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Vermont Gov. Peter Shumlin stands in front of big American flag.
Vermont Gov. Peter Shumlin is leading on single-payer, but Republicans are making it easier for everyone else to follow.
So over at the nascent, Sarah Kliff delves deeply into Vermont's efforts to enact a single-payer health-care system. In fact, the only reason the project hasn't launched is ironically because of Obamacare.
Green Mountain Care cannot start until 2017 because the Affordable Care Act requires states to hew to the federal health reform model for the next three years. This is frustrating for Vermont’s single-payer supporters, who want to put the new system in place sooner.

"When I ran for governor, I had it in my mind...I could find a way to get around it," [Gov. Peter] Shumlin [said]. "My team finally convinced me — and it took some convincing — that it couldn’t be done without losing all our federal funding, which would be suicide. So my goal is to get this done as close to January 1, 2017 as we possibly can."

This is the future of America, and Vermont is leading the way.

Republicans fear single payer above all, but ironically, their intransigence on the Affordable Care Act makes it more likely that we'll get to that holy grail of health-care reform.

Had Republicans embraced their Heritage-devised plan, worked with Democrats to best shape it in their mold, then accepted this market-based approach in bipartisan fashion, Obamacare's numbers would look much better. And if overwhelming majorities approved of the plan, any hope of future progress on the issue would be dead in the water. Republicans might not have their ideal (i.e. screw the uninsured), but their CEO buddies would still be living large and they'd still be able to boast of a market-based solution in line with their political ideology.

But with approval of the law still in iffy territory, liberals have room to agitate for further improvements without having to tackle an entrenched and deeply popular law. And with Republicans refusing to allow even minor technical fixes to the law to improve its efficacy, heir continued undermining of the law makes it just as easy in the longer term for liberals to push for bigger and broader chances.

If Republicans wanted to kill any chance of single payer ever happening, the best way to do that would be to ensure that Obamacare was firmly entrenched. Luckily, they have no interest in ever allowing that.

Originally posted to kos on Fri Apr 11, 2014 at 11:29 AM PDT.

Also republished by Obamacare Saves Lives and Daily Kos.

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Comment Preferences

  •  Tip Jar (145+ / 0-)
    Recommended by:
    skillet, Calvino Partigiani, annieli, George3, ericlewis0, mungley, commonmass, this just in, blueoregon, Polly Syllabic, Free Jazz at High Noon, Drocedus, puakev, Cadillac64, antooo, bleeding blue, Dave in Northridge, implicate order, ItsSimpleSimon, Betty Pinson, TrueBlueMountaineer, fumie, skepticalcitizen, Ottoe, kevinpdx, Alice Olson, tampaedski, wasatch, vahana, sowsearsoup, CA Nana, jan4insight, yet another liberal, howabout, jimstaro, slowbutsure, rmonroe, No one gets out alive, tegrat, Liberal Granny, poliwrangler, Aquarius40, marleycat, rhutcheson, TexasTom, Catte Nappe, paulex, TheLizardKing, joanbrooker, AnnieR, jck, pierre9045, offgrid, Brian82, maggiejean, WisVoter, PatConnors, hwmnbn, CoolOnion, Shadowmage36, brae70, no way lack of brain, Angie in WA State, Shockwave, anodnhajo, zerelda, wbr, twigg, Gentle Giant, Involuntary Exile, Eagles92, Pluto, tarkangi, gmats, ybruti, Grandma Susie, hulibow, Cronesense, millwood, travelerxxx, Bule Betawi, LS Dem, dandy lion, planmeister, buckstop, NCJan, BeninSC, Anne Elk, librarisingnsf, Odysseus, Railfan, Mystic Michael, mconvente, rbird, vjcalaska, alwaysquestion, Chrislove, Mokurai, flavor411, kjoftherock, CwV, camlbacker, VPofKarma, The grouch, mstep, boadicea, karmsy, cwsmoke, Ran3dy, myboo, GleninCA, etherealfire, OldDragon, Lencialoo, chimene, terabytes, Aaa T Tudeattack, nocynicism, Linda1961, ratcityreprobate, Noodles, yoduuuh do or do not, zitherhamster, kaliope, Rosaura, JerryNA, Eric Nelson, Chicago Lawyer, deepeco, sujigu, Creosote, OleHippieChick, ladybug53, dicentra, Sharon Wraight, ivy redneck, Libby Shaw, BadKitties, eyesoars, dewolf99, ERTBen, ruleoflaw, stitchingasfastasIcan, twocrows1023, Toprow
  •  exactly - they will lay the foundation for even (25+ / 0-)

    more efficient administration of healthcare with their reactionary politics


    Warning - some snark may be above‽ (-9.50; -7.03)‽ eState4Column5©2013 "I’m not the strapping young Muslim socialist that I used to be" - Barack Obama 04/27/2013 (@eState4Column5).

    by annieli on Fri Apr 11, 2014 at 11:38:40 AM PDT

    •  counter-force rather than the GOP's counter-farce (13+ / 0-)
      Aikido is performed by blending with the motion of the attacker and redirecting the force of the attack rather than opposing it head-on. This requires very little physical strength, as the aikidōka (aikido practitioner) "leads" the attacker's momentum using entering and turning movements. The techniques are completed with various throws or joint locks.

      Warning - some snark may be above‽ (-9.50; -7.03)‽ eState4Column5©2013 "I’m not the strapping young Muslim socialist that I used to be" - Barack Obama 04/27/2013 (@eState4Column5).

      by annieli on Fri Apr 11, 2014 at 11:43:18 AM PDT

      [ Parent ]

      •  So Aikido is akin to Judo. (3+ / 0-)
        Recommended by:
        lgmcp, duhban, rbird

        "Non-violence is a powerful and just weapon which cuts without wounding and ennobles the man who wields it. It is a sword that heals." - Martin Luther King, Jr.

        by Gentle Giant on Fri Apr 11, 2014 at 01:26:01 PM PDT

        [ Parent ]

        •  mostly true (5+ / 0-)

          Aikido is actually founded on jui jutsu (Daitō-ryū Aiki-jūjutsu) which Judo also hails from

          Der Weg ist das Ziel

          by duhban on Fri Apr 11, 2014 at 01:34:07 PM PDT

          [ Parent ]

          •  Similar in principle to Tai Chi/Kung Fu as well? (1+ / 0-)
            Recommended by:

            We are the principled ones, remember? We don't get to use the black hats' tricks even when it would benefit us. Political Compass: -6.88, -6.41

            by bmcphail on Fri Apr 11, 2014 at 02:38:15 PM PDT

            [ Parent ]

            •  well now that's more complicated (2+ / 0-)
              Recommended by:
              Creosote, eyesoars

              Kung Fu (more properly known as Whushu) is a collection of diverse techniques and disciplines over the centuries. This ranged from Drunken Boxen to Elemental Boxing to Animal forms to T'ai chi ch'uan (Tao Chi).  Most people think Kung Fu is a specific style when the truth is more complicated. It's more a loose collection of techniques and styles that are passed on from master to student.  And that doesn't even get into differentiating from say Southern Mantis Kung Fu from Northern Shaolin Lohan Kung Fu.

