SHUMLIN’S BILL: The Glass Is Half Full

By Ethan Parke

March 10, 2011

John Walsh, writing in Dissident Voice, a radical blog based in Santa Rosa, California, has delivered a scathing criticism of Governor Shumlin’s health care bill, claiming that its passage would not result in a single payer system in Vermont, and that therefore supporters are being hoodwinked.

Walsh is right that the bill is heavy on interim steps, such as the health care exchanges called for in the recent federal health care legislation. He is also right that many components of single payer (the financing mechanism being the most obvious) are left out of Shumlin’s bill. He’s also right that the bill gives a nod to “payment reform,” which could be interpreted to mean ACOs—a nebulous concept suspiciously like HMOs, which are currently all the rage among establishment health policy analysts.

But hoodwinked? No. Single payer activists in Vermont are fully aware that H.202 could be improved, and some advocates have been testifying to the very points made in Walsh’s commentary.

David Himmelstein’s pessimistic analysis, cited repeatedly by Walsh, is also not news to the leaders of Vermont’s single payer movement. Himmelstein’s indefatigable work for single payer at the national level has been extraordinarily helpful over the years. However, the Vermont single payer proponents have chosen to look at the Shumlin bill as a glass half full rather than half empty. In this light, the fact that not everything is spelled out in H.202 is an asset, not a liability.

Consider: If a financing package had been proposed this year, there is a good chance that the entire bill would be defeated. That’s because financing will inevitably stir a huge debate. And remember that Peter Shumlin was elected governor by a very slim margin. Better to have a framework in statute to begin with, and pass a financing package in a later year when more details of the system have been filled in and when Governor Shumlin has had more time to solidify a political base.

Consider: It’s a good thing that the benefit package, cost-sharing provisions, the health care budget, and many other details would be left to the new health care reform board. For anyone who has watched the Vermont legislature over the years ignore, obfuscate, water down, compromise, and/or destroy perfectly good health care legislation, a five-member board appointed by a governor who is a friend of single payer sounds like a breath of fresh air.

Finally, Walsh asserts that a less-than-perfect bill is a bad organizing tool. It would be if everyone was content to let it pass as is and go home. But the fight for single payer is a long haul, a very long haul. We are perhaps closer in Vermont than ever, but no one is breaking out the champagne. There are many issues remaining to be discussed and fought for. There are many strategic decisions still to be made and there will be plenty of criticism along the way, from the right and the left and everywhere in between. And so Walsh’s blog is no surprise.

Vermonters in favor of single payer are no dummies. We want H. 202 passed, and in the years to come we will fight for the other measures—the financing, the federal waivers, the global budgets—that will someday make single payer a reality.

9 Responses to “SHUMLIN’S BILL: The Glass Is Half Full”

  1. Dayle Ann Stratton says:

    During the Nixon era, his administration proposed a national health care program that went beyond anything proposed up to now. It was stalled by Democrats because they felt it did not go far enough. As I recall, they were after a true national single payer system similar to the programs in Europe. The proposal died, and the result was that we ended up with a regressive, profit driven, system that denied care to those most in need and drove health care costs up for middle income families. Please note that I am not, nor was I then, a Nixon supporter. But the fact remains that his proposal, had it passed, would have set the United States on a course that would have established the ground work for a truly equatable and workable national health care system. By now, it is even possible we would have a single payer system and be taking it for granted.

    The proposed Vermont system is not all I would like to see, but I support it fully. We have to start somewhere, and this proposal has been well-thought out in terms of the current situation in Vermont, and the potential for future adaptations as our experience in administering single payer grows. We can fiddle around trying to make something perfect before we implement it, but the fact is that that is not how things work. As with all things, we start with the best we have do at the beginning, and work from there.

  2. Ilse Raymond says:

    I worry about the paper work. I am on Medicare and receive so many papers in the mail every week or two that I can’t help but think, if it’s from the government it’s going to waste all that paper. And I am reasonably healthy and don’t go see a doctor very often!!!

  3. Ellen Oxfeld says:

    I totally agree that we should support H.202, because it is a roadmap to single payer. I am not sure, however, that Nixon ever proposed anything like single payer at all. As I remember, he was enamored of the HMO concept, which involved private insurers, and that is what they started to push. There is a scene in “Sicko” that deals with Nixon’s health care policies where Nixon actually talks about a plan he likes because it keeps private insurers in the game and is based on “free enterprise” in his words. But again, I may not be remembering this correctly.

  4. Frank Davis says:

    In the spring and summer of 1787, a convention met to deal with a national crisis. The plan of government as it existed, The Articles of Confederation, was failing. As a result the nation was failing. Without the courage to take some risk, to do more than tweak a failing system, we would not have the U.S. Constitution. There were those who opposed change. At present we have a serious health care crisis. It threatens to consume our economy and puts lives at unneccessary risk. There are those who oppose change in our own time, who only want to tweak a failing system. It is the time for bold action. The Constitution written in 1787 was not perfect, within four years ten amendments were added. There have been 27 amendments in total. The single payer proposal may not be perfect but it is time to show the courage of our forebears and move forward. If we stand still we shall surely sink in the mire.

  5. Malformed Disconnect says:

    I am not a Vermonter, but I am in this fight for Single Payer also.

    I am very cynical of attempts to implement Single Payer via creeping incrementalism. This is how we got Obamacare, so beware! (And, amazingly, there are still idiots out there who believe that Obamacare is the first step toward Single Payer. These are the same people who are confused by East v West, Left v. Right, etc.)

    As to the Constitution not being perfect when it was ratified, I have to laugh. It took 87 more years of human suffering to abolish slavery. Imperfect? Or more like Inhumane? The founding fathers were hardly enlightened, in my opinion. They were products of the same dark and insensitive society that coerced them to maintain the slavery system.

    Now we are engaged in another battle, this time being the legal doctrine that equates corporations with humanity. How long will that take — another 87 years perhaps? Can humanity wait that long?

    I am hardly impressed with the US federal constitution. It leaves out far too much.

    Suggestion: Vermont is the state that is farthest along in the fight to achieve Single Payer (although California could be too?). Do the rest of the country a big fat favor and get out to your state house and protest 24×7 until your legislators relent and give the People of Vermont what they need and deserve. Please. Do it for the rest of us, if not for yourselves. (Thanks ahead of time.)

    A legal and social construct like Single Payer will not occur organically.

  6. Robert M. Padilla says:

    I’m glad to see Vermont and California are working toward single payer health care systems. I’m told by a good friend, a very savvy and reliable lady, Mary Mcgill, California Association of Retired Americans, that a single payer health care system in CA could provide increased quality in health care while reducing costs. That kind of situation might possibly provide a boost for the state budget which might would allow us to free some monies to improve our educational system. And, health and education are the keys to our future.

  7. Mary Dillion says:

    Great Job Vermont! The Northeast is always ahead in their
    intelligent decisions. You have a great senator in
    Bernie Sanders.

    We envy you – we have a republican dictator in Ohio by the name of
    John Kasich, and he is ruining our state. Robbing from the middle
    class, and the poor giving to the rich corporations. Paying his
    staff huge salaries.

    Keep up the good work you set a fine example for the rest of the country.

  8. Richard green says:

    I am totally against this bill. Simple, to many unanswered question on how this bill will be payed. The cart infront of the horse. I have good insurance why should I go to a insurance that will cost me more. I earned may insurance. If I have to pay more I will leave this state.

  9. Those Republican-s are clueless as usual — not talking jobs, ignoring or denigratin-g Hispanic voters, discussing all the fringe issues — outside the mainstream-…Tera gold

Leave a Reply