Ben Day’s Response: Lessons from Vermont

December 19, 2014

Generally, I think my role at Healthcare-NOW is to support all of the great organizing work our affiliates do, and to work as closely as possible with our other national allies to advance this cause, and not to editorialize on our allies’ strategies, which are very contextual and vary both by region and constituency (labor, medical providers, community groups, etc). But I have to say, there are some crazy lessons being drawn from the Shumlin announcement.

He is very clearly bending to political pressures, not logistical ones. Do we really think that having Medicare & Medicaid cover seniors and the disabled makes it HARDER for a single-payer plan to cover everyone else if the state doesn’t get federal waivers, and that therefore state legislation is impossible? It actually makes it easier financially. Yes, this would be a 2-payer plan instead of a 1-payer plan, but a 1-payer plan exists in very few places – certainly not in Canada where every province has a separate plan, nor almost anywhere in continental Europe. The worst case scenario for state legislation is still incredibly good for patients, those who care for them, and payers.

I can guarantee you that federal enabling legislation for states will be no easier than passing federal single-payer legislation itself. Almost no meaningful legislation of any sort has passed in the last 4 years, and it will be worse the next 2-4 years. Hitching our cart to the Congressional wagon seems like a very poor decision given the elections we just lived through.

To me the lesson coming out of Vermont is that every state getting close to single-payer is going to see tremendous fight-back and opposition, and things will get much, much harder before they get easier. We saw this in Hawaii. We just saw a ballot initiative in California to regulate health insurance premiums – something that over 30 other states already do to little effect – and the opposition mounted an opposition campaign spending around $60 million to kill it. $60 MILLION! That’s just for inadequate regulatory oversight that we already have here in Massachusetts and no one cares about. We know single-payer threatens the profits of an extraordinarily powerful and wealthy segment of society, and Vermont is now a threat to them.

To me the option isn’t state vs. federal legislation – we HAVE to pursue both at the same time – the question is whether we support our allies in Vermont who are the first to face the full brunt of opposition, or fall to divide-and-conquer tactics. Sadly, Shumlin is currently deciding to put politics ahead of the conscience that has guided his career, and the story of why is all behind closed doors and we may never know it.

All of us will eventually have to face this level of opposition, and probably indecision or abandonment by some of our political leadership. When it happens we’re all going to need support from our allies around the country. Let’s start things off right by doing everything we can to win in Vermont – particularly since it isn’t Shumlin’s decision to make, and his job as Governor is to IMPLEMENT law passed by the legislature, not second guess or undermine it.


Benjamin Day

Director of Organizing


Cell: 617-777-3422


4 Responses to “Ben Day’s Response: Lessons from Vermont”

  1. David Himmelstein on December 19th, 2014 4:36 pm

    Ben incorrectly claims that the persistence of Medicare and Medicaid (as well as federal employees’ private insurance) as seperate plans is not problematic. Having more than one payer virtually precludes global budgeting of hospitals, which sacrifices much of the potential administrative savings that could be achieved through single payer. The fact that each Canadian province has its own plan is irrelevant – there is only a single payer in each province.

    States can make some progress on health care reform without federal enabling legislation, but we should not confuse that with the much greater steps possible with a true single payer.

  2. billshaver on December 22nd, 2014 9:27 am


    Each province is the adminstrator of its medical plan in that province, they run it with the insuarance ( assurance) companies they buy policies from, nothing marxixt about that. It is paid fror by revenues collected at tax time on the federal & provincial levels, both levels of govt work on this… nothing new….

    why not in usa…funny question… easy…but waiting for this enactment in usa is like watching paint dry….We need a man in washington & in state capitals with the smarts & know how..and backbone to do whats good for the people & not listen to lobyists…this is what i see happening in recent meeting around new york stste…its about time! A man none other than like NELSON Rockafeller…. He knew where to spend money for public good and was not shy about it….

  3. billshaver on December 22nd, 2014 9:35 am

    From Federal & state level…a two pronged attack on the profiteers…actually you wont defeat them rather its more expedient to work with them…they will still be in the picture with single payer, just you’ll hear less about them. costs will be bore out by tax hikes and the like. according to H.R 676 it’ll proballby be around 8-9 %, but then agin the fist few years after enactment it’ll climb to cover the many who have outstanding conditions and eventually costs will taper off, people will go in for regular check ups and avert many many manifested problems that result in death, E.R visits etc, etc…but it has to move forward and supplant the ACA.

  4. billshaver on December 22nd, 2014 10:11 am

    Another point of contention here on single payer. When somone gets deathly ill in usa and needs time in hospital, no doubt there are bills still to be paid by the person. If hes not working & in hospital or at home recovering …wheres his income comming from….also your portion of your bill from hospital will be 20% of the total cost over all…thats in the thousands of dollars too…in many cases i’ve seen people go into bankruptcy over this…seen people lose their homes & life savings for this…..not good, not fair at all….single payer will lessen this from happening…. cant have it soon enough.