              Honestly untangling the origins of any of the Eastern fighting style are horribly complicated. They all are influenced by each other and none of them were hesitant to incorporate elements of the philosophy of a different style. And some like Shaolin Kung Fu  simply absorbed into it's tool set anything it found to work including complete fighting styles.

              Everyone puts their own 'spin' on the martial art they practice and it's highly common for serious practitioners to study several different styles. Bruce Lee for example invented Jeet Kune Do for example as a completely new martial art though he used his experience in a variety of martial arts to do so.

              Der Weg ist das Ziel

              by duhban on Fri Apr 11, 2014 at 05:02:51 PM PDT

              [ Parent ]

    •  It's what they fear about the ACA, (3+ / 0-)

      that it's a plan hatched by socialists to irrevocably break the American healthcare system (in order to usher in single payer). That's what they're trying to get at when they say Obamacare can never work. They fear it's not designed to work, but to fail in a particular way.

      Kos is right; their intransigence brings the country step by painful step closer to the very thing they fear most.

      You will not be punished for your anger. You will be punished by your anger.

      by mstep on Fri Apr 11, 2014 at 03:26:14 PM PDT

      [ Parent ]

  •  The GOP can't see any further than "obstruct (28+ / 0-)

    Obama every way we can". It's their entire platform. Eventually, their voters will get sick and tired of it. Especially as they get less sick because they now have insurance.

    Pope Francis: the Thumb of Christ in the eyes of the Pharisees.

    by commonmass on Fri Apr 11, 2014 at 11:42:47 AM PDT

  •  It's just shockingly ignorant (18+ / 0-)

    They practically make the argument for us.  

    It's so funny now, because it's the Republican rank and file who are now the ones making arguments for including a public option.


    by otto on Fri Apr 11, 2014 at 11:45:36 AM PDT

  •  Before too long (39+ / 0-)

    the dumbasses are going to find themselves defending Obamacare as a free-market solution against the "government takeover of healthcare" - that's going to be hilarious.

  •  Ssh! The GOP doesn't need to know that. (7+ / 0-)

    Our government is not yet small enough to drown in a bathtub. That doesn't mean it can't be waterboarded.

    by furrfu on Fri Apr 11, 2014 at 11:55:59 AM PDT

  •  When Vermont passed single-payer, (25+ / 0-)

    I thought it was a nice story but what we really need is California to do it if it is going to go national.

    Now, however, I'm glad Vermont is doing it first.  I think single payer will be much easier to implement (and therefore seen as successful) in a small state than in a huge one.

    I'd rather naysayers complain that Vermont isn't a typical state (already among the healthiest) than have them point to California and point out all the initial difficulties.

    •  It's what happened in Massachusetts (19+ / 0-)

      Romneycare paved the way, and a few years later along came Obamacare.  If Shumlin can do the same thing in Vermont, God bless him.

      This isn't freedom. This is fear - Captain America

      by Ellid on Fri Apr 11, 2014 at 12:21:55 PM PDT

      [ Parent ]

    •  CA has a Dem supermajority for now (4+ / 0-)
      Recommended by:
      BlueKS, Gentle Giant, duhban, Shockwave

      It can and will happen.

      Make sure everyone's vote counts: Verified Voting

      by sacrelicious on Fri Apr 11, 2014 at 12:36:40 PM PDT

      [ Parent ]

      •  Sadly, no. (8+ / 0-)

        We lost the supermajority in the state senate due to several corrupt assholes getting indicted and convicted.  We'll probably get it back eventually, but not this year.

        •  and even with a supermajority (7+ / 0-)

          Getting all of them to vote for a large tax increase isn't likely.

          •  Although, given that both employees (7+ / 0-)

            and employers pay for health insurance, and that HR departments spend much of their time dealing with health benefits, etc, you could sell this as an actual tax cut. If you add up the amount that employees, the self-employed and employers pay out every year to get the really inefficient healthcare they do, then you ought to be able to show that more money stays in people and Companies pockets as a result. If that were not true, then why would we even want single payer? I am sure that opponents would point to the tax component, but you have to balance the argument with the huge offset.

            Voting is the means by which the public is distracted from the realities of power and its exercise.

            by Anne Elk on Fri Apr 11, 2014 at 01:53:22 PM PDT

            [ Parent ]

        •  And even if we did have that supermajority, (2+ / 0-)
          Recommended by:
          Aquarius40, ferg

          I still don't see it passing. I remember the first ballot initiative on single-payer in CA. It won a single county - San Francisco - and died everywhere else. It'd be interesting to see how it would do this time around. However, I think insurance companies would spend their last dime to defeat it. Gotta keep trying though.

          Voting is the means by which the public is distracted from the realities of power and its exercise.

          by Anne Elk on Fri Apr 11, 2014 at 01:45:22 PM PDT

          [ Parent ]

      •  Single-payer won't spread. (2+ / 0-)
        Recommended by:
        mconvente, askew

        It's complicated enough to enact it in Vermont, a small wealthy homogenous liberal state. Enacting it in a large diverse state like California is virtually impossible, given that it would require blowing up the popular employer-mandated coverage system. If Obamacare reduces the rate of the uninsured significantly (in blue states) there will be no reason for anyone to jump into the health care debate again.

        •  Actually ... (12+ / 0-)

          ... it's easy to assume Vermont is wealthy, homogenous and liberal. This really isn't the case.

          Racially and ethnically, we're pretty homogenous -- though that's slowly starting to change in the Burlington area thanks to a robust refugee resettlement program.

          Politically, though? Not at all. The vast rural majority of the state leans more right and/or libertarian. We just appear highly liberal because the largest city is -- and the people there make all the noise.

          If you don't believe me, read the comments section of the Burlington Free Press.

          Wealth also tends to be concentrated in Chittenden County. There are a lot of at- or below-poverty line folks in the state.

          I don't disagree with your assertion that single-payer will be difficult to enact here, or elsewhere. Just wanted to point out the misconception (broadly shared by many people) that everyone who lives here is alike. I do think we all share the same pragmatism, though, which helps bridge the political divide a hell of a lot more effectively than most other places.

          God used to be my co-pilot, but then we crashed in the mountains and I had to eat him.

          by Eagles92 on Fri Apr 11, 2014 at 01:40:56 PM PDT

          [ Parent ]

          •  The state has an interesting history. (1+ / 0-)
            Recommended by:

            It used to be one of the most Republican states in the country, thanks to the all-white rural population. As soon as liberals started moving in, the demographics changed quickly. There were some moments of backlash, like the Take Back Vermont movement early in the 2000s, and GOP governors have been elected (similar to other Northern New England states). For now though, it is overwhelmingly liberal in its politics and does not have the huge political mood swings in places like NH.

            •  Vermont voted for Bernie Sanders and GWB (0+ / 0-)

              in the same election.

