By: Ethan Parke, VT for Single Payer, Supporter

The federal health care legislation that is about to become law does more harm than good and should be scrapped. That is the position now taken by the Physicians for a National Health Program. It’s also the position of the executive director of the nation’s largest nurses’ union, National Nurses United. Even former Vermont governor Howard Dean supports this view.

With our new president and a Democratic super majority in the U.S. Congress, how did we get to such a dismal state of affairs? Is there any hope for meaningful health care reform?

Some would say the prospects for a U.S. single payer plan, the system of health care financing successfully used by most of the developed world, are dimming. This despite overwhelming evidence that it’s the best way to control costs and to provide health care to all citizens. Unfortunately, Congressional leaders and the Obama administration, from the very beginning of the 2009 federal legislative process, declared that single payer was “off the table.” Instead, the Democratic leadership started with the idea of a meager “public option,” which would have covered only 2 percent of non-Medicare beneficiaries by the year 2019, leaving the rest of us to the mercy of the private insurance market (source: Congressional Budget Office).

Having started from a severely compromised position, the Democrat-controlled Congress then proceeded to make major concessions—to the insurance and pharmaceutical industries, and to the Republican minority, which wanted no reform plan at all. An individual insurance mandate—without a public option—was the insurance industry’s top priority, and the Congress delivered it. The mandate will give insurance companies millions of new customers by forcing the uninsured to buy private policies or be subject to fines. At the same time, the Congress failed to control the price gouging and predatory claims denial practices of the insurance industry, meaning that too many people, even with government subsidies, will face impossibly expensive out-of-pocket health care expenses.

Health care “reform” that strengthens the worst aspects of a dysfunctional and inhumane system, and that pours taxpayer money into the coffers of private industry, while ignoring the opportunities for cost control through direct public financing of health care delivery, is no reform at all. Although the federal legislation by 2013 or 2014 may help some Americans buy insurance through “purchasing exchanges,” it is a law that does much harm and may set back the momentum for change at the federal level for years to come. The new reality is that millions of Americans will be forced to buy insurance products that are inadequate and over-priced. Hundreds of billions of dollars will be channeled into notoriously inefficient and wasteful private companies, rather than into health care for people.

In my view, the hope for meaningful health care reform now turns to the states and to the grassroots. The California legislature has twice passed a single payer bill that has been vetoed by Governor Schwarzenegger. Vermont has a single payer bill waiting for legislators’ consideration. Pennsylvania and many other states are moving in the same direction. The push for state-level reform will come from physicians, nurses, and businesses, and from the masses of people disaffected and disillusioned by the false promises of the federal legislation.

It is therefore up to all of us, working with our legislators, to see that state single payer is taken seriously. The single payer bills in the Vermont House and Senate are starting points. They are the bare bones of a single payer mechanism. Because state single payer has never been tried, there are lots of questions about how the program would fit with Medicare and Medicaid and within our existing health care infrastructure. Much needs to be done to work out the details and to make sure that Vermont can accomplish what the federal government has not. Let the deliberations begin!