Single-payer plan, alive and kicking in Vermont

After Congress passed the health insurance reform bill, it seemed that the idea of single-payer healthcare was all but dead for at least the next decade. But the great state of Vermont has come to a different conclusion. Its state legislature recently passed a bill mandating the study of three approaches to universal healthcare—single payer, insurance-based healthcare with a public option, and the system based on the health insurance reform bill passed by Congress. The legislature plans to choose the best plan in 2011 and begin implementation in 2012.

According to Katrina vanden Heuvel, editor of The Nation, Vermonters, with the support of Senator Bernie Sanders, turned out for the “Healthcare is a Human Right” campaign and pressured the state legislature to pass the bill.

Senator Sanders is confident that the study will show that the single-payer approach is the most cost-effective way to provide universal healthcare to every Vermonter. According to Sanders, the bill is important because it demonstrates that Congress doesn’t have the last say in health care. He feels that states can and should go forward in the fight for a Medicare-for-all/single payer system. If Vermont chooses a single-payer system, he plans to go to President Obama and the Senate and insist that Vermont become the laboratory for other states, and the country, for the adoption of single payer healthcare.

But there is a problem in states adopting single payer that both Sanders and Senator Ron Wyden tried to address in the Congressional health reform bill. States need a waiver to implement alternatives to the insurance market exchanges. That waiver date was 2014 but was pushed back to 2017 in the final bill. Sanders and Wyden are pushing for 2014. If the date is not restored to 2014, Vermont would have to first implement an exchange system, then only in 2017 could it ask for a waiver for a single payer system.

“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.”

You can read more about the waiver issue here.

Vanden Heuvel reminds us that Canada achieved single payer health care after Saskatchewan adopted it and served as a laboratory for the rest of the country.

“If Vermont sees this fight through, and achieves single payer by 2014, it may serve as the laboratory this country needs to finally achieve quality affordable healthcare for all.”