Don’t count single-payer out yet.
The Vermont legislature passed a bill this week mandating the study of three approaches to universal healthcare—a single-payer system, healthcare with a public option, and the current system under the healthcare reform bill passed by Congress. The legislature will choose the best plan in 2011 and plans to begin implementation in 2012.
According to the Vermont Workers’ Center, the prospects for passing this legislation looked bleak as recently as January. But thousands of Vermonters—including Senator Bernie Sanders—mobilized for the "Healthcare is a Human Right" campaign and it changed the political climate.
"As a long-time advocate of single-payer I’m glad the state is going to have a study," Senator Sanders told me. "I think the result of it will show that the most cost-effective way to provide universal, comprehensive healthcare to every Vermonter is through a single-payer approach. What the Vermont legislature has done is very important, very positive, and I strongly support their efforts."
Sanders said the bill is also important because it demonstrates that "just because a healthcare reform bill was passed in Washington, does not mean that Vermont and other states should not continue to go forward in the fight for a Medicare for all/single-payer system."
Sanders said that in the event the state legislature chooses a single-payer system, he "will be going right into the President’s office, and making the fight on the floor of the Senate that Vermont should be able to become a laboratory and go forward with a single-payer program. And I think if it works in Vermont many other states will want to do the same thing." (It was a single-payer laboratory in Saskatchewan that evolved into the Canadian healthcare system.)
Sanders will indeed have a fight on his hands. During the healthcare debate, he and Senator Ron Wyden pushed for states to have the right to apply for "waivers" so they could implement alternatives to the private insurance market exchanges. Initially, the waiver option was set for 2014—the same year the exchanges take effect. But due to Congressional Budget Office pressure the waiver date was pushed back to 2017. The problem with that is that it requires the states to spend the time, money and attention on creating the exchanges, only to then propose and implement a completely different system three years later.
It’s a tough road, and Sanders said he and Wyden are still pushing for the earlier date.
"We are working together on that—and hoping to enlist the support of some governors—who will make the fight to push that [waiver] up to 2014. We think that states should have the flexibility to go forward with, among other things, the single-payer program, and I intend to work very hard on that."
If Vermonters see this fight through, their state may well serve as the laboratory this country needs to finally achieve quality affordable healthcare for all.