              •  George W. Bush? (0+ / 0-)

                Bernie Sanders was the at-large congressman from 1990 and is senator from 2006. Vermont voted for Democratic nominees in these years. That said, there is an interesting twist here - Jim Jeffords, a Republican, was reelected in 2000, and he was on good terms with Sanders. Sanders only decided to run for senator after Jeffords retired.

                •  I assume (1+ / 0-)
                  Recommended by:

                  that when Sen. Sanders said that he saw "thousands" of lawns with Sanders signs next to Bush signs he must have meant for his House elections in 2000 and 2004. I don't know whether Vermont voted for Bush, but apparently many Vermonters voted for both Bush and Sanders.

            •  I found this analysis pretty interesting (0+ / 0-)

              But the “old” Vermont never really went away. There’s now something of a split between new, highly educated and left-leaning Vermonters and old, less-educated and more fiscally conservative Vermonters.

              Lots of other good stuff here, too -- including how VT Republicans generally don't love national Republicans.

              God used to be my co-pilot, but then we crashed in the mountains and I had to eat him.

              by Eagles92 on Sat Apr 12, 2014 at 03:43:28 PM PDT

              [ Parent ]

          •  All the Noise (1+ / 0-)
            Recommended by:
            We just appear highly liberal because the largest city is -- and the people there make all the noise.

            If you don't believe me, read the comments section of the Burlington Free Press.

            I think you've got that backwards. I'd say the population of Burlington is more representative of Vermont than a few dozen people commenting in its news site.

            Vermont is highly not politically aware or sophisticated, like everyplace else in the US - and practically everyplace in the world.

            "When the going gets weird, the weird turn pro." - HST

            by DocGonzo on Fri Apr 11, 2014 at 05:31:49 PM PDT

            [ Parent ]

          •  I love the path that Vermont has blazed. I always (1+ / 0-)
            Recommended by:

            tell my wife, "if it gets much worse with all these right wing Christian and tea party freaks- we can always move to Vermont." You have become our beacon of sanity and reason in government. Yet my wife reminds me that Vermont is really cold, rural and in the woods and may be a nice place to visit but......

            The price of anything is the amount of life we are willing to exchange for it.

            by theslinger on Fri Apr 11, 2014 at 06:38:02 PM PDT

            [ Parent ]

            •  When I'm particularly depressed by politics ... (1+ / 0-)
              Recommended by:

              I remind myself that Vermont was once an independent Republic ... and we could become one once again, if things got bad enough!

              And we're only "really cold" about 8 months of the year. ;-)

              God used to be my co-pilot, but then we crashed in the mountains and I had to eat him.

              by Eagles92 on Sat Apr 12, 2014 at 07:38:08 AM PDT

              [ Parent ]

          •  Never base any opinion on unmoderated forums (0+ / 0-)
            If you don't believe me, read the comments section of the Burlington Free Press.
            This is a recipe for frustration.  Unmoderated forums are a cesspool of spam, idiots and bought opinions (i.e., politispam).

            Make sure everyone's vote counts: Verified Voting

            by sacrelicious on Sat Apr 12, 2014 at 02:45:18 AM PDT

            [ Parent ]

          •  Many seniors didn't have health insurance pre-M. (0+ / 0-)

            Now all do. Also, don't forget when Medicare was enacted. After LBJ won an overwhelming reelection over Barry Goldwater and thus had the biggest majorities he could imagine (sort of like Obama post-2008). I don't see such circumstances bubbling up anytime soon. Even if the GOP were to melt down, health care would probably be as controversial as it was in 2009-2010. Democrats would limit themselves to small fixes, like insuring those left out through the Medicaid gap.

        •  Enacting single payer is far easier than Obamacare (2+ / 0-)
          Recommended by:
          atana, Ozzie

          The SB 810 which failed to get to Jerry Brown's desk thanks to 6 Dem Senators had only about 100 pages vs. 2700 fotr the ACA.

          Once California does it then the whole country will follow.  Watch next year.

          Daily Kos an oasis of truth. Truth that leads to action.

          by Shockwave on Fri Apr 11, 2014 at 02:50:21 PM PDT

          [ Parent ]

          •  For the record... (4+ / 0-)

            ...The Patient Protection and Affordable Care Act is 906 pages.


            Anything you hear a Republican tell you, question.

            •  You are right (0+ / 0-)

              Daily Kos an oasis of truth. Truth that leads to action.

              by Shockwave on Fri Apr 11, 2014 at 03:42:50 PM PDT

              [ Parent ]

              •  I say this in the friendliest way possible: (2+ / 0-)
                Recommended by:
                Shockwave, bananapouch1

                "Still" nothing. Don't talk yourself out of it: they lied.

                They thought it was a huge deal when "If you like your plan, you can keep it" turned out to be only 99% true rather than 100%, so I'm not willing to let them off the hook for padding their criticism of the ACA by multiplying a basis for it by a factor of 3.  

                If they lie about something like that, what else do they lie about? Question, question, question.

                Okay, I'm finished beating my point to death. I hope we can be friends just the same.

                •  I know very well they lie (2+ / 0-)
                  Recommended by:
                  StevenWells, bananapouch1

                  I also understand how significant Obamacare will be in the November mid-terms.

                  California is (with Kentucky) the leading state as far as ACA enrollment and implementation.  Heck, I enrolled.

                  Still, as a single payer activist, once November is behind, I know things will get restarted.

                  Daily Kos an oasis of truth. Truth that leads to action.

                  by Shockwave on Fri Apr 11, 2014 at 04:40:23 PM PDT

                  [ Parent ]

                  •  Thanks for enduring my rant... (0+ / 0-)

           a spirit of good fellowship.

                    And I'm definitely with you on your final point. Back during the sausage-making process when it became clear which way the wind was blowing, I was fearful we'd be stuck with what - helpful as it is - is basically a patch job, and single payer (or anything else) would be dead for 15-20 years.

                    So I'm encouraged by Markos' observations and yours.    

                  •  If California has great Obamacare enrollments? (0+ / 0-)

                    Then why would anyone want to risk single-payer?

                    •  I won't presume to speak for Shockwave... (0+ / 0-)

                      ...but my answers are these:

                      - I see no "risk" involved; nothing existing should be in any way jeopardized by pursuit of single payer, even if that pursuit were unsuccessful.

                      - The upside to single payer is that it's simply better and cheaper.

                      Unlike what some might say, "repeal" isn't necessary before any undertaking to "replace."

                      •  Nothing jeopardized? (0+ / 0-)

                        Wouldn't single payer rip up the employer insurance market?

                        Obamacare relied on blowing up the problematic individual market, and that was controversial enough.

                        •  There would be no need... (0+ / 0-)

                          ...for employer-based health insurance with single payer.

                          By "no 'risk' involved," I was referring to private citizens utilizing health care services. Sure, the profit-based health care insurers would fight it tooth and nail. And if they were successful in derailing it, so-called Obamacare would still be in place.

