A common practice in politics is to define your opponents before they define themselves. Usually this results in gross misrepresentation of where the opposition stands. But earlier this week, Donald Trump gave Democrats a helpful shove as he described their position on health care reform.

In a meeting with GOP senators at the White House, Trump rambled on about what Republicans should do to “fix” health care. In the process, he characterized what he sees as the Democratic position on health care:

The way I looked at it, we have no democrat help. They are obstructionists and that’s all they’re good at is obstruction. They have no ideas and they’ve gone so far left, they’re looking for single payer, that’s what they want, but single payer will bankrupt our country, because it’s more than we take in for just health care. So single payer’s never going to work, but that’s what they like to do. They have no idea what it will be and you wait in line for weeks before you see a doctor.

Clip begins at five-minute mark.

The good news is that Trump said about the Democrats what they could not say for themselves – that their position on health care reform is to adopt the single-payer, or more accurately phrased, Medicare-for-All system. Yes, there are the Claire McCaskills and Nancy Pelosis of the world who think that Democrats should continue to be mired in the world of confusing health care policy that is in essence what the Affordable Care Act became when the Public Option was no longer an option. But more and more Democrats are coming to see that Medicare-for-All is the best policy to adopt because (a) it provides the greatest amount of care at the most affordable cost and (b) politically it is viable because it is simple to explain.

Trump, who once said that Medicare-for-All was a good idea, now demonizes it and uses “reasoning” that is as fake and most everything else that he says.

He states that Medicare-for-All will bankrupt the country. Well yes, if the government was paying for all health care coverage without reforming taxes, that would be the case. But what he, and all Republicans and many Democrats fail to point out, is that there is a huge reservoir of untapped revenue for the federal government because the payroll tax (Social Security and Medicare) is capped at $118,500. Most taxpayers have 100% of their earned income subject to the payroll tax because they make less than $118,500. But for someone who make a million dollars a year, they have FICA taxes levied on less than 12% of their income. For someone who earns ten million dollars a year (and certainly is in a position to pay more taxes), FICA withholding applies to only 1.2% of their earnings.

Here a couple of other economic benefits of Medicare-for-All that are rarely mentioned:

1. By taking private insurance companies out of the equation, there is an immediate saving of 20% in health care. That’s because under current law, insurance companies are essentially guaranteed a profit of 20% on their transactions. Medicare, as we know it, has no such profit siphoned from consumers.
2. Under Medicare-for-All, employers would no longer provide health care coverage. That eliminates a huge cost for them. The beneficiaries become both those business as well as consumers who would then pay lower prices for the goods and services that the business provide.

Now might be the time for Democrats to thank Donald Trump for clarifying their position on health care reform. Progressives, step ahead of Claire and Nancy and lead.

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Until we have single-payer, Medicare for All healthcare in America, insurance companies will continue to screw their customers in as many ways as possible. For now, though, the Affordable Care Act, aka Obamacare, is at least helping people who were previously uninsured–or uninsurable according to the skewed rules of the industry–to avoid health-crisis-induced bankruptcy. Many of the new rules in the Affordable Care Act eliminate the worst abuses of the old system. But bad practices persist. Recently, HealthCare-Now!–a group that advocates for  a Medicare-for-All system- asked its supporters to submit nominations for the 2013 Award for Profiteering and Deceit in the Private Health Insurance Industry. Of course, HealthCare Now’s contest was unscientific, and mostly a public-relations stunt, but the results are enlightening anyway. Based on the submissions HealthCare Now received, the top vote-getters  are:

UnitedHealth, for paying its CEO, Stephen Hemsley, $49 million in 2012. HealthCare Now notes that among CEOs, healthcare CEOs receive the highest median pay at $11.1 million. There are thousands of insurance companies, but the seven largest publicly traded health plans alone are paid their CEOs a collective $87 million.

Humana, for charging women over 50% more than men for the same insurance plan.

Anthem Blue Cross for predatory premium increases.

Moda Health for paying $40 million for naming rights to the Portland Trailblazers arena.

Each of these examples is emblematic of the stuff health-insurance companies continue to get away with, and that could be reigned in–if not eliminated–under a Medicare-for-All system. Or, as Health-Now puts it:

Under a single-payer health plan, health coverage would be offered as a public good to all, administered by civil servants who will not siphon millions of dollars meant for patient care into their personal bank accounts. So we could use that $87 million in wasted money on CEOs to pay for as many as 8,700 hip replacements.

