[quote][i]^Vermont's estimate of what single-payer can do for them (in millions).[/i][/quote] [url=http://www.vox.com/2014/4/9/5557696/forget-obamacare-vermont-wants-to-bring-single-payer-to-america]Think Obamacare is Literally Hitler? Well, Vermont wants to be even Hitlerer.[/url] It's a long(ish) article, so I copied and pasted some key points here. [b]Vermont Background:[/b] [quote]Shumlin just barely sold Vermont voters on the plan (he beat his Republican opponent by less than one percentage point). Then, he got the Vermont legislature on board, too. [b]On May 26, 2011, Shumlin signed Act 48, a law passed by the Vermont House and Senate that committed the state to building the country’s first single-payer system.[/b] Now comes the big challenge: paying for it. Act 48 required Vermont to create a single-payer system by 2017. But the state hasn’t drafted a bill that spells out how to raise the approximately $2 billion a year Vermont needs to run the system. [b]The state collects only $2.7 billion in tax revenue each year, so an additional $2 billion is a vexingly large sum to scrape together.[/b][/quote] [b]Why Single Payer:[/b] [quote][b]Vermont’s case for single-payer health care can be summarized in one number: $82,975.[/b] That’s the amount a 2011 study in the journal Health Affairs found the average American doctor spends on dealing with insurance companies. Across the border in Ontario, doctors spend about a quarter of that amount — $22,205 per physician — interacting with the province’s single-payer agency. American doctors spend lots of money dealing with insurers because there are thousands of them, each negotiating their own rate with every hospital and doctor. An appendectomy, for example, can cost anywhere from $1,529 to $186,955, depending on how good of a deal an insurer can get from a hospital. [b]That doesn’t happen in single-payer systems. When the government owns and operates one health insurance plan for all residents, it sets a single price for each medical procedure.[/b] It’s that simplicity that tends to be single-payer’s biggest selling point, and the reason at least a dozen countries around the world use that type of system. ... Overall, single-payer systems tend to be especially good at two things: increasing health coverage rates and holding down health care prices. Getting people covered is, unsurprisingly, a much easier task when the government is running a health insurance plan. When Taiwan implemented a single-payer system in 1995, the insured rate went from 53 to 96 percent in nine months. [b]Single-payer systems also tend to have lower prices because the government is negotiating one rate for all citizens. [/b]Think of it as a bulk discount: when the government can promise to deliver loads of patients to a given hospital or doctor, they have lots of leverage to insist on a lower price. Administrative costs tend to be lower, too. Instead of dealing with dozens of insurers who set hundreds of prices, doctors only need to send bills to the federal government. [b]The administrative savings of a single-payer system do come at a price. Single payer requires the government to make difficult decisions about what benefits they will and won’t cover — and often leave out pretty standard medical services[/b], things like prescription drugs or dentist visits. Vermont, for example, is still working through whether its plan will include dental coverage, a service that would add at least $218 million to the system’s annual price tag.[/quote] [b]Cost:[/b] [quote]In the Vermont legislature, [b]most people ballpark the cost of single-payer somewhere around $2 billion[/b] — and spend even more time worrying about how to raise that money. Single-payer opponents have already begun framing it as the largest tax-increase in Vermont history, which worries those trying to shepherd it through the legislature. "You are raising $2 billion, and that’s just such a significant amount of money," Shap Smith, the speaker of the Vermont House, says. "Even if it’s not new money and just a different way of raising it, that’s still a tough transition. There’s so many people who have a stake in the way things are currently done, and getting them to see that a different way would be better is difficult." Vermont isn’t alone in its money problems. [b]Single-payer countries around the world have regularly struggled with figuring out the best way to pay for the system.[/b] Countries take different approaches to funding single-payer systems. Some pull the funds from a general revenue stream while others create a specific premium tax that goes towards health care. Hsiao had suggested the premium tax approach for Vermont, but the legislature didn’t include a financing plan in the 2011 legislation. "We recommend that Vermont have a payroll tax contribution designated for health specifically," he says. "Canada doesn’t have such a system, so during a political recession they may decide to cut health care to support education. We designed a system for Vermont where you can’t get into that situation and protect revenue for health care." [b]Whatever way Vermont ultimately pays for the single-payer system, it will be a noticeable tax increase for Vermonters. [/b]There are only four taxes in Vermont right now that bring in more than $100 million annually — the largest of which, the payroll tax, nets $624 million.[/quote]