The 'State' of Health-Care Reform: Activists Push for Universal Primary Care in Vermont

By Michael Corcoran
Truthout, Feb. 3, 2016

When Vermont's plan for a public, universal health-care system died in late 2014 it was a major blow to single-payer activists everywhere. Conservatives tap-danced on the proposal's grave, and wrongly claimed that its death was proof that single-payer could never work. Progressives were put on the defensive, dealing with the pain of losing an extended, promising battle, plus an influx of even more misinformation about the economics of public health care.

The woeful state of health care in the United States, however, has kept the dream of joining the rest of the developed world in having universal public health care alive as an urgent priority for activists in Vermont and elsewhere. And so, advocates of health-care justice in Vermont, not inclined to disengage from the process, have advanced a new proposal: statewide "universal primary care." The plan would offer primary care - including some mental health and substance abuse treatment - to every single Vermonter regardless of their ability to pay.

Supporters of this proposal know it falls well short of reforming the state's entire $5 billion health insurance industry, but hope it offers a new path toward that goal. Advocates for the policy point to the history of Canada's universal system, which is rooted in the Saskatchewan policy that made hospital care universal in 1947. Moreover, according to a recently published study commissioned by the Vermont Legislature, the plan would be affordable and cost-effective, ultimately saving the state money that is now wasted due to the woefully inefficient nature of private insurance.

Vermont's continued reform efforts reflect an important trend in health-care reform; states are trying to succeed where the federal government has failed, in terms of paving a path toward universal coverage. As Truthout reported in October 2015, activists in Colorado recently put a single-payer plan on the ballot in 2016 via a statewide referendum. Other states, including New Mexico, New York, Maryland and Oregon, are also fighting for single-payer in a variety of ways. But most Washington, DC, politicians are toothless on this issue, lacking the political will to stand up to the powerful drug and insurance industries while also placing many logistical barriers in the way of statewide reform efforts. As a result, the battle for universal health care in the states is an important part of the much larger fight for social justice.

'Salvaging Something' From Failed Reform Efforts

When Vermont Gov. Peter Shumlin announced that he would no long pursue a major overhaul of his state's system, "the single-payer movement sort of crashed and burned in Vermont," said Dr. Deb Richter, a longtime local advocate of single-payer legislation, in an interview with Truthout.

Richter certainly had her fair share of skin in the game. Richter, according to Vermont journalist and policy analyst Hamilton Davis, "has been one of the leading proponents of single-payer health-care reform for two decades." She was so committed to the issue that she toyed with the idea of running for lieutenant governor of Vermont in 2008 to push the issue forward, before deciding against it. In the 2010 gubernatorial campaign, she was among many doctors who endorsed Shumlin, saying he was "the only candidate who has shown unwavering support for a publicly financed universal health-care system in Vermont." Her engagement didn't skip a beat when Green Mountain Care hit the wall - she was testifying for other means to improve health care at the State House within two months of its demise.

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