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Vermont Approves Single-Payer Health Care: 'Everybody in, nobody out'

http://que2646.newsvine.com/_news/2013/11/22/21577799-vermont-approves-single-payer-health-care-everybody-in-nobody-out-occupy-democrats?lite#threadId3873712-lastNewId1

The ACA provided states with federal funds to institute a Medicaid expansion.  The states chose to expand the program also were able to set up their own state exchanges, which were relatively free from the problems the federal site had.  Vermont decided to take it a step further by setting up their very own single payer system.

The slogan of the program: Everybody in, nobody out.

The program will be fully operational by 2017, and will be funded through Medicare, Medicaid, federal money for the ACA given to Vermont, and a slight increase in taxes.  In exchange, there will be no more premiums, deductibles, copay’s, hospital bills or anything else aimed at making insurance companies a profit.  Further, all hospitals and healthcare providers will now be nonprofit.
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Avatar universal
I agree too.
I think Pro is extremely articulate. I always have.
Mike
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649848 tn?1534633700
I'm with teko; I think you express yourself quite well.

I don't specifically recall you having said where you're from, but for the most part it doesn't really matter, except in this case, you have first hand knowledge about the state of VT and this program.  

I don't know when you moved your parents to FL, but things are changing here, too and I'm not sure that the differences are all that great.  While it's true that we have no state income tax and we do have $25K homestead exemption, our gas has taken another hike upwards (almost $0.30 in the past week alone), some electric companies are much less expensive than others.  We, too, have areas where work is seasonal (or there is none).  We also have a large disparity in income, particularly, in my area.  I have to admit that in spite of those things, we're a pretty good place to retire.

I've often wondered how long it will be, before FL implements a state income tax.

This taken from the article, makes it sound like a done deal:  "The program will be fully operational by 2017, and will be funded through Medicare, Medicaid, federal money for the ACA given to Vermont, and a slight increase in taxes.  In exchange, there will be no more premiums, deductibles, copay’s, hospital bills or anything else aimed at making insurance companies a profit.  Further, all hospitals and healthcare providers will now be nonprofit."

Wouldn't it be nice if tea party meant just that all over the country?  In spite of the cost of living in VT, it's refreshing to know that there's some places that do get things done.



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Avatar universal
We'll see what happens teko, I have an open mind.
Things get done in Vt, whether it's on a local level at town meeting day or at the state house, things do get done. Not a gridlock situation here and tea party means just that, a party at which one drinks tea.

But I can't emphasize enough how state taxes play into the equation with an aging population. As I said, I've seen first hand numbers of what the difference between living in the top 10 worst retiree tax state is compared to living in a top 10 best.
It changes the direction of flight for the "snow birds", better to reside in the south and fly north, than live in the north and fly south. :*)
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Avatar universal
I think you do a fine job expressing yourself, by the way....And thank you for clarifying that you do live in Vermont, as it was the ACA deal, that threw me off. Not understanding how these two work hand in hand or how that is possible with the current law, but that's okay. There are many single payor plans around the world and not sure how this one is different than the other or what to compare it to. Is it comparable to Canada, Australia or do we know yet?
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Avatar universal
PS: another example of VT being first..
Bill would make Vermont 1st state to drop oil stocks
By DAVE GRAM / Associated Press
POSTED:   11/24/2013 06:10:42 PM EST | UPDATED:   ABOUT 11 HOURS AGO

MONTPELIER -- To Sen. Anthony Pollina, it makes sense that if Vermont wants to strike a blow against climate change, it should have its pension funds divest from oil, coal and other fossil fuel companies.
To state Treasurer Beth Pearce, the best course is for Vermont to stay invested in those companies, to "keep its seat at the table and push for change from within."

It's a debate prompted by bills pending in the state House and Senate that would have Vermont's public employee pension funds - those covering state employees, teachers and municipal employees - sell off their investments in "any company which has as a principal business the extraction, production, or manufacture of fossil fuels."

Pollina explained it this way: "If in fact as a state we have a commitment to combatting climate change, and if we have a commitment to moving toward renewable energy ... it's very contradictory that we would then be investing our dollars in fossil fuel industries that actually lead toward climate change."

The push for divestiture by institutional investors is being led by an arm of 350.org. The international group was founded by Bill McKibben, a Ripton resident, scholar at Middlebury College and well-known environmental activist and writer.

