 14 hospitals.

The increase in annual spending for the hospitals and the roughly three quarters of the state’s doctors who work for them was the lowest since formal oversight of the system began in the 1980s.

The final figure for fiscal 2014, which begins on Oct. 1, was $2.2 billion ($2,181,770,664), an increase of 2.7 percent.

AP/Toby Talbot

When someone writes the history of health care reform in Vermont, he or she would do well to look closely at the Green Mountain Care Board hearing last week on Fletcher Allen Health Care’s proposed fiscal 2014 budget.

There are 14 hospitals in Vermont and they and the doctors that work for them spend upwards of $2.1 billion a year to keep Vermonters healthy. Fletcher Allen accounts for a billion dollars or so of that amount, nearly half the system. No other hospital comes close to its size and influence.

AP/Toby Talbot

A series of developments in health care reform over the last couple of weeks has demonstrated how tangled this policy problem is and how knowledgeable people, including former Vermont Governor Howard Dean, can make a hash out of it. The public is the loser every time.

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