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Single Payer Skeptics Point To Other Health Care Reforms To Control Costs

Some organizations who support Gov. Peter Shumlin's decision to back away from single-payer health care say there are other health care reform efforts that could have a positive impact on medical costs. 

Tom Torti, president and CEO of the Lake Champlain Regional Chamber of Commerce, is one of those watching the health care reform efforts closely. As part of the governor's business advisory council, Torti said he has seen various scenarios for how to fund single payer and was worried about the price tag.

He was relieved by the governor's decision. "When the governor saw the final numbers, he looked at the income tax, he looked at the payroll tax, he made the only decision that he could have made, so I was very happy about that," Torti said.

Torti added that he supports the four things the governor plans to do: continuing support for the Blueprint for Health, which aims to improve preventative and primary care; finding the money to alleviate the Medicaid cost shift; moving aggressively to secure an all-payer waiver, which would allow the Green Mountain Care Board, which oversees health care in Vermont, to move away from the fee-for-service model of health care; improving the use of technology by hospitals for electronic medical records, electronic payments and electronic scheduling to reduce costs.

An 11.5 percent payroll tax, Torti said, would have been too much for many Vermont businesses.

"It would have put them out of business. We heard at the chamber from business after business, small, medium and large, that that level of payroll tax would have wiped out their margins. On top of that, you're talking about an income tax. So you're looking at the highest income earners in the state, people over $120,000-$130,000 of adjusted gross income and hitting them with an additional income tax when they're already contributing far more than their fair share."

Torti said that kind of tax would have stalled the economic recovery in Vermont and crippled business.

Bea Grause, president and CEO of the Vermont Association of Hospitals and Health Systems, said her group also supported the governor's decision, citing concerns about the costs and affordability.

"We have been focused on payment reform, which to us is another essential strategy to make health care affordable and accessible for Vermonters. So we will continue to work on payment reform, hopefully with the federal government, in 2015," Grause said.

Payment reform is where the not-for-profit hospitals want to focus, but Grause said she'll keep her eye on the Statehouse as single payer is likely to continue to be a topic of discussion for lawmakers.

"We're also going to focus on the Green Mountain Care Board as they start their process to pursue an all-payer waiver with the federal government," Grause said.

Thursday on Morning Edition we heard from single-payer advocates who disagree with the governor's decision. You can find that story here.

Melody is the Contributing Editor for But Why: A Podcast For Curious Kids and the co-author of two But Why books with Jane Lindholm.
Peter was a Producer/Announcer at VPR until 2015. He began his public radio career in 2007 at WHQR-FM in Wilmington, North Carolina where he served as Morning Edition host and reporter, covering county government and Camp Lejeune Marine Corps Base. His work has won several Associated Press awards and has appeared on NPR's All Things Considered, Weekend Edition, and PRI's This American Life. A graduate of the creative writing program at the University of Maine at Farmington, Peter enjoys writing, cooking and traveling.
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