So far, the campaign has succeeded in persuading several colleges, including Green Mountain and Sterling colleges in Vermont, as well as cities and towns from Provincetown, Mass., to San Francisco, to push toward divestment from fossil fuel companies.

But in Vermont, the legislation's prospects look uncertain at best, in no small part because Gov. Peter Shumlin, who would have to sign such a measure into law, is cool to the idea.

Shumlin said in an email from his office that he is "extremely concerned about the impact of climate change, which I believe is the single greatest long-term challenge to our world and our state.

"At the same time, like the Treasurer, I believe that by keeping a seat at the table and by encouraging smart investments, we can make progress towards a cleaner, greener economy while still meeting our obligations to pay for the retirement of hard working municipal and state workers, as well as our state municipal and education workers, in the most responsible way for taxpayers."

The idea of trying to use investment decisions to influence political outcomes around the world is not new.

The current divestment push mirrors those launched in Vermont and elsewhere against companies doing business with the apartheid regime in South Africa during the 1980s. In 1989, the Legislature directed the pension funds to ensure that, if they were invested in companies doing business in Northern Ireland, there were assurances those companies were dedicated to eliminating religious discrimination in that country's workplaces.

In its 1997-1998 session, the Legislature called on the retirement funds to divest from tobacco companies. In 2006, the Vermont Pension Investment Committee forbade investments in nations "identified as State Sponsors of Terrorism by the U.S. State Department."

Pearce, who oversees administration of the state's pension funds, said she sympathizes with those concerned about climate change. But she said she would stop short of divestment.

"I have concerns about the methodology," she said. If the state maintains its role as a shareholder in a company, its pension fund managers can vote on issues of corporate governance. By selling those investments, "we give up our seat at the table and we may be replaced by shareholders that don't have those values," which, for example, would push energy companies to move toward more renewable sources.

Withdrawal of climate activists from their ranks of investors "gives them less incentive to change," she said, adding that she prefers a posture of "constructive engagement."

She noted Vermont has been active in efforts to get companies to think about the risks posed by climate change. The state has been working for a decade with CERES, a Boston-based nonprofit trying to get companies to focus on risks posed by climate change, water scarcity and other environmental issues.

McKibben argued in an email exchange with The Associated Press that Pearce's idea of working within the system has not worked.

"The big fossil fuel companies have five times as much carbon in their reserves as any scientist says it would be safe to burn, and yet their business plan calls for them to burn it," McKibben wrote. "There's been no sign, over the last twenty five years, of them bending from this path, despite lots of appeals from people like (Pearce). I think, given the timing of climate change, many have decided it's time to actually act."
http://www.reformer.com/localnews/ci_24589531/bill-would-make-vermont-1st-state-drop-oil
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Avatar universal
Hi Barb, I guess I took for granted most knew where I was from, my mistake.

First off, I helped my parents change residency to Fl from Vt. so I have a good idea of the cost of living in Fl as well, no state income tax, $25k homestead break, cheaper gas, cheaper food, cheaper electric-huge difference {FL kilowatts cost 1/2 those of Vt's.}. Heck, I have a dairy farm a mile or so down the road from me, and milk is cheaper in FL! (g).

Vermont on the other hand has very high taxes, a large disparity in income, but even more pronounced is the income disparity geographically, ie, one town to another. There might be a ski area in one town and no work in another. Much of the work is seasonal(with seasonal pay scale), based around tourism and the winter ski industry, especially in the southern half. (see my post above). While Vt used to have a strong republican base, now much more progressive and left leaning

This single payer deal is still pie in the sky thinking,typical of Vt,but nothing concrete to study yet. I mentioned in an earlier post VT was one of the first to jump on the ACA, we banned fracking 3 years ago-never been an oil or gas well drilled here to my knowledge, it's the free thinking way Vt does things.
VT also has an aging population, not enough good jobs to keep the younger generation here. Much of the population are throw- backs from the city to Vermont migration back in the 60's & 70's and communal thinking still abounds.
---we currently only have 2 insurance companies offering policies on our state exchange. Before the exchange (now) we still only have 2 companies offering health insurance, rates are annually approved by the state. Now with the ACA there are new rules regarding pre-existing conditions, but we already had that mandated in state law, so that is not new to Vt.
--I read VT has the 5th highest insurance rates in the country being offered on the new exchanges, before the ACA (now) it probably still ranks as one of the most expensive states for insurance.
( not surprising with a small aging population)

The sad part is, after spending a good part of my working life in VT, loving the state and it's people , when/if I'm able to retire it might have to be to a more tax friendly state. I can only see taxes going higher in the future, and eventually they'll hit the tipping point as I described above with the goose and the golden egg.

