Vermont health law spurs fresh interest in single-payer reform: doctors group

As governor signs a 'universal health care' bill, a national physicians group says the Vermont developments show that many Americans want to go beyond the new federal health law to more fundamental reform

May 25, 2011

Garrett Adams, M.D.
David Himmelstein, M.D.
Ida Hellander, M.D., or Ali Thebert, (312) 782-6006,

Gov. Peter Shumlin's signing of Vermont's health reform bill this Thursday is spurring renewed interest in single-payer health reform across the United States, even though the Vermont legislation is much more modest in its actual reach than a single-payer plan would be, a spokesperson for a national doctors group said today.

"The people of Vermont, including the state's doctors, nurses and other health professionals, have inspired the entire nation by their unflagging dedication to winning a publicly financed, comprehensive and equitable health care system based on the principle that health care is a human right," said Dr. Garrett Adams, president of the 18,000-member Physicians for a National Health Program. "We salute their efforts and the efforts of their many organizations, even as we share their conviction that their work has just begun."

"This praise also extends to Gov. Peter Shumlin, who was elected to office on a single-payer platform and who has made many speeches in support of publicly financed care," Adams said. "The governor has argued, for example, that single payer is the best way for Vermont to get its economy back on track and to create jobs."

"Credit is also due to Sen. Bernie Sanders and other members of the state's congressional delegation who are seeking waivers from the federal government so Vermont can innovate with its own model of reform," he said. As of now, the federal Affordable Care Act prohibits states like Vermont from adopting their own models of reform until 2017. Shumlin, Sanders and others are trying to move that date up to 2014.

Adams continued: "Vermonters, like their counterparts across the United States, recognize that our current way of financing care – using wasteful, inefficient middlemen known as private health insurance companies – is broken and economically unsustainable. Many also understand that the new federal health law, while containing modest benefits, is an insufficient remedy, among other reasons because it retains a central role for these same greedy insurers."

He noted that several other states, including California, are looking at variations of a single-payer model for reform.

Adams said while the Vermont law declares health care to be a "public good" and says the state has a responsibility to "ensure universal access to and coverage for high-quality, medically necessary health services for all Vermonters," a praiseworthy objective, the actual provisions of the law fall considerably short of the single-payer reform needed to realize those goals.

A major problem, he said, is that the Vermont law will permit multiple private insurers to operate in the state indefinitely, setting the stage for multi-tiered care, rising costs and needless waste.

"Allowing multiple insurers in the system will deny Vermonters the enormous administrative savings they would otherwise get under a true single-payer plan," Adams said. "Having multiple insurers also nullifies the potential bargaining power of a 'single payer' to negotiate reduced prices for pharmaceutical drugs and other goods and services."

Dr. David Himmelstein, co-founder of Physicians for a National Health Program, said that the law's emphasis on complying with the Affordable Care Act means that it will leave the door open for burdensome co-pays, deductibles and other out-of-pocket expenses that deter people from seeking timely care. Finally, to the extent the law permits large, for-profit institutional providers to allocate their profits as they see fit, it will deny the system the ability to do effective health planning.

"In this context, the continuing mobilization of Vermont's broad-based movement for true single-payer reform will be essential," Himmelstein said. "Such a mobilization can bolster the governor's clear enthusiasm for the single-payer project and the courage of the Legislature as they face the inevitable onslaught of corporate opposition to deep-going health reform."

"We remain hopeful that the rhetorical commitment to further reform will become a reality," Himmelstein said. "Much more work, including continuing advocacy for a national solution – a single-payer system as embodied in legislation such as H.R. 676, the Expanded and Improved Medicare for All Act – will be needed in the years ahead to achieve Vermonters' goal of universal access to high-quality, affordable care."


Physicians for a National Health Program ( is an organization of 18,000 doctors who support single-payer national health insurance, an improved Medicare for all. To speak with a physician/spokesperson in your area, visit or call (312) 782-6006.