                          I confess I'm not sure what you mean by "blowing up" the individual market.

                          •  This is what I meant. (0+ / 0-)

                            That the individual market was significantly overhauled, with new requirements, and many plans getting canceled (even if the people affected found new insurance later on). As you mention, there would be no need for employer-based insurance under single-payer. Therefore, millions of individuals who like their current plans would lose them.

                          •  Technically... (0+ / 0-)

                            ...I guess that's so. I have a '98 Pontiac, which I keep because I like it. If someone came along and said, "I'm taking it away from you, but here's a brand-new one for you," I'd still "lose" something I like.

                            So the questions become:
                            - What replaces what's lost?
                            - If it's an improvement, isn't it a net gain?

                          •  Current health insurance is not like a 98 car. (0+ / 0-)

                            Most people like their health insurance, and therefore, they do not want to lose it with something that may or may not be better. They want to retain choice over what is and isn't covered in their plan etc. and are unwilling to jump into something uncertain.
                            This is the American way, that certain social goals are achieved through a privatized system that is probably more complicated than just straight-down public benefits. Just like with college financial aid - the government has a complicated program of student loans, grants, scholarships when it could probably just have free public college tuition and save money that way.

          •  Would it have passed? (0+ / 0-)

            If so, it would have probably been challenged through ballot initiative. Don't forget, it would blow up the employer-based plans everyone has.

            I just don't see many states passing single-payer except for Vermont. Few states in the country have united liberal Democratic control over their governments, and some of those that do have veto referendums. That alone would make it hard for such sweeping change to get enacted.

      •  We've got a Governor who won't get behind it (3+ / 0-)

        (while at least he doesn't openly oppose) and we had a pack of turn-coats who changed their votes once Arnie was out of office.

        They were for it when they knew it would be vetoed, against it when they weren't so sure.

        Is it "Gordon Gecko Democrat" week here at Dailykos?

        by JesseCW on Fri Apr 11, 2014 at 01:57:12 PM PDT

        [ Parent ]

    •  I'm worried about a two-tier system... (6+ / 0-)

      ...where blue states have single payer, and red states have privatized, bastardized Obamacare and no Medicaid expansion.

      The way we have "right to work" states now, effectively stifling unions, it depresses wages nationwide. These folks are perfectly willing to screw their own constituents. I fear it will be no different with healthcare, and a long, painful slog to get where we need to go.

      We truly need "Medicare for all", including the red states.

      "No matter how cynical I get, I just can't keep up." --Lily Tomlin

      by paulex on Fri Apr 11, 2014 at 12:57:45 PM PDT

      [ Parent ]

      •  I imagine it won't last long. Even die-hard (8+ / 0-)

        Republican voters have friends and family in States which accepted the Medicaid Expansion and it's federal dollars.

        Think of the email conversations, the #FaceCrack postings, the Reddit forum postings... where Red Staters find THEIR TAX DOLLARS are paying so even poor folks in blue states have healthcare insurance, but their Republican Governors have denied them access to it?

        Think all of those voters are going to continue to be fooled into supporting the Party which denies them this federal benefit for political reasons only?

        Armageddon is coming for the Republicans. If we make enough noise about these facts before November 4th, it might come this year.

        The first week in August, be sure to participate in #WalkYourDistrictWeek, knocking on the doors of your 1100 closest neighbors, reminding them to vote Democratic on November 4th - and why they should!

        "I like paying taxes...with them, I buy Civilization"

        by Angie in WA State on Fri Apr 11, 2014 at 01:23:53 PM PDT

        [ Parent ]

        •  I've already seen a lot of commotion on (7+ / 0-)

          social media.
          But what may well happen, especially if single payer/Medicare for All does take hold in half the states, is a brain drain from states with healthcare that sucks to states with healthcare that doesn't. When red states start losing talent and companies begin to follow that talent relocating their businesses, then changes will come.

          Most red states won't allow Medicaid expansion which would help with the well-being of their citizens, but they'd do it in a heartbeat if not doing it cost them boatloads of money in lost industry and talent going elsewhere.

          "Non-violence is a powerful and just weapon which cuts without wounding and ennobles the man who wields it. It is a sword that heals." - Martin Luther King, Jr.

          by Gentle Giant on Fri Apr 11, 2014 at 01:32:27 PM PDT

          [ Parent ]

          •  Unfortunately, that process has been going on (2+ / 0-)
            Recommended by:
            nocynicism, Gentle Giant

            for a couple of hundred years....

            When red states start losing talent and companies begin to follow that talent relocating their businesses, then changes will come.
            Henry Grady to the Bay State Club of Boston, 1889

            I attended a funeral once in Pickens county in my State. . . . This funeral was peculiarly sad. It was a poor “one gallus” fellow, whose breeches struck him under the armpits and hit him at the other end about the knee—he didn’t believe in decollete clothes. They buried him in the midst of a marble quarry: they cut through solid marble to make his grave; and yet a little tombstone they put above him was from Vermont. They buried him in the heart of a pine forest, and yet the pine coffin was imported from Cincinnati. They buried him within touch of an iron mine, and yet the nails in his coffin and the iron in the shovel that dug his grave were imported from Pittsburg. They buried him by the side of the best sheep-grazing country on the earth, and yet the wool in the coffin bands and the coffin bands themselves were brought from the North. The South didn’t furnish a thing on earth for that funeral but the corpse and the hole in the ground. There they put him away and the clods rattled down on his coffin, and they buried him in a New York coat and a Boston pair of shoes and a pair of breeches from Chicago and a shirt from Cincinnati, leaving him nothing to carry into the next world with him to remind him of the country in which he lived, and for which he fought for four years, but the chill of blood in his veins and the marrow in his bones.

            We are the principled ones, remember? We don't get to use the black hats' tricks even when it would benefit us. Political Compass: -6.88, -6.41

            by bmcphail on Fri Apr 11, 2014 at 02:45:06 PM PDT

            [ Parent ]

          •  I wish you were right, but... (1+ / 0-)
            Recommended by:
            Gentle Giant

            ...the red states are already magnets for skads of low-wage, low-skilled jobs, and the companies that provide the same.  We're talking about industries such as food processing, textiles, and of course agriculture; companies that are very traditional and top-down in culture, with very few lucrative opportunities in management...and that require lots and lots of warm bodies to perform relatively menial jobs.

            Such companies - and industries - are attracted to the red states precisely because employee wages & benefits are kept so low, union presence is nearly non-existent, state regulations are lax and rarely enforced, and because the states give away millions in tax abatements and other perks - while requiring virtually nothing in return.  Such companies aren't interested in pushing the envelope with innovative, value-added products & services.  They're interested only in keeping operating costs low.  By and large, they produce only commodity products.  And they compete based on price alone.  They're not likely to evolve anytime soon.

            By and large, the kinds of economic forces you're describing are happening only in the blue states - home to companies & industries that produce innovative, value-added products & services that actually compete on the basis of quality - not quantity.  Those are the kinds of enterprise that value education and creativity.  IMO, they are the only kinds of companies & industries that are even subject to the kinds of economic pressures you've indicated.

