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"Let Vermont be the first state in the nation to treat health care as a right and not a privilege."

-- Governor Sumlin's inaugural address, January 6th, 2011

Peter Shumlin minutes ago signed into law H.202 (pdf), a law which has as its ultimate goal the creation of a single-payer health care system in Vermont. The Vermont Senate passed the legislation several weeks ago by a 21-9 margin, with the Vermont House acting first on a vote of 92-49.  From the introductory text:

Statement of purpose: This bill proposes to set forth a strategic plan for creating a single-payer and unified health system. It would establish a board to ensure cost-containment in health care, to create system-wide budgets, and to pursue payment reform; establish a health benefit exchange for Vermont as required under federal health care reform laws; create a public-private single-payer health care system to provide coverage for all Vermonters after receipt of federal waivers; create a consumer and health care professional advisory board; examine reforms to Vermont’s medical malpractice system; modify the insurance rate review process; and create a statewide drug formulary.


The state of Vermont must ensure universal access to and coverage for high-quality, medically necessary health services for all Vermonters. Systemic barriers, such as cost, must not prevent people from accessing necessary health care. All Vermonters must receive affordable and appropriate health care at the appropriate time in the appropriate setting.

This statewide legislation is the first of its kind in the United States (Medicare and VA programs are examples of limited US Federal Government single-payer systems). Other countries, of course, have had universal single-payer systems for decades, including Norway, Japan, Canada, Australia, Italy, Spain, Slovenia, Kuwait and Taiwan.

Here is Governor Shumlin speaking on the intent of the new law:

Here's our challenge. Our premiums go up 10, 15, 20% a year. This is true in the rest of the country as well. They are killing small business. They're killing middle-class Americans, who have been kicked in the teeth over the last several years. What our plan will do is create a single pool, get the insurance company profits, the pharmaceutical company profits, the other folks that are mining the system to make a lot of money on the backs of our illnesses, and ensure that we're using those dollars to make Vermonters healthy.

According to Amy Goodman of The Guardian

Vermont is a land of proud firsts. This small New England state was the first to join the 13 colonies. Its constitution was the first to ban slavery. It was the first to establish the right to free education for all -- public education.

Vermont was also the first state to institute civil unions, and the first state to have its legislature enact into law same-sex marriage. And now it is the first to legislate a system whose goal is universal health care coverage.

So, should everyone up and move to Vermont (snow and mud be damned)?  No so fast.  They haven't even figured out how they are going to finance the system yet. The whole thing could come crashing down in a year or two once there's a concrete proposal on the table as the legislation demands.

Nor do they have permission from the Federal government to do most of what they want to do either. That will come at the earliest in 2014, and not until 2017 unless Congress can be convinced to change the PPACA to allow Vermont to get a waiver earlier than the 2017 date written into the health care law.

In fact, according to Vermont State Senator Anthony Pollina:

... the proposal does not lock us into a single payer system at all... Green Mount Care, a single payer system, can only be implemented if certain requirements are met: there is a comprehensive coverage plan; we know the cost; we know how we will pay for it; The Federal government provides certain waivers and our Legislature votes to approve it...

Still, it's the beginning, both for Vermont and the United States. What is taken for granted now in the rest of the industrialized world -- health care for all as a right -- may, in twenty years, spread across the United States thanks to the seeds that are being planted today in Vermont.


Meanwhile, in Rand's Christie's paradise New Jersey:

New Jersey health officials are pushing to tighten the eligibility requirements for new Medicaid enrollees...

The proposal would deny coverage to new adult enrollees who earn more than $5,317 per year for a family of three - about one-fifth of the current income requirement... about 23,000 uninsured adults could lose eligibility.

If we don't make health care a right, insane meglomaniacs like Christie are going to continue to do just that.  Program by program, person by person.

Originally posted to jpmassar on Thu May 26, 2011 at 07:51 AM PDT.

Also republished by Single Payer: The Fight for Medicare for All, Single Payer California, Progressive Policy Zone, and The Democratic Wing of the Democratic Party.

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