The post The worst health insurance companies in America appeared first on Occasional Planet.

I must confess; I’m a semi-secret fan of the mainstream press. This is not because I admire its approach to the news. Rather, I think that the mainstream accepts the conservative mantra that all is well so long as the government doesn’t intervene. My soft spot for the mainstream is nostalgia; I grew up with it. The descendants of Huntley-Brinkley and Uncle Walter are no match for their elders, but all the same, I prefer to first receive news from sources that were my initial introduction to “news.”

CNN is not far behind; it celebrated its thirty-third birthday this year. That’s the combined ages of Fox News and MSNBC. It purports to be politically neutral, and it certainly is as much so as the three broadcast networks (damnation by faint praise). However, if you’re able to dig into the network’s on-line platform, you can often find links to progressive thinking. Such was recently the case as I found a link to a post by Paul Waldman of CNN, “The health care reality conservatives ignore.”

Waldman points out how liberally the conservatives criticize the Affordable Care Act. Whether or not there is any merit to their contention that it is flawed, they have no alternative to suggest save just repealing it. That means that we would go back to a system of virtually unfettered capitalism in which private insurance companies offered plans that would only elevate their profit margins, regardless of what kind of care of accessibility citizens were left with. As Waldman says:

In the American system, there are multiple points where companies do the rational thing: Extract as much money as possible from the system. That’s why an MRI costs three times as much in the U.S. as it does in France or Holland.

The rational thing for private enterprise to do is to increase profits; the rational thing for a government program like Medicare to do is to optimize care to as many people as possible at minimal cost. Which better serves the public? As Waldman says:

But people living under the oppression of those other governments’ systems must hate them, right? Wrong. The Commonwealth Fund recently released a study of health systems in 10 developed countries around the world which included a survey of satisfaction. America’s health system was the least popular, with only 25% of Americans saying it works well and the other 75% saying it should be fundamentally changed or completely rebuilt.

The most popular was the most socialized, Great Britain’s, with 63% saying it works well. You may remember that the opening ceremonies of the 2012 summer Olympics in London included a tribute to the National Health Service, so proud are Britons of their health system.

For decades, liberals [in the United States] have been working to devise policy solutions and create the political conditions for health care reform that would achieve secure, universal coverage. On the other hand, in the face of millions who can’t get insurance because of pre-existing conditions and millions more who just can’t afford it, the conservative response was always, “Whatever.” The market spoke, and you lost. Too bad for you.

The Affordable Care Act can certainly be improved. But in health care – to paraphrase Ronald Reagan — the free market isn’t the answer to our problems. It is the problem.

What Mr. Waldman has to say is sensible and logical. I just have to wonder what some of his colleagues like Wolf Blitzer, Anderson Cooper, Erin Burnett, Don Lemon, John King, Dana Bash and Gloria Borger have to say about Waldman’s post. Do they say, “Yea, that really makes sense, and it’s exactly what I think, but I can’t say it on this network,” or do they say, “We have this radical guy working here who makes no sense; somebody should shut him down.” I’d prefer that it be the former because if they know that single-payer makes more sense than unfettered capitalism, then one or several of them may reach a tipping point at some time. When they do, they’ll ditch the false equivalency of points on the right and left and instead will be a news organization that better informs the public and raises the dialogue.

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Rep. Rush Holt (D-NJ), considered by many to be one of the smartest members of Congress, is running for New Jersey’s open senate seat in a primary against Wall Street and hedge fund backed Democrat Corey Booker, mayor of Newark. Another progressive, New Jersey congressman Frank Pallone, has joined the race to fill the late Frank Lautenberg’s seat. Booker has a substantial lead in the polls over both Pallone and Holt, but insiders give Holt a better chance to defeat Booker. Here’s one of Holt’s refreshing campaign videos—refreshing because he presents truly progressive ideas. You can view his other videos on NSA spying, Wall Street, climate change, Social Security, and student loans on his campaign website.

Holt is a scientist, a teacher, an expert on monitoring nuclear weapons – and (I love this) a five-time Jeopardy! winner who beat IBM’s computer “Watson.” He holds a Ph.D in physics, has been an assistant director of Princeton’s Plasma Physics Laboratory and a faculty member at Swarthmore. Before he ran for Congress, he did a stint at the State Department monitoring the nuclear programs of countries like Iraq, Iran, and North Korea. As a congressman, he has led the fight on climate change, working to add tough new restrictions on greenhouse gases to cap-and-trade proposals. He voted against the war in Iraq, against unwarranted spying on Americans, and he fought to repeal the misguided PATRIOT Act. Holt, is a strong advocate for single payer health care.