Time will tell where VT thinking progresses(-sives). On the other hand if I was to lay naked out on my deck or walk down the road, I wouldn't be breaking any laws. If I chose to wear cloths when I went out ,I could legally carry a concealed weapon without a permit.
But it is still illegal to spit on a sidewalk, Vt's a quirky little state.

Hope I answered your questions, I'm not all that great at expressing myself via writing, or sometimes verbally for that matter(g) (but again, not enough info out there to consider regarding single payer). Vt still doesn't even have their ACA exchange kinks worked out)

(LOL, adgal I wasn't singling you out as being Canadian, I was alluding to the blast of cold air coming down from Canada--4 degrees this morning,
fahrenheit, not that crazy celsius the rest of the world uses(ha,ha))
Helpful - 0
377493 tn?1356502149
Good Lord no, Ford jokes sure wouldn't run me off, I make them too.  He is a joke - gotta call it like we see it right?

I'd sure be interested in learning more about this and compare it to our National Plan.  I'm honestly not entirely certain our taxes are that much higher then yours.  I pay about 30% end of story.  We don't have any Provincial taxes in my province, so that is Federal.  And I get a very decent return due to my RRSP's (like a 401K), my childcare costs and now that my son is in a ton of sports, all of that is a write off too (part of our incentive/assistance to help parents get their kids active).  So not entirely sure I really do pay more then you guys?  Our program really relies on the majority being working and paying into taxes, so as long as that is the case, we should be ok.  Again, not even close to a perfect program - it needs improvements, but still, I wouldn't change the crux of it.  
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649848 tn?1534633700
Good evening.... sorry I'm so late to this party, but it's been a busy day.

First off - no, it wasn't 9 degrees here in FL (I live further north than teko does), with a 30 mph wind this morning, and I didn't have to feed  my wood stove; it was a balmy 63 (at 5:30 am), with a light breeze that kept me just cool enough while I took my morning walk.

Nah, we didn't run off our Canadian member; it's the weekend and she's most likely busy with family time.

I've been wondering the past couple weeks where you're from; thank you for clearing that up with a sense of humor...

Of course, I had to mention the "slight" tax increase; you can't let a tax increase "roll off" like water from a duck.  I want to know who's determining that this increase is "slight".  Is that something like "affordable" insurance premiums with the ACA?

There are a lot of comments I could make now, but I'll refrain...

"Not all people of VT like the idea."  Is that something like "not all people of the U.S like the ACA?"...

Now, I have a question for you, though; yeah, I'm gonna make life tough... lol

You said, in another thread that you signed up for the ACA and you seemed to be happy with your premiums, once your subsidy was calculated; how does the change in VT's law affect that, since everyone has to be on it?  Will you still have the ACA policy, or will you be on VT's dole (excuse the terminology.. :-( ), with your increased tax assessment?  And will the tax assessment be more/less than the premium you would pay for ACA?

Sorry, but inquiring minds want to know, just in case he!! freezes over and FL adopts a similar plan.  We're one of the few States that don't have a State income tax, so if one were adopted, I'm sure it would bite large chunks from the pocketbook..
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Avatar universal
Teko, my fault, I apparently haven't been direct enough. I live in Vermont, have on and off for 40 years.
Not all people of VT like the idea.
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Avatar universal
You said the plan didnt have dental? There are various plans, some offer dental and vision and some dont. I opted for one without dental or vision. It depends on what you choose.

Proactive? I will say it again, the people of vermont evidently like the idea or it wouldnt be happening? Maybe you should never think of moving there if you dont like it? Im not saying its a good thing or a bad thing, as I have not really given it all that much thought or delved into all the statistics. But like I said, it would carry more weight with me, hearing from someone who has lived there and get their views on it.
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Avatar universal



"Vermont seems to have less variance as regards
income than other states so it might work out differently there."


