Vermont and Single Payer, Laboratory for the States?

Law Professor Kevin Outterson, Health Law, Bioethics and Human Rights, at Boston University School of Law (as well as Editor in Chief of the Journal of Law, Medicine & Ethics and Faculty Advisor to the American Journal of Law & Medicine), gives a good account of the implications of Vermont’s recent declaration that it will be instituting  a single payer health care plan (yes, if you haven’t heard, that Single Payer Plan) on WNYC’s Brian Lehrer Show.

Professor Outterson observes that  implementation “will require multiple steps,” but that the formal decision to move forward was “a significant step,” and that “if Vermont is able to control costs better than their neighboring states, than they will be a magnet for employment.” He also notes that adjustments will need to be made by the federal authorities in order for Vermont’s plan to mesh with PPACA, Medicare and Medicaid, and addresses conflicts of interest in medicine, as presently financed and practiced, which add to the costs of healthcare.

The Single Payer segment starts at 3:48

“Who’s Looking At the Compensation of the Health Care Insurance Executives?” and “Where’s H.R. 676?”

photo by alusiaaa via Flickr

Interesting comments from Kevin T. and Jeremiah regarding Conrad Dillon’s post the other day, “Obama to Unveil Plan for Health Care Reform.” Jeremiah is a proponent of John Conyers “single payer plan,” The United States National Health Insurance Act, H.R. 676 (you can also see the plan in the sidebar of this blog under “Health Reform Plans” and an excellent summary at Healthcare-NOW.org ).

We wrote about H.R. 676 back in December, in a post titled, “Medicare for All?” We noted then that “the plan seems to have received little mention in the media,” though it has a number of supporters–including, at the time, 94 co-sponsors, and “most labor unions, thousands of doctors, nurses and health care professionals.”

The Conyers proposal, also backed by the Physicians for a National Plan, would gradually provide Medicare for everyone who wants it and would pay a premium; it is sometimes referred to as “The Medicare for All plan.”

As Saul Friedman, columnist for Newsday, explained, the Medicare for All plan

“would absorb such programs as Medicaid, SCHIP and be paid for by taxes and premiums. It could relieve auto manufacturers and other businesses of paying for health insurance for employees and retirees. Its sponsors say it would save $300 billion a year in administrative costs, for it would deny insurance companies a role.”

And that may be the rub.

Friedman states:

“Getting over that hurdle may be why HR 676 has gotten so little publicity, even from alleged friends of older people. There is no mention of it on the Web site of AARP, which earns $700 million a year in royalties on the sale of private health insurance it sponsors.”

In an Op-Ed piece in the Atlanta Journal Constitution, Dr. Oliver Fein, associate dean and professor of clinical medicine and public health at Weill Cornell Medical College in New York and president of Physicians for a National Health Program wrote that

“As long as we rely on private health insurers, universal coverage will be unaffordable…. There is a cure, however. Eliminating the private insurance industry would save $400 billion annually in administrative costs, enough to ensure that everyone is covered and to eliminate all co-pays and deductibles.”

Perhaps understandably, there has not been a great deal of support voiced for the Conyers plan (or for Dr. Fein) by the Insurance Industry. The common adage concerning health care reform at present has been that “if you’re not at the table, you’re on the menu.” By all accounts, private insurers have taken a seat at the table–and the “menu” they’re protecting there would seem to readily qualify as sumptuous.

Kevin T. was kind enough to forward to us these figures concerning CEO compensation for major medical insurers. The figures for Insurance Co. profits (2007, Aetna: 1.831 Billion profit) as well as the CEO compensation figures can be found  here, courtesy of the very interesting Insurance Company Rules.org- a project of Health Care for America Now.org. The numbers were culled from the companies’ SEC filings (Schedule 14A) and are well worth a look. But I’ll list a few of the figures here as well:

Ins. Co. & CEO With 2007 Total CEO Compensation

• Aetna Ronald A. Williams: $23,045,834
• Cigna H. Edward Hanway: $25,839,777
• Coventry Dale B. Wolf : $14,869,823
• Health Net Jay M. Gellert: $3,686,230
• Humana Michael McCallister: $10,312,557
• U.Health Grp Stephen J. Hemsley: $13,164,529
• WellPoint Angela Braly (2007): $9,094,271
  L. Glasscock (2006): $23,886,169