When Obama came into office in 2009, single payer was the obvious and rational solution to our predatory, inefficient, and costly health insurance system, but single payer, or “Medicare for all” was unacceptable to Obama’s Wall Street backers. So, with the help of other corporate Democrats and health insurance executives, Obama kludged together the Affordable Care Act, which, among other things, was designed to knee-cap single payer. Obama and Senate Finance Chairman Max Baucus brought in insurance lobbyist Liz Fowler to write the mind bogglingly complex bill in secret. Their guiding principal was to do no harm to any corporate profit stream. FDR saved capitalism, but Obama saved the health insurance industry—at least for now.

The official line, that Obama had to write the bill to please Republicans, is a myth. Republicans and most Democrats work for the same donors. Obama, rather cynically, used the so-called “public option” to co-opt the progressive base that had worked tirelessly to elect him. Because his brief was to pass a bill that was acceptable to heath care CEOs and Wall Street, the public option never was a viable “option.” To that end, he delivered a highly flawed, industry friendly, insurance-based health care delivery system spawned from warmed-over Republican ideas.

Is Obamacare better than what we had? Of course it is—our health care system was so bad there was nowhere to go but up. Some of the worst industry practices, such as denying coverage to sick people, have been ended in exchange for the mandate that everyone buy insurance. The exchanges, at least in some states, will drive down the cost of premiums for the uninsured. There are new options for preventive care. But, because it is profit-driven, Obamacare remains an absurdly expensive, complicated, and inefficient way to deliver healthcare. And, as we will soon discover, it is full of loopholes beneficial for the health care industry.

We, the American people, need single payer, and, if elected to the Senate, Rush Holt, a true progressive, will advocate for it.

The post Rush Holt, New Jersey progressive running for Senate, backs single payer appeared first on Occasional Planet.

Maybe I didn’t get the memo, but I don’t recall seeing much airtime/ink/bandwidth devoted to discussing single-payer healthcare as a jobs program. And that’s too bad, because job creation could be an effective talking point.

Here’s the crux of the argument: Under a national, single-payer healthcare plan [and can’t we just call it Medicare for All, already?], businesses would no longer have to pay the huge costs of health care benefits for their employees. Removing the cost of health care benefits would mean that creating jobs would be less expensive. Voila! One less reason to hold back on hiring. Companies will be quicker to hire when they’re growing, and quicker to rehire when the economy starts recovering from recession.

I’m not saying that single-payer  Medicare for All is the only answer to America’s jobs crisis, but it certainly could contribute to a much improved employment picture for businesses.

Here are a few salient numbers that help make the case, as compiled by the Business Coalition for Single Payer Healthcare. Under Medicare for All [HR. 676], businesses would:

• Eliminate health care benefits and reduce their labor costs by 10 – 12 %
• Cut workers’ compensation by up to 50%
• Become more competitive with foreign products
• Eliminate health care benefits management costs and related labor negotiations
• Free up worker income to buy new products and services, thereby improving the economy

In addition,  in a 2009 study, researchers at the California Nurses Association concluded that Medicare for All would be both a job creator and an economic stimulus:

Overall, expanding and upgrading Medicare to cover all Americans (single-payer) would create 2.6 million new jobs at an average salary of $38, 262 per year, [paralleling almost exactly the total job loss in 2008], infuse $317 billion in new business and public revenues, and inject another $100 billion in wages into the U.S. economy.

On the political front, a national Medicare for All  plan would blunt conservative criticisms [many of which are not based on fact, of course] of the healthcare reform law passed in 2010. Politicians who want to repeal the 2010 Affordable Care Act claim that it has increased health care premiums and is contributing to slow job growth. That assertion has been shown to be false, but when facts don’t matter, the contention lives on as a talking point for politicians hell-bent on undermining anything promoted by the Obama administration. A Medicare for All system would render moot the contention that “rising health care premiums caused by the health reform act”  are strangling businesses.

Another popular meme is the one about how small businesses create a significant proportion of new jobs in the U.S. [A popularly quoted figure is 65 percent, but it depends on the meaning of the term “small.”] If that’s the case, then Medicare for All would be a plus in that sector, too.  In Vermont, for example, where a proposed single-payer plan is in the works, a recent Burlington Free Press article  put it this way:

You probably know people who dream of starting their own businesses, or joining their spouse’s business, but who can’t quit their day jobs because they need the health insurance. Imagine the boon to the economy if all those people become free to unleash their entrepreneurial passion. Imagine the great new products and services that they will create. Imagine how much happier those people will be working for themselves in a business they care about.

