Vermont: A Model for Health Care Reform?

By Carl Berdahl
Atrium Magazine, Friday, February 11th, 2011

In the wake of ineffective national health reform, Vermont is poised to try again: Legislators are considering guaranteeing—rather than mandating—health insurance for all Vermonters through a single-payer system.

Lack of health insurance is this era’s major social issue. There are 50 million uninsured Americans by the latest count, and about 45,000 people die each year as a result. Americans love to say that we have the best health care system in the world, but this is statement is false by almost any account. The United States trails other developed countries in most indicators of health: infant mortality, maternal mortality, and life expectancy, for example. We spend more money than any other country on health care, and we really cannot claim to be better off.
During his inaugural address, Governor Shumlin of Vermont proposed guaranteeing health insurance to all Vermonters. Current health care costs, he says, “[represent] an enormous hidden tax on families and small businesses across our state. If left untethered, the rising cost of health insurance will cripple us.” Shumlin’s wants to create a single-payer system for Vermont, in which private delivery of healthcare would continue but the government would act as everyone’s health insurer. Such a system, which was systematically barred from the national health reform debate by special interest groups, can be thought of as “Expanded and Improved Medicare-for-all”. By choosing a single-payer system, Vermonters would (1) cleanse themselves of administrative waste that private insurance companies create and (2) unlink health insurance coverage from employment, thereby significantly easing stress that the recession has caused. The people of Vermont would save money, and bureaucracy in the medical system would shrink dramatically.
Some people fear that a single-payer system would mean “rationing” of health care resources. The reality is that our current system rations care by ability to pay—and paying is increasingly difficult even for the middle class. A single-payer system, on the other hand, would guarantee Vermonters access to all medically-necessary care.

National health reform under the so-called Affordable Care Act makes half-hearted attempts to control health care costs. It does chip away at the number of uninsured Americans, but it does so by mandating that individuals purchase insurance from a flawed industry, thereby crippling Americans with high copayments and deductibles.

Why waste time bracing a system that is failing?

The nation needs full-fledged health care reform, and Vermont can lead the way. A single-payer universal health care system would save Vermont money and give its people security that the Affordable Care Act simply does not offer. The amount of bureaucracy built into the system would decrease, allowing patients and health professionals to focus one thing—health.
But perhaps most importantly, it is time to take care of our friends, family, and neighbors who are uninsured. It is time to put an end to death by uninsurance. It is time to pass guaranteed single-payer universal healthcare. America deserves it, and Vermont will start it.

For more information about single-payer, visit Health professional students and other interested parties will be holding a rally for single-payer in Montpelier, VT on March 26, 2010. Please sign the petition at to join the mailing list for this event.

Carl Berdahl, columnist of “Reform”, taking a year off from clinical studies to compare resource utilization and clinical decision-making in American and Canadian emergency departments. He is also working with Physicians for a National Health Program to revitalize the Connecticut chapter through the development of local events and the creation of a statewide speakers’ bureau. Carl has provided care at free clinics in Connecticut, California, and Peru. He welcomes your thoughts and questions via email.