            All that is necessary for the triumph of the Right is that progressives do nothing.

            by Mystic Michael on Fri Apr 11, 2014 at 03:31:50 PM PDT

            [ Parent ]

        •  I think you're thinking too logically (0+ / 0-)
          Think of the email conversations, the #FaceCrack postings, the Reddit forum postings... where Red Staters find THEIR TAX DOLLARS are paying so even poor folks in blue states have healthcare insurance, but their Republican Governors have denied them access to it?
          you're more likely to see red staters angry their tax dollars are paying for poor folks in blue states and thank God their Republican governor isn't doing the same. If only there were 50 like him.
      •  Medicaid is already kind of like that. (3+ / 0-)
        Recommended by:
        paulex, Shockwave, weneedahero

        A bunch of Blue States try to cover everything the Feds will match, a bunch of Red States try to cover as little as the law will allow.

        Is it "Gordon Gecko Democrat" week here at Dailykos?

        by JesseCW on Fri Apr 11, 2014 at 01:59:35 PM PDT

        [ Parent ]

      •  The ACA is already multi-tiered... (0+ / 0-)

        Platinum, Gold, Silver, and Bronze.  Shouldn't we all have Platinum coverage?

    •  Vermont can't actually do it untill they get (0+ / 0-)

      the waiver.

      Hasn't happened yet.

      Is it "Gordon Gecko Democrat" week here at Dailykos?

      by JesseCW on Fri Apr 11, 2014 at 01:55:52 PM PDT

      [ Parent ]

    •  Local plans is how Canada got Single Payer (0+ / 0-)

      Great history on how it swept the country, here.

      As Vermont Goes, So Goes the Nation? - NYT

      "Work for something because it is good, not just because it stands a chance to succeed." -- Vaclav Havel

      by greendem on Fri Apr 11, 2014 at 04:39:30 PM PDT

      [ Parent ]

    •  California has been trying for years to figure out (1+ / 0-)
      Recommended by:

      how to do it.  Now that we have kicked the rethuglicans to the curb we just might do it.

      We are not powerless!! "Activism is the rent I pay for living on this planet."– Alice Walker

      by nocynicism on Fri Apr 11, 2014 at 04:42:15 PM PDT

      [ Parent ]

    •  some observations from a Caifornian (0+ / 0-)

      1 - Ca, or at least San Mateo County, has a very effective Community Health center system. We should be praising it to the skies.
      2 - the only reason CA doesn't have single payer is because 4 assemblymen (were bribed) to miss the vote.

  •  Vermont's not out of the woods yet (21+ / 0-)

    there are challenges still ahead, mainly with the funding mechanism, as Kliff's piece points out.  Right now Vermont raises $2.7 billion in tax revenue each year; according to the piece, $2 billion will need to be raised to fund Vermont's single payer system.  

    As Kliff notes in the article, speaking of the experience of William Hsiao who is consulting Vermont and has worked with 10 governments around the world to set up single payer systems, "Only half of those bills actually become law. The part where it collapses is, inevitably, when the country has to pay for it."

    And there's the cost angle.  While Canada pays way less than the US, the piece notes that Shumlin

    "sees Canada more as a cautionary tale than an inspiration. The government has found it increasingly difficult to pay for its health-care system, which has grown from 7 percent of the economy in 1975 to 11.4 percent in 2011. Over the same time period, Canada’s system has grown to rely slightly more on private funding, asking citizens to pay a bit more of their overall costs.

    "The problem is they haven’t gotten costs under control," Shumlin says. "They’ve got a publicly financed system that is on steroids sucking up dollars because it relies on the same failed fee-for-service model as American health care. I believe we’re going to have to come up with our own way of doing this in America."

    A lot is at stake in Vermont.  Because if Vermont can get this right, if they can actually get the funding set up and then see major cost reductions, there will be a very strong case to make for doing single payer in more states and nationwide.

    I know I'm pushing and wishing and praying hard that Vermont gets this done and gets it right.  As Vermont goes, so goes the nation hopefully.  

    "Those who have wrought great changes in the world never succeeded by gaining over chiefs; but always by exciting the multitude." - Martin Van Buren

    by puakev on Fri Apr 11, 2014 at 12:17:48 PM PDT

    •  Two points: (13+ / 0-)

      1) What do the residents of VT now pay for private health insurance? That is the money pool to use. Since government single payer has much lower overhead than private insurance companies, they should be able to cover everyone at around the same cost. Hell...even if it costs more, it's worth it to cover everyone.

      2) This is important:

      " relies on the same failed fee-for-service model..."
      Single-Payer is not the final answer. What we actually need is full socialized medical care, where the hospitals and clinics are actually owned by the government, and doctors and other health-care professionals are payed a salary, not on a per-service basis. Like the VA is now, but for everyone, not just military vets.

      "If you lose your sense of humor, it's just not funny anymore" Wavy Gravy

      by offgrid on Fri Apr 11, 2014 at 01:07:22 PM PDT

      [ Parent ]

    •  As goes Maine, so goes Vermont. (4+ / 0-)

      The mantra in the 1930s was "as goes maine, so goes the nation" given that ME was viewed as a bellwether state. In 1936 however, Maine and Vermont were the only states to vote Republican, and the phrase was changed "as goes Maine, so goes Vermont."

    •  that's another part of the delay (11+ / 0-)

      kos rather glibly pins it on compliance with the ACA, but there is a ton of work still undone to get single payer up and functioning. In short, there is no way it could have been put in place by now. We had a worse website roll out than the federal exchange; small businesses still can't pay online, more than six months on. We don't have a financing mechanism yet, and that's kind of a biggie. Provider compensation is up in the air, and I am hearing that a number of physicians are looking at leaving the state because they think they'll be working for a lot less if they stay. That is not a good omen, and though the MDs here tend to skew rightward, and thus tend to be blowhards about such things, I can see that the uncertainty could be cause to at least keep options open.

      Democrats in our state leg have started making noises about 'alternatives' to SP, or multi-year delays, and the few vestigial republicans we have are sounding triumphant (they don't get much of that here, but I still begrudge them).
      No, Vermont is not out of the woods yet. What surprises me is there still seems to be no outside interference like Koch money gumming up the works.

      Last full month in which the average daily temperature did not exceed twentieth-century norms: 2/1985 - Harper's Index, 2/2013

      by kamarvt on Fri Apr 11, 2014 at 01:08:34 PM PDT

      [ Parent ]

  •  it is not clear (to me at least) wether this (0+ / 0-)

    single-payer has to continue to operate within the ACA exchange. In a true single-payer system there would be no need for an exchange as there is only a single plan that covers everyone. Seems this may require more federal legislation to allow them to eliminate the exchange

  •  I see it unfolding differently... (9+ / 0-)

    I think there will be pressure to allow Medicare to be a provider in the exchanges before we see single payer. No way insurance companies can match Medicare's low overhead, but it will be fun to see the Republicans try to argue that big government is wasteful and inefficient while trying to keep Medicare out of the exchanges. Clearly something as bloated as a government program couldn't possibly compete with the Invisible Hand of the Marketplace, no? So why not let them compete? It might force Medicare to become lean and mean like WellSource!! ;-)

  •  O-Care --) O-Care + public option --) Single payer (4+ / 0-)
    Recommended by:
    ferg, Angie in WA State, paulex, Shockwave

    that's the trajectory. It's why the GOP fought the 1st step so hard.