Admittedly, a single-payer system could have the effect of eliminating a lot of jobs in the existing health insurance industry. That result would, indeed, stand in contrast to the less-talked-about job security for claims deniers, plan administrators and exorbitantly paid executives that the 2010 health reform act created when its mandate gifted millions of new members to private health insurers. But Medicare for All will need administrators, too, so many current workers would find new opportunities in the new structure.

In Oregon, where a single payer act was proposed in the state legislature early in 2011, the pro-single-payer group, Mad as Hell Doctors, compiled a list of popular knocks on the proposed bill. Among them was the charge that, under a state-run single-payer health plan, “…twenty-one hundred (2,100) independent insurance agents with an estimated annual payroll of $350 million would immediately have no business and no jobs.” Mad as Hell Doctors countered this contention by saying:

The bill as drafted includes funding for the retraining of workers displaced by implementation of the Plan. Based on single payer studies from other states and nationally, Oregon will enjoy creation of approximately 40,000 new jobs. Thus these 2,100 agents would be retrained and compete for the 40,000 new jobs. While they retrain, they and their families, like other Oregonians, would enjoy uninterrupted access to health care.

In addition, as current Medicare enrollees know, even under a single-payer system, there’s going to be a need for some form of supplemental insurance for services and expenses not covered by the program. That’s an opportunity for private insurers, who will need employees to administer those policies.  One CEO who sees the up side is Bill Little, vice president for Vermont’s MVP Health Care, as reported by VT Digger:

“It’s not keeping me up at night,” said Little, who added that under the plan his company might be able to offer supplemental coverage to Vermonters covered by the single-payer plan, including Medicare patients.”

Policymakers, pundits, state legislators, health care providers, insurance companies, lobbyists and individual citizens have been debating the merits of Medicare for All for years [led, of course, by the ahead-of-his-time Congressman Dennis Kucinich]. With the economy in a slump and employment at record highs, there’s a whole new economic rationale for pushing the Medicare for All scenario.While unceasingly vilified by the profit-makers, ignored or labeled as [gasp!] socialism in campaign dialogues and debates, and shot down by legislators bought and paid for by the private-insurance lobbying juggernaut—Medicare for All deserves serious consideration through the wide-angle lens of job creation.

The post Single payer, job creator appeared first on Occasional Planet.

Add Montana Governor Brian Schweitzer to the short [so far] list of state leaders who think single-payer health care is the way to go in their states.  According to the Progress Report, on Sept. 28, Schweitzer announced his intent to set up his own universal health care system in Montana, modeled after the single payer system in Canada.

Gov. Brian Schweitzer said he will ask the U.S. government to let Montana set up its own universal health care program, taking his rhetorical fight over health care to another level.  The popular second-term Democrat would like to create a state-run system that borrows from the program used in Saskatchewan. He said the Canadian province controls cost by negotiating drug prices and limiting non-emergency procedures such as MRIs.

Schweitzer’s proposal comes on the heels of a similar framework proposed earlier this year by Vermont Governor Peter Shumlin.

No fan of the PPACA health reform law passed by Congress in 2010, [Schweitzer has been quoted as calling that law “a pack of crap that gives away far too much to the pharmaceutical industry”], Schweitzer wants to tailor his plan to the demographics and economics of his state.

Under his plan, Montana citizens with private insurance could keep it or drop it if they choose and buy into the state-run plan at a cheaper rate. He envisions a system that would cover, with co-pays for service, all the uninsured in Montana.

To get what they want, Schweitzer, Shumlin—and any other governors hoping to create state-specific, single-payer programs—will have to get a waiver from the federal government that would exempt their states from the requirements of PPACA. The Obama administration has said that it’s willing to grant waivers as a way of encouraging innovations health-care delivery. But, under current rules, waivers would begin to become available in 2017—which seems a long way off, especially if your state has a high percentage of uninsured citizens. Vermont is asking to move the start of waivers to 2014, but it’s not clear, yet, whether that move will succeed.

One thing we do know is that Canada’s single-payer healthcare program got its own start in the province of Saskatchewan [whose demographics, says Schweitzer, are similar to those of Montana], and spread province-by-province, until the system went national. Perhaps a similar state-by-state strategy could ultimately bring single payer health care to all of the U.S., as well. And, perhaps, that’s what Schweitzer and Shumlin are envisioning.

