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Aspiration is Not Enough

Not Single-Payer in Vermont

by RUSSELL MOKHIBER

Look at the headlines that came out of Vermont last month.

CBS News: Vermont Governor Signs Single Payer Health Law.

Democracy Now: Vermont Governor Signs Single Payer Health Law.

Kaiser Health News: Shumlin Signs Vermont’s Single Payer Law.

Here’s the problem:

It’s not single payer.

Not even close.

Physicians for a National Health Program (PNHP) was onto the Vermont bill early.

On April 7, the group put out a press release titled:

Vermont Bill Mislabeled Single Payer.

But PNHP’s criticism of the bill was muted.

After all, one of PNHP’s own ? Dr. Deb Richter ? was taking the lead in Vermont to get the bill passed.

But single payer activists ? not happy with the Vermont result ? are now coming out of the closet.

"Single-payer activists need to be honest," Chicago single payer activists Helen Redmond told Single Payer Action last week. "The law signed by Gov. Peter Shumlin is not single-payer."

"Not even close."

Redmond says that even the phrase "single payer" was "stripped out early on during ‘sausage making’ sessions."

"Single payer means one payer, like Medicare and the VA," Redmond said. "One source paying the bills, not several. The Vermont law continues to allow private insurers to operate in Vermont indefinitely. That’s why the insurance industry vampires didn’t declare total war on Shumlin and the Green Mountain Care ‘universal’ health care program because they’ve still got a ton of skin in the game."

Redmond said that the bill only declares "an intention or aspiration: to provide health care for all Vermont residents ? "six years down the road, when by the way, Shumlin will no longer be in office."

"Aspirations and intentions are not good enough," Redmond said. "We need health care as a human right now. 45,000 Americans die every year because they lack access to health care."

And Redmond questioned whether moving for single payer at the state level is a realistic strategy.

"The deck is stacked against passing single-payer at the state level because of a complex series of federal programs, laws and regulations and the savvy, we-can-wait-‘em-out, insurers understand this," she said. "Vermont and any other state that attempts to pass single-payer must obtain waiver after waiver allowing them exemption from federal constraints. The powers that be inside the beltway will not grant these waivers. Remember, they take a lot of cash from the insurance and pharmaceutical industries to ensure their financial health."

"When it comes to state single-payer initiatives, activists have to think strategically and ask themselves, ‘Is this the fight that we need to have?’ Fights over waivers and ERISA, or a nationwide fight to win a single-payer system for the entire country?"

"In my opinion, it’s better to have a fight for national legislation like H.R. 676 as proposed by Rep. John Conyers that really does create a single-payer system and abolishes the private insurance industry than to have a fight over a piece of state legislation with no funding mechanisms, is riddled with numerous bureaucratic roadblocks and makes vague promises to enact what the majority of people want ? health care as a human right for all."

"There is no short-cut to a national single-payer health care system and politicians with the best of intentions will not gently enact it. There is no way to avoid a head on collision with the parasitic, for-profit insurance industry to put them out of business once and for all. Let’s stay on that road."

Russell Mokhiber edits Single Payer Action.