    -1.63/ -1.49 "Speaking truth to power" (with snark of course)! Follow on Twitter @dopper0189

    by dopper0189 on Fri Apr 11, 2014 at 01:04:26 PM PDT

    •  I don't think it works that way. (2+ / 0-)
      Recommended by:
      JesseCW, Shockwave

      Public option could lead to single payer, if enough consumers chose the public option. The public option was absent from Obamacare, and I don't see it being added there anytime soon. If Obamacare proves to be controversial as it is now, no one will ever want more government involvement. If it proves to be a success, there won't be any reason to overhaul it significantly.

      •  I think your wrong (2+ / 0-)
        Recommended by:
        Shockwave, bananapouch1

        I see an early buy in for Medicare as a 1 step. I could see saying letting the poorest 30-50% of people buying into Medicare at age 50 as something insurance companies might support (they may see them as the biggest cost). If you charged them 2% over Medicare's cost you could do it by reconciliation in a Democratically controlled Congress. Maybe that happens in 6-8 years.

        Then eventually that gets expanded.

        I like to point out to people It was 20 years between Truman's military desegregation order in 1948 (the start of the modern civil rights movement) and 1968 when the final major civil rights bills was signed. 20 years!!!

        That's what keeping hope alive means. Look at the the 3 backlashes it with stood in the 50s, 60s, 70s, so yes we can stand down the Tea Party.

        -1.63/ -1.49 "Speaking truth to power" (with snark of course)! Follow on Twitter @dopper0189

        by dopper0189 on Fri Apr 11, 2014 at 01:48:52 PM PDT

        [ Parent ]

        •  You didn't have one party against civil rights. (0+ / 0-)

          Southern Democrats were racists, but not the entire Democratic caucus was, and most Republicans supported civil rights. Here, you have any situation where one party (that happens to have a majority in the House) is against any type of health care reform, and wants to roll it back as much as possible. In these circumstances, I don't see the country expanding health care. Heck, I would be surprised if reform wasn't attacked successfully in the coming years, much like the abortion restrictions which don't fully ban the procedure but make it as hard to obtain as possible.

          Whether, once the dust settles, there will be any appetite left for any public option/single payer is an interesting question. I wouldn't expect it to be a mainstream position with the Democratic party though.

  •  Sounds like Vermont is overdue (1+ / 0-)
    Recommended by:
    Angie in WA State

    one of those Executive Waivers :)

    I hope that the quality of debate will improve,
    but I fear we will remain Democrats.

    Who is twigg?

    by twigg on Fri Apr 11, 2014 at 01:24:18 PM PDT

  •  The title. (3+ / 0-)
    Recommended by:
    Pluto, paulex, Shockwave

    I've thought this very thing many times. And I wonder how much of the ACA is meant as a stepping stone to single payer.

    "Non-violence is a powerful and just weapon which cuts without wounding and ennobles the man who wields it. It is a sword that heals." - Martin Luther King, Jr.

    by Gentle Giant on Fri Apr 11, 2014 at 01:24:55 PM PDT

  •  Vermont doesn't even have an actual plan yet (0+ / 0-)

    What they have so far is an unfinanced fantasy.

    The reality is that (1) single payer is not a panacea and (ii) it is not popular in the United States.

    Politics in America is an incremental game. We would do better to take a lesson from President Obama and move the ball forward incrementally.

    So, what is the next, incremental step that we can take to improve Obamacare?

  •  Hmmmm (0+ / 0-)

    I'm always suspicous of "Give 'em enough rope to hang themselves" strategies.  Only ver rarely, it seems to me, do things get better by getting worse.

    "The extinction of the human race will come from its inability to EMOTIONALLY comprehend the exponential function." -- Edward Teller

    by lgmcp on Fri Apr 11, 2014 at 01:30:51 PM PDT

  •  Please! (2+ / 0-)
    Recommended by:
    Kentucky DeanDemocrat, Shockwave

    I keep hoping for single payer.

    Maybe not in my lifetime, but my son's, or grandchildren's lifetime.

    "People should not be afraid of their government; governments should be afraid of their people." --V

    by MikeTheLiberal on Fri Apr 11, 2014 at 01:34:34 PM PDT

  •  Single payer is the final destination (2+ / 0-)
    Recommended by:
    Kentucky DeanDemocrat, paulex

    Obamacare is a step in the right direction.

    In 2009 it became clear that the healthcare system we had was NOT the best in the world.  The ACA was all that could be done in the dysfunctional DC.

    It's now up to the states.

    Vermont leads.  

    Massachusetts in 2012 tried something very interesting;

    Massachusetts Senate Vote on Single Payer Health Care Amendment


    Amendment #125 would have committed Massachusetts to comparing, each year, its actual health care costs with the costs it would face under a single payer plan, and if after several years the ‘single payer benchmark’ proved more cost-effective for better access to care, the state would submit a single payer implementation plan to the state legislature for approval.
    And in California, the single payer movement will become very visible again next year.

    Daily Kos an oasis of truth. Truth that leads to action.

    by Shockwave on Fri Apr 11, 2014 at 01:38:02 PM PDT

  •  I've been saying this ... (2+ / 0-)
    Recommended by:
    paulex, Shockwave

    ... ever since the bill was being debated.  Just ask anyone!

    Well, anyone who remembers me saying this, that is.

    Kos, I couldn't agree with you more.  I've thought it would take a long time for enough Americans to get disenchanted with the inefficiency of the for-profit model of health insurance, and look for an alternative.

    But you may be right.  And the sooner we get to single-payer, the better.

    "Equal rights for gays." Yeah, it's just that simple.

    by planmeister on Fri Apr 11, 2014 at 01:42:20 PM PDT

  •  Whoever controls the appointment of the Sec HHS (2+ / 0-)
    Recommended by:
    paulex, Shockwave

    post-2017 controls whether there will be any State-Level Single Payer waivers.

    Is it "Gordon Gecko Democrat" week here at Dailykos?

    by JesseCW on Fri Apr 11, 2014 at 01:54:35 PM PDT

    •  True. We'll see what Sylvia Mathews Burwell says (2+ / 0-)
      Recommended by:
      greendem, JesseCW

      She is a super wonk.  Her previous association with the Walton and Gates foundations concerns me.  But the "state waiver" is in the law.

      Daily Kos an oasis of truth. Truth that leads to action.

      by Shockwave on Fri Apr 11, 2014 at 02:57:07 PM PDT

      [ Parent ]

      •  OMB has been anti-progressive (1+ / 0-)
        Recommended by:

        Under Obama.

