Vermont Becomes First State to Enact Single-Payer Health Care

The law signed by Gov. Peter Shumlin will extend coverage to all 620,000 Vermonters

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Historically, Vermont does two things best: maple syrup and progressive politics. The nation's leading producer of the popular waffle-topping today became the nation's only provider of single-payer health care for all. Earlier this afternoon, Vermont governor Peter Shumlin signed into law a plan meant to transform the private-run health insurance industry into a the nation's first government-funded, government-run health care system that offers a uniform benefit package to every eligible resident. The first phase of the law will extend coverage to all 620,000 Vermonters through the option to participate in the state health benefits exchange called Green Mountain Care, which Reuters reports, "will set reimbursement rates for health care providers and streamline administration into a single, unified system." Per a federal mandate (read: Obamacare) the exchange will offer coverage from private insurers as well as state-sponsored and multi-state plans. The plan also calls for tax credits to make coverage affordable for low-income residents.

Howard Dean is flipping out right now. But probably in a good way. After all, the last time Vermont garnered national attention for health care was 2004 during his presidential bid. Dean had made some assertive moves towards a single-payer system by expanding public insurance eligibility with measures that would alter be adopted by Obama's health care reform legislation. But as Dr. David Gratzer indicates in a Wall Street Journal op-ed, Dean's attempt to level the playing field for policy pricing had little effect on the number of uninsured in the state. Even worse, accelerating health care costs for the state actually accelerated even faster. Perhaps as a result Shumlin placed cost containment at center stage in his new, methodical and very drawn out plan. With the deadline for the first financing plan to be delivered to legislators by 2013, Green Mountain Care would likely not make an appearance until 2014.

Based on Amy Goodman's read of today's ground-breaking legislation, the fact that Vermonters will have to wait a little longer is hardly the point. After listing Vermont's historic firsts--the first to ban slavery in their 1777 constitution, the first state to shutter a nuclear power plant in the name of environmental policy, the first state to legalize same sex unions--she points out that precedent shows how the Green Mountain State's bold move will reverberate throughout the country:

Vermont has become an incubator for innovative public policy. Canada's single payer healthcare system started as an experiment in one province, Saskatchewan. It was pushed through in the early 1960s by Saskatchewan's premier, Tommy Douglas, considered by many to be the greatest Canadian. It was so successful, it was rapidly adopted by all of Canada. (Douglas is the grandfather of actor Kiefer Sutherland.) Perhaps Vermont's healthcare law will start a similar, national transformation.

Goodman also tempers fears about the cost laid out by Gratzer in his op-ed. Under the advice of Harvard economist William Hsiao, a single payer system like the one signed into law today "will produce savings of 24.3% of total health expenditure between 2015 and 2024." Shumlin pointed to the fiscal underpinnings of the state's health care reform but said firmly that it meant more than that. "We have a moral imperative to fix this problem, with 47,000 Vermonters uninsured and another 150,000 underinsured and worried about how to afford keeping their families healthy," he said.

This article is from the archive of our partner The Wire.