Incomes of Vermont’s Richest Households Dwarf
Those of Its Poorest
Inequality Worsening Since the 1970s
The richest 5 percent of households have average incomes 9.6 times as large as
the bottom 20 percent of households and 3.7 times as large as the middle 20
percent of households.
After decades of widening inequality, Vermont’s richest households have
dramatically bigger incomes than its poorest households.
http://www.cbpp.org/files/pullingapart2012/Vermont.pdf
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585414 tn?1288941302
  The Affordable Care Act is not as comprehensive
as it could be with the specific benefits and treatments
it covers. For example I found out after looking it up for a family member
that at least at this point it doesn't cover dental care.
  The issues with formularies and deductables
only make things more difficult. I was never happy
with the issue with managed care when It started
and it only seems to have made things more difficult.
However for some people offering different healthcare
plans with different options seems to work best.
The issue with the effect on taxes and expenditures
would have to be studies for its long term effect
economically as this is new legislation.
  Vermont seems to have less variance as regards
income than other states so it might work out differently there.
I support the idea and concept but it depends what
its effect is overall.
  
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Avatar universal
Do you think it is 9 degrees in Florida this morning Teko? (VBG)

From Kiplingers -Least Tax-Friendly States for Retirees
State Income Tax: 3.55% to 8.95%
State Sales Tax: 6%
Estate Tax/Inheritance Tax: Yes/No

Prepare to pay lofty taxes if you retire in the Green Mountain State. Vermont taxes most retirement income. Social Security benefits are taxed to the same extent as they are by the federal government—up to 85%.

In addition to the state sales tax, local jurisdictions may add 1%. Food, clothing, prescription and nonprescription drugs are exempt. You'll pay 9% on prepared foods, restaurant meals and lodging, and 10% if you order a glass of wine or beer in a restaurant.

Vermont's property taxes are the eighth-highest in the U.S., according to the Tax Foundation. Median property tax on a $216,300 median-valued home is $3,444. Real estate taxes have two components: school property tax and municipal property tax. Both taxes are billed and collected by the town or city where the real estate is located. A statewide education tax is imposed on all nonresidential and homestead property. There are no property tax breaks specifically for seniors; however, residents with income of less than $99,000 may be eligible for a rebate of their school and municipal property taxes. The maximum adjustment is $8,000.

Vermont taxes estates that exceed $2.75 million. The maximum estate-tax rate is 16%. Assets left to a surviving spouse are exempt.
http://www.kiplinger.com/slideshow/retirement/T006-S001-10-least-tax-friendly-states-for-retirees/#uRupRAVXkWd9VwcG.99

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Avatar universal
Does anyone here live in Vermont? Evidently, Vermont is happy with it? So, whats the problem?
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Avatar universal
Morning Barb, (I'm up early feeding my woodstove, 9 degrees and 30mph wind--refreshing(ha,) we must have po'd the Canadians with our Ford jokes:-)

"and a slight increase in taxes."

You had to bring it up! I was going to let it slide off my back for now. Vermont is already one of the highest tax states in the country. Rated 4 th worst for retirees, --all income is taxed including SS and property taxes are high.
  Vt is kind of split in thirds (NE Kingdom, northern & middle and Southern ). The business/industry, highest income earners are in the North & Middle(along with the universities, colleges etc.). NE Kingdom is what the name suggests. Southern has some industry, but tourism is key and most importantly second(vacation) homeowners.

Higher property taxes will kill the goose that was to hopefully lay the golden egg (baby boomers), the goose being vacation/retiree home ownership.
If you are a resident of the state you get a homestead property tax break based on income(comes directly off your tax bill), the top income limit to qualify being a bit over $100k per year (to high of a top,that bar should be lowered,imo). Now the vacation homeowners whom drive economy in a large part of the state don't get that break, not being their primary residence, so they pay full high $ taxes. The result is I pay 1/2 what my vacation owner neighbor pays on equally valued property. Obviously I can't complain(although I do), but my neighbor sure does.
Moral of the story, we don't need higher taxes. Will Vt. end up with higher taxes, imo yes.

I could go on, but for now I'm not going to get worked up over it. I love the state for it's beauty, free spiritedness(not a word?) and many other reasons, not so much for it's socialist leaning political governing.

:^)



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649848 tn?1534633700
"The program will be fully operational by 2017, and will be funded through Medicare, Medicaid, federal money for the ACA given to Vermont, and a slight increase in taxes."

I'd like to see that "slight" increase in taxes!!  Probably about as "affordable" as the ACA.
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Avatar universal
Doesn't surprise me at all when you think about it. Vermont is bordered by Canada and the left field out of bounds line. :)
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