        Lots of good environmental rules have died there.

        That should make us cautious.

        "Work for something because it is good, not just because it stands a chance to succeed." -- Vaclav Havel

        by greendem on Fri Apr 11, 2014 at 04:36:30 PM PDT

        [ Parent ]

      •  No waivers 'till 2017. It won't be her. (0+ / 0-)

        The "state waiver" is in the law, but it's HHS that decides that if a proposed state change is really just as expansive/complete in coverage as the vanilla ACA exchange model.

        If we've got a Republican President, any Single Payer attempt is going to have to go through the SCOTUS.

        Is it "Gordon Gecko Democrat" week here at Dailykos?

        by JesseCW on Sat Apr 12, 2014 at 04:47:07 AM PDT

        [ Parent ]

  •  Single Payer is not the only destination... (2+ / 0-)
    Recommended by:
    Shockwave, Tony Chew

    ... France, Germany and Belgium have two-tier systems that combine government-subsidized care with supplemental private insurance.

    There's a good 2011 article in The Guardian comparing them to Great Britain's NHS.

    Each country is a little different. In France, for example, the patient pays the doctor and gets reimbursed by the state within a few days. The patient is the "the customer" and as a result gets excellent service.

    American conservatives would heartily approve of that angle.

    I expect that GOP will eventually stop agitating for "repeal" and switch to "reforms"... market-oriented, of course. Conservatives in Europe have never stopped trying to tinker with national health care policies, despite the long tradition of "socialized" medicine.

    “It is useless to attempt to reason a man out of a thing
    he was never reasoned into” - Jonathan Swift

    by jjohnjj on Fri Apr 11, 2014 at 02:42:01 PM PDT

    •  The Single Payer movement in the US... (0+ / 0-)

      ...has been going on for 30 years.

      Certainly Taiwan and Canada are the best examples but however different all single payer systems are they have much in common and we are aware of all these differences.

      Watch California lead next year.

      Daily Kos an oasis of truth. Truth that leads to action.

      by Shockwave on Fri Apr 11, 2014 at 02:59:45 PM PDT

      [ Parent ]

      •  longer (0+ / 0-)

        The Wagner Bill evolved and shifted from a proposal for federal grants-in- aid to a proposal for national health insurance. First introduced in 1943, it became the very famous Wagner-Murray- Dingell Bill. The bill called for compulsory national health insurance and a payroll tax. In 1944, the Committee for the Nation’s Health, (which grew out of the earlier Social Security Charter Committee), was a group of representatives of organized labor, progressive farmers, and liberal physicians who were the foremost lobbying group for the Wagner-Murray-Dingell Bill. Prominent members of the committee included Senators Murray and Dingell, the head of the Physician’s Forum, and Henry Sigerist. Opposition to this bill was enormous and the antagonists launched a scathing red baiting attack on the committee saying that one of its key policy analysts, I.S. Falk, was a conduit between the International Labor Organization (ILO) in Switzerland and the United States government. The ILO was red-baited as “an awesome political machine bent on world domination.” They even went so far was to suggest that the United States Social Security board functioned as an ILO subsidiary. Although the Wagner-Murray-Dingell Bill generated extensive national debates, with the intensified opposition, the bill never passed by Congress despite its reintroduction every session for 14 years! Had it passed, the Act would have established compulsory national health insurance funded by payroll taxes.
        (and the history goes back to before that)
    •  More complex than most want to admit (0+ / 0-)

      While I think most of us readlily admit that Europe's solutions to the Healthcare morass are obviously more humane and effective, I don't think most understand the variety of solutions being used. The Guardian article is fascinating and only covers a handful of countries near the UK. I want public options, I want guarantees of coverage for all Americans, but I am not convinced that a single payor solution is clearly the best solution yet. I think  that the AFA can itself evolve and gets stronger and better over time if we look at the rest of the world.

    •  In addition to the Guardian article (1+ / 0-)
      Recommended by:

      see this page from the Frontline site (from a book by T.R. Reid) describing types of programs worldwide

  •  We MUST elect Don Berwick in Mass! n/t (0+ / 0-)
  •  ACA helps people focus on effeciency (1+ / 0-)
    Recommended by:

    Eventually they will start to ask, "Why are we paying 20% overhead to private insurers when we could run a state-run program for 4-6% overhead. I don't want my healthcare dollars going to CEOs or shareholders."

    Making everyone see how Big Insurance rips us off, by putting dollar amounts on the exchange website was part of ACA's brilliance.

    "Work for something because it is good, not just because it stands a chance to succeed." -- Vaclav Havel

    by greendem on Fri Apr 11, 2014 at 04:34:22 PM PDT

    •  They Have to Be Told (0+ / 0-)

      Americans aren't going to think that all by themselves. They need to be organized. In fact they tend to think the opposite, because they're organized by CEOs to think CEOs will give them good service and government is the problem. There is a whole Republican Party, and lots of the Democratic Party, telling them that.

      "When the going gets weird, the weird turn pro." - HST

      by DocGonzo on Fri Apr 11, 2014 at 05:41:37 PM PDT

      [ Parent ]

  •  if we get to (0+ / 0-)

    single payer it won't be because the dems are aggressive in pushing for it, the republicans pushing back too hard against any healthcare at all will be the vehicle, too bad we don't have a party worthy of our nations needs on either side of the aisle.

    save america defeat all republicans and conservatives

  •  Single Payer Will Be Private Monopoly (1+ / 0-)
    Recommended by:

    Yes, we probably will get single payer eventually.

    But the single payer will be "privatized". It will be a private monopoly on healthcare finance. It will be a bank. Or it will be like the Federal Reserve: a banking monopoly made of all the banks in a cartel. Same difference.

    Unless we insist on Medicare for All. Now.

    No more word games. No more "reasonable" Democrats joining with insane Republicans to give us the last generation's "reasonable" Republicans' health finance system.

    Just Medicare for All. Now and forever.

    "When the going gets weird, the weird turn pro." - HST

    by DocGonzo on Fri Apr 11, 2014 at 05:27:43 PM PDT

    •  I spent Nov '08 to Mar '10 with these 11 dimension (1+ / 0-)
      Recommended by:

      arguments ... holding my nose, believing few to none of them.

      Obama & Clinton & all the DLC'ers - THEIR ENTIRE CLA$$ - they've proven over and over and over that they are NOT on my side.

      What really sticks in my craw is that I voted FOR the lying fuckers for decades, cuz they were gonna make stuff work -

      yeah, they made stuff work - their highly paid cushy jobs leading us sheep around by the nose.


      Yond Cassius has a lean and hungry look; He thinks too much: such men are dangerous

      by seabos84 on Fri Apr 11, 2014 at 07:37:22 PM PDT

      [ Parent ]

  •  Ummm, We have Universal Healthcare in SF (0+ / 0-)

    Set up Healthy San Francisco in about 3 years. And that was pre-ACA, with huge business push-back all the way to the Supreme Court and many more hoops to jump thru.