One has to applaud both of these governors for their courageous and enlightened approaches to improving the quality of health and life for their citizens. It’s very heartening to see that the single-payer concept is still on the table. And maybe success in a few individual states will inspire other civic-minded state leaders to shed their irrational and hypocritical fears of “socialistic” programs and get on board. I sincerely hope they do, and, at the moment, I’ll cheer for any incremental steps that might help us move toward a national single-payer system.

Still, for this writer, a state-by-state approach is not as good as a national, Medicare for everyone plan. The incremental trajectory of going one state at a time is risky. There’s no guarantee that all states would ultimately adopt single-payer healthcare structures. And that would mean that where you happen to live would affect the cost and quality of your healthcare. And, while I’d like to think that both Governor Shumlin and Governor Schweitzer are proposing single-payer plans for the best interest of the citizens of their states, one must remember that other governors may see the chance to opt out of PPACA as convenient subterfuge for  asserting a states’-rights agenda while undermining any effort at creating a sane, uniform, nationwide healthcare policy. We’ve seen states’ rights at work before, and it’s not pretty. We need to remind ourselves of the dysfunction and fundamental inequalities created by a free-for-all patchwork of state policies on voting rights, racial integration, reproductive rights and economic assistance.

State-specific, single-payer healthcare plans could work and eventually go viral, and that could be a good thing that I would cheer for. But let’s go into this with our eyes open.

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On May 26, Governor Peter Shumlin (D) signed the legislation passed earlier by the VT House and Senate making Vermont the first state to make health care a right and not a privilege. Hopefully, it will be a model for the rest of the country, a system designed to take care of the people of the state, rather than provide profits for  Big Pharma and the health insurance industry. The state will spend the next four years setting up the system.

“This law recognizes an economic and fiscal imperative – that we must control the growth in health care costs that are putting families at economic risk and making it harder for small employers to do business,” the Governor said.

Just as importantly, he added, “We have a moral imperative to fix this problem, with 47,000 Vermonters uninsured and another 150,000 underinsured and worried about how to afford keeping their families healthy.”

According to Think Progress:

In order to actually enact the system, the state needs a waiver from the Affordable Care Act health reform law. Currently, the federal government will start handing out state waivers in 2017 — three years after Vermont wants to implement its system. Rep. Peter Welch (D-VT) has introduced an amendment that would move the waiver date up to 2014, an idea that President Obama has endorsed.

Because of the corrupting influence of Big Pharma and health insurance corporations on House and Senate members, it will be exceedingly difficult to get a single payer health care system passed first at the federal level. But there is a chance that the U.S. could eventually end up with a single payer system on a state-by-state basis. For example, Canada did not begin with a federal system. It arrived there through a series of incremental steps.

Canada developed its universal health care system province by province

The Canadian province of Saskatchewan had always had a chronic shortage of doctors, which led to towns using public monies to subsidize doctors to practice there. Then, various communities joined together to create subsidized hospitals. In 1946, building on its tradition of government involvement in health care, the government of Saskatchewan passed the Saskatchewan Hospitalization Act, which guaranteed free hospital care for much of its population. It had hoped to provide universal health care, but the province did not have the money.

In 1950, Alberta created a program similar to Saskatchewan’s, which included hospitalization and prepaid health services providing medical coverage to over 90% of its population.

In 1957, the federal government of Canada passed the Hospital Insurance and Diagnostic Services Act‘ to fund 50% of the cost of such programs that Saskatchewan and Alberta had created for any provincial government that adopted them. The HIDS Act outlined five conditions:

• public administration
• comprehensiveness
• universality
• portability
• accessibility.

These remain the pillars of the Canada Health Act. By 1961, all ten provinces had agreed to start HIDS Act programs. So, it was province by province that Canada moved toward universal, free health coverage for all.

Do Canadians like their single payer health care system?

Canadians strongly support their publicly funded health care system. In a 2009 poll by Nanos Research, 86.2% of Canadians surveyed supported or strongly supported public solutions to make our public health care stronger.

A 2009 Harris/Decima poll found 82% of Canadians preferred their healthcare system to the one in the United States, with only 8% stating a preference for a US-style health care system. A Strategic Counsel survey in 2008 found 91% of Canadians preferring their healthcare system to that of the U.S.

Is Vermont the “camel’s nose under the tent” for single payer in the U.S.?

