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.
Director of Organizing