By Louis Porter
September 11, 2007
MONTPELIER — U.S. Sen. Bernard Sanders, I-Vt., has introduced a bill that would give five states money to try out programs providing for universal health care coverage — an experiment he hopes will show that so-called single-payer government insurance is “the cost-effective and moral thing to do.”
If his bill wins passage and becomes law — a feat Sanders acknowledges will be an uphill fight — he hopes Vermont will be one of the five states to apply for money and flexibility from the federal government to enact a pilot program, the senator said by telephone.
“I think, for a variety of reasons, Vermont can be a national leader in moving forward in universal health care,” Sanders said. Under Sanders’ proposal, at least one of the five states would institute a single-payer system.
But Vermont is already in the midst of implementing Catamount Health, a hybrid of private and public insurance systems reached as a compromise between Gov. James Douglas and the Legislature.
If Sanders’ proposal could provide more money for Catamount, it might be a good idea for the state to apply to be in it, said Michael Smith, secretary of administration. But Vermont has already had the debate over single-payer health care and decided against it, Smith said.
“We would welcome the additional money” for Catamount, Smith said. But Vermont should not join a new program that would take it in a different direction, with Catamount expected to begin this fall.
“We are just implementing Catamount,” he said. “This was a consensus piece of legislation, something Washington is incapable of.”
“We are going to stay on course on this,” Smith said.
Sanders said he would personally like to see Vermont’s health care reform effort go farther toward a single-payer system than the Catamount compromise program.
“My own view is, if a state in America — I would hope it would be Vermont, maybe it would be Maine or some other state — would go forward with a single-payer system I think it would show that you could provide every man, woman and child with coverage and do it in a cost-effective way,” Sanders said.
The Vermont Public Interest Research Group, which has lobbied for health care reform in the state, praised Sanders’ proposal.
“This bill could pave the way for states like Vermont to fundamentally change the way we think about health care,” said Stefanie Sidortsova, health care advocate for the organization, said in a statement.
Smith and Sanders agree on one major point, however. Health care innovation will likely come from the states, not the federal government, they said.
“If Washington can’t lead, they need to get out of the way and let states lead,” Smith said.
Given the powerful lobbying interests in Washington from the insurance and drug industries, states will likely provide the path to major health care reform — and eventually a single-payer system — not the feds, Sanders said.
“Let states be the laboratory of democracy,” Sanders said. And such a system might be better administered from the state level anyway, he said.
His legislation would help that along by allowing a handful of states to administer and fund five-year pilot programs.
“Let us give different states in this country the opportunity to experiment, to develop different models, but with the goal of providing universal access to all of their people,” Sanders said. If such an experiment included a single-payer program, it will likely show “that you could provide quality health care to everyone in the state without spending a nickel more than you are currently spending,” Sanders said.
If one or more of the pilot projects was successful other states would take the ideas from it, he said.
“That is what good governors do all the time, they steal the best ideas from other states,” Sanders said.
He is confident a single-payer system — administered by the states — would be the winning version of such a trial objectively measured.
“The United States is the only country in the industrialized world that does not have a national health care program,” Sander said. And, he said, Vermont could be the starting point.
“I think we have the infrastructure to, in fact, lead the nation into a single-payer national health care concept,” he said.
Contact Louis Porter at email@example.com.