Hopefully Vermont will serve as a model for  achieving universal single payer health care in the United States. It will not happen over night, but if Vermont and other states are successful in setting up efficient and cost-effective single payer systems that provide universal health care and improve the quality of life for their residents, the idea of healthcare as a right will supplant health care as a privilege. Hopefully, in time, the for-profit health care system we have today, will become nothing more than a bad memory.

The post Vermont governor signs historic single payer health care law appeared first on Occasional Planet.

Peter Shumlin, the newly elected governor of Vermont, ran on single-payer healthcare and he plans to deliver. For sure, there are hurdles to clear, like getting a waiver to opt out of the federally mandated health insurance program, but he’s convinced he can pull it off. He’s also convinced single-payer is essential for the economic health of his state. The following are excerpts from his January 21st interview with Amy Goodman of Democracy Now!

I was elected governor to create jobs and to ensure that Vermonters have a better and more hopeful economic future. The biggest challenge for business in Vermont, or one of them, is the rising cost of healthcare. And I think what we want to do here in Vermont is to create a single pool, much like General Motors, Ford, Oracle, ensure that healthcare is a right and not a privilege, and use technology and other methods to contain cost. We want to have universal access. We want to be the first state where health insurance follows the individual and is not a requirement of the employer—I think that will be a huge jobs creator

Not wasting any time, Shumlin mentions that he has already spoken with Secretary Sebelieus and President Obama about his plans for a single-payer system. He needs to find a way to get a waiver so Vermont can opt out of federally mandated health insurance. President Obama was supportive of his efforts, telling him that “We want the states to be laboratories of change,” which is quite an encouraging statement. Canada achieved universal single payer healthcare one province at a time, so perhaps President Obama sees the United States achieving it in the same fashion.

The current system in America is unaffordable. I think Democrats and Republicans can agree on that. If we stay on the current course, we will be spending the lion’s share of our income on healthcare. It will bankrupt our businesses. It puts us at a competitive disadvantage with all of the other countries that have figured this out.

My vision is that if Vermont can get this right, the other states will follow. Now, I’ve spoken with the President. We work together with our congressional delegation, with Secretary Sebelius. We need some waivers to make this happen. And what they’re saying is, “As long as you’re not lowering standards,” which we’re not, “we want to work with you. We want the states to be laboratories for change.” So, it’s an ambitious goal. We understand the land mines that lie out there, the special interests and the folks who are profiteering from our healthcare system, but we’re going to give it our best shot and try, lead the country.

Vermont is already more enlightened and ahead of the game when it comes to health care. For example, it insures all children and every adult below 300% percent of poverty, which is quite generous. Shumlin sees the big challenge of a single payer system as cost containment

My challenge is this: it’s about cost. And I have watched some of the most capable politicians in America, from President Obama, President Clinton, Hillary Clinton, Howard Dean here in Vermont, both on a state and federal level, fail in designing a system that contains cost. That is what drags us down. I believe Vermont can be the first state in the country that shows how to get cost containment right.

Amy Goodman asked Governor Shumlin about Blue-Cross-Blue-Shield, the biggest health insurer in Vermont, wanting to administer single payer for the state when it happens. A Blue-Cross executive was reported as saying, “If there’s a single payer system, we’d like to be the single payer.”

Well, he’s a smart insurance executive, and he’s got it right. Listen, here’s why we can do this in Vermont, why we have a better shot than perhaps anywhere else in America. Today is the anniversary of the Supreme Court decision that allows corporations to spend unlimited cash to influence our elections. What is different about Vermont is that our legislators are not in the pockets of special interests; they’re in the pockets of their constituents. Now, there’s a very simple reason for that. I was president of the Senate. My last campaign cost $2,500. My counterpart in New York’s campaign, the president of the Senate just across the lake, probably cost multiple millions of dollars. My point is, we have a citizen legislature in the state. We are not beholden to the special interests. We fight for our constituents in their best interest. And frankly, our insurance companies are smart enough to know that. So, I think that—you know, we all know that what’s destroying democracy is the extraordinary influence of corporate money. The folks that are making money off the system then elect the politicians that make the decisions about their economic future. So we have a real opportunity here, and I think our insurance companies are smart enough to see that we’re going to make progress, and they want to be the company that has the single payer.

It appears Vermont could be the first state to achieve single-payer healthcare, hopefully the first of many. And Democrat Peter Shumlin sounds like the person to make it happen.

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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.”

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