    We funded it mainly by rationalizing (not rationing) existing HC assets and Fed/St/Local HC funding into one HC plan. You would be surprised how many dollars and assets there are already in place - it is NOT a zero sum game.

    Plus scaled member premiums similar to the ACA w/subsidies, but cheaper. Also a requirement that all businesses with 20+ employees provide HC or be taxed. Plus we assumed a lower overall cost due to everyone having a local medical home/doctor, reducing emergency room visits and getting preventive care.  

    The big investment was in getting it setup, as with any business. And it has worked for the last 7 years. 85+% of the uninsured covered, 95% member satisfaction rate, costs BELOW budget.

    Healthy SF is being largely superseded by the ACA, as it is not technically health insurance and thus people are being moved off it to MediCal or Covered CA. However it is still in place mainly for immigrants and anyone who falls thru the ACA cracks.

    Every human being has a right to healthcare.  Keep fighting!

  •  Our song of the day (0+ / 0-)

    should be Saskatchewan based . I'll start writing "Take Me Back to Saskatoon" tonight. Should be a big hit in about 5 years...

  •  There is a road to SP through successful ACA (0+ / 0-)

    And I'm not saying it will happen, but it seems within the realm of non-zero probability:

    What if people woke up and said, "hmmm, my tax dollars are going to support my fellow American's health care. And ya know, that's actually ok. It means I have more security in life, and so do the people I care about. But why are my tax dollars supporting the health insurance companies?  Nope, that part I don't get. We should keep this new feature of not facing bankruptcy due to illness, but we should stop sending our tax dollars to Aetna by subsidizing its customers from them."

    Now, how could we do that?

    Just like Obama took the banks out of federal student loans.

  •  We have gotten to the point... (1+ / 0-)
    Recommended by:

    where efforts to advance the Republican/conservative platform are self-defeating, almost in a 1-to-1 ratio.

    Gay marriage is the clear example of this.  Courts are overturning gay marriage prohibitions regularly these days---seems like once a week to the casual observer; not one, to my knowledge, has survived an appeal to federal court.  It's only a matter of time one of these will show up at SCOTUS, by which time the legality and protected status of gay marriage will have been all but established in this country's jurisprudence.  Would never have been the case if all those states hadn't banned gay marriage by constitutional amendment back in 2004.  

    Similarly, the more these cracker states push for religious freedom laws, to allow businesses to discriminate against homosexuals because they want to, and the more the same states push to restrict voting rights, the closer we get to having sexual orientation granted protected status under the 14th amendment and federal standards for voting.  

    More than 10 million people have health insurance today solely because of the Patient Protection and Affordable Care Act of 2010.  This law is not going away...ever.  The more conservatives fight the law, the closer we come to a right to health care and single payer.

  •  You'd have to prove that single payer (0+ / 0-)

    would topple existing structures on a state by state basis?  I mean, if Vermont gets it, and Vermont has a great system, will that make other states have it, and therefore, a domino effect?  Because otherwise I don't see how this works out Kos.

    "Hatred is never appeased by hatred in this world. By non-hatred alone is hatred appeased. This is a law eternal."

    by sujigu on Fri Apr 11, 2014 at 10:58:32 PM PDT

  •  Expect some of the billions in corporate welfare (0+ / 0-)

    to the insurance companies to be used to buy off politicians and fight any move to single payer every step of the way.  In our corrupt society, money speaks louder than any kind of public sentiment.

    Hillary does not have the benefit of a glib tongue.

    by The Dead Man on Sat Apr 12, 2014 at 05:17:11 AM PDT

  •  Let's look at one fundamental flaw (of many) (0+ / 0-)

    ERISA employers will have to pay twice - once for third party insurance and once for GMC. I use the term "have to" loosely, as many employers in this boat could easily pull up stakes. Ask anyone who has lived in VT for a while what an IBM and/or Ben & Jerry's exodus would do to the state.

    I personally believe that Republicans are quietly cheering on VT's efforts, because they have almost no chance of succeeding if enacted. That would be death to national single payer, which probably COULD work.

  •  Is there a math person who can do an estimate... (0+ / 0-)

    on the amount of money going into the domestic economy through a national single payer option?
    A ballpark amount would be great.

    There will still be money flowing to Big Pharma if we can't negotiate on script prices. If we ever started manufacturing scripts already out of proprietary protections, we would even more jobs created and the money kept here. Competition on this idea is already tough and I am not sure we could move jobs and development here. We still have extremist pols here who would block such a development for their paying buds in Big Pharma.

  •  Gee, if they really did ... (1+ / 0-)
    Recommended by:

    Republicans, and their Tea Party and Libertarian allies, talk about letting people keep more of their money - less interference and controls over them. Well - if that's true - how about getting rid of one of the main reasons that people are DYING ... killed by the CARTEL known as Health Insurance Companies.

    Can any among you give me a good reason as to why we need to pay insurance companies for the right to gain reasonable access to health care?  Insurance companies do not insure your health - that's an oxymoron. It's more like they assure your misery and anguish.

    Wake up folks. Get rid of health insurance companies and the Republicans - Tea Party and Libertarian folks who support them.

    Oh - and boycott AARP - they are no more than a front for one of America's biggest health insurance companies.

    •  Yeppers. (0+ / 0-)
      Oh - and boycott AARP - they are no more than a front for one of America's biggest health insurance companies.
      AARP started coming after me about 10 years ago.  I declined.  Then they closeted themselves with Big Insurance during the creation of Obamacare and I patted myself on the back for getting their number early on.

      Now, not a month goes by that I don't receive a "pre-approved" card from AARP.  If that's not a big business tactic, I don't know what is.  

      And every new card gets cut up and thrown away while most of the paper goes to recycling.  I do stuff the pre-paid envelope and mail it back to them.  Let them pay for the postage both ways.  Maybe they'll stop the constant barrage of mail if enough of us do it?   - - - - Nah.  We couldn't be that lucky.


      The price of apathy is to be ruled by evil men - - Plato . . . . . . . . . . . . . . . . . . . . We must be the change we wish to see in the world - - Mohandas Gandhi

      by twocrows1023 on Sun Apr 13, 2014 at 06:33:43 AM PDT

      [ Parent ]

  •  Hoist by their own petards. (0+ / 0-)

    The GOPT never learns.  They do just keep cutting off their noses to spite their faces.  

    I agree with you that they've really put their foot in it this time.  They've cried stinking fish over Obamacare so many times that it's only logical that someone, someday, will finally say, "OK, they can't scream any louder than they are already doing so we might as well get a GOOD program while we're about it."  Then bye-bye insurance companies.  And good riddance.

    The price of apathy is to be ruled by evil men - - Plato . . . . . . . . . . . . . . . . . . . . We must be the change we wish to see in the world - - Mohandas Gandhi

    by twocrows1023 on Sun Apr 13, 2014 at 06:39:48 AM PDT

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