Will single payer health care be passed on state level. Will it spread to the national level

There have been blogs about how Vermont is supposedly working on a single payer health care system.


The governor and legislature supposedly both support it, and the gov. has supposedly gotten federal waivers to opt out of federal health programs.

Other states like Oregon, California, Illinois, Pennsylvania, and likely a few others have state level programs pushing for single payer.

I think that as austerity becomes more and more of a concern, and with health care being the biggest factor in austerity, maybe states will be forced to adopt single payer. They’ll have to increase the tax rate to fund it (private spending will go down to compensate), but the negotiation power of a single payer system could cut medical costs, making it appealing to various states.


With health care being as expensive as it is now (and as big a factor in our long term debt crisis), any effort to reduce cost and increase efficiency will likely be looked at more seriously.

On the other hand, government expansion during times of austerity may not go over well with the public. Even if private spending and total spending end up less, the concept of higher taxes and gov. expansion during times of debt will piss off certain segments of the electorate.

Not for a long time if ever; American national politics is simply too corrupt, too much in the pocket of corporations. And the Republicans would prefer to see the country economically ruined than let something like that pass.

If the success of single payer with the of rest of the Civilized World isn’t proof enough, would Vermont’s success really seal the deal?

Keep in mind that we’ve already had a form of single payer (for everybody over 65) for the past 40 years.

It’s not a matter of proof so much as overcoming entrenched corporate interests. Most Congressmen know how to count, counting votes being important to them, the economic benefits of single payer are obvious. But as Der Trihs has pointed out, any state that seeks to adopt single payer will be fighting every health insurance company in America. Tough row to hoe, given that corporations can now spend unlimited funds anonymously to back political campaigns.

I recall reading somewhere (but I don’t have a cite) that there’s a proposed bill that might be picked up by Congress later in the year. It would allow a state to opt out of the exchanges and still receive the same amount of Federal money if the state can implement a system which achieves the same coverage rate. If that goes through, then there’s a theoretical mechanism for a state to adopt single-payer, although I don’t know how many states would do so.

Its actually a provision in the already passed legislation, but for various reasons States need to wait until 2017 to set up their own systems. Bernie Sanders and several other senators are trying to pass a bill that would move the date forward to 2014.

There are plenty of industrilized countries without single payer. They all have Universal Health Care, but a single payer system isn’t necessary to have universal health care.

That’s how the Canadian system was created.
It started in one province, was successful, was copied in some others, and eventually became a national system.

I believe there’s no such thing as a “national” plan in Canada insofar as each program is administered by each respective province including the percent tax rate (yes, I know, tax, a dirty word) levied to each individual, i.e. in Quebec you might be taxed 3% more than in Manitoba for instance based on income level.

having said that, without all the co-pays, yearly decuctibles, 80/20’s whatever the average Canadian pays yearly for health care is of course far less than what the average American pays but because Canadians pay for their helath care via a tax and it’s administered by a provincial government many in America immediately reject it outright.

Yes, each province and territory administers its own health care system, but there is a national funding system for health care. The federal government contributes a major portion of the funding in each province and territory, but only if the provincial/territorial system meets the conditions set out by the Canada Health Act, a federal statute:

If those standards are met, federal dollars flow.

Why not a hybrid system? The public system could take care of the sickest/most expensive folks, and free up the private system for people who want more premium healthcare.

So you’d have the government pick up the tab for the most expensive and highest risk people while leaving the most profitable segment of the population to the insurance companies to cover?

The insurance companies would love that but the state and the taxpayers would be getting the crappy end of that stick.

There’s a name for that. It’s called the “pretty much what we already have” plan. Medicaid, Medicare and hospital emergency rooms get the most expensive patients, and the private insurers get everyone else.

Which is pretty much the definition of the safety net. I don’t understand why this is atrocