Should VT Pursue Single-Payer based on Federal Reform?

This week that is the question being asked by Vermont's joint legislative healthcare committees. We say Yes! The current version of S.88 calls for implementation in 2012 of a real universal healthcare system (see our breakdown of the bill here: ). The new federal health bill will set up healthcare insurance state exchanges in 2014 which could mess this up. But the new bill does establish the right of state's to make their own universal single-payer healthcare system in 2017. But Sen. Bernie Sanders and and others are pushing to pass new legislation to move that date up until 2014.

From David Reynolds, Senior Health Policy Advisor for Senator Bernie Sanders, who is speaking today at a joint meeting of the Senate-House health committees:

"Since last week, the one question I have been repeatedly asked in various forms by single payer advocates, legislators, and policy makers in VT is:
Should Vermont continue to pursue a single payer system given that the earliest date for waivers is 2017 and, before then, Vermont would have to set up an exchange?”

ANSWER: Yes, Vermont should proceed with legislation. We intend, before 2014, to seek a change in the waiver date to 2014. If Vermont and other states pass legislation to set up a single payer system, it will provide added leverage for us and our allies in the Senate to get this change adopted. "

For the sake of the millions of people like us who suffer and die each year in our broken market based healthcare system, Vermont must continue moving forward to lead the country. We must not let the vested interests in the current system, may they be those directly profiting under the current system or those acting on their behalf, get in the way of real progress.

We must pass a strong version of S.88 which develops implementation plans of how Vermont would navigate the federal programs and receive waivers where we need them. The bill calls for this to be designed for January 2011 and implemented in 2012. We can start putting our system in place prior to the state exchanges and work with Sen. Sanders and the rest of our delegation to get any additional waivers we need to make it work. We cannot let this be an excuse to preserve the status quo.


I am glad to see you directly addressing the impact of the new Federal legislation on our efforts to implement a single payer system here in Vermont. However, I think a lot of Vermonters will need a lot more education about what the Federal bill does--and does not--do. It is so long, so convoluted, that even those of us with lots of experience in this field have a hard time understanding it.

We need basic info, like what is an exchange? What is trying to comply with the legislation likely to cost Vermont? How much money will we have to spend trying to jump through hoops that only benefit for-profit insurers? How much health care for Vermonters could we have purchased for those same dollars? We need this information to galvanize ourselves, our friends and our neighbors, into action! Many people seem to think the battle for health care is over for now...