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Red Healthcare, Blue Healthcare

Obamacare may have survived the Supreme Court, but some states are determined that it won’t have the last say on healthcare policy. Vermont and Michigan are both unhappy with Obamacare, and are both pursuing alternative policies to solve the problem the Affordable Care Act didn’t even attempt to address: rising costs.

In red Michigan, Gov. Rick Synder recently signed malpractice reform legislation aimed at protecting doctors from excessive lawsuits:

The legislation is comprised of Senate Bill 1115 – which clarifies that loss of society or companionship constitutes noneconomic damages and is therefore subject to Michigan’s noneconomic damages limit – and Senate Bill 1118 – which limits the time period for suing on behalf of a deceased person and bans prejudgment interest on costs and attorney fees incurred during the time before a judgment is issued.

Conservatives have always treated malpractice reform as one of their favorite healthcare solutions, because defensive medicine—doctors ordering more tests than necessary to insure themselves against malpractice suits in the future—accounts for as much as 20-30 percent of national healthcare costs. Reds argue that medical malpractice reform can cut significantly into those costs, but, so far, they’ve been unable to attain it on the national stage. MI’s recent rightward turn has made it possible on the state level.

In blue Vermont, residents are unequally unhappy with Obamacare’s failure to tackle rising costs, but they’re exploring a very different solution: a single payer system, the holy grail of blue healthcare policy. VT has been looking at a single payer system ever since 2011, but it’s recently taken another step closer:

A state law passed in 2011 with strong legislative support called for Vermont to move well beyond the federal health overhaul of 2010 to something closer to what Canada has in place: a universal health insurance system in which the government ensures everyone has coverage…

One section of the law set a deadline of Jan. 15, 2013, for the administration to make a proposal for the legislature providing what the new system would cost and how it would be paid for.

Vermont’s governor has now released that proposal and his office estimates that it would cost an additional $1.6 billion in taxes to set up the system. The number sounds exorbitant, but the governor’s report argued that it would save the state the $1.9 billion currently spent on private health care, resulting in a (modest) net savings.

We don’t know if either of these policies will work. Most other developed nations have something like a single payer system, and they manage to deliver reasonable quality care at lower prices than America. But transferring that kind of system to the US would be fraught with difficulties. Medical malpractice reform seems like a very good idea, but we’re sure the law of unintended consequences will effect its implementation somehow.

But these stories are very encouraging. Reds and blues need the freedom to experiment with different policies, while we watch to see what works, what doesn’t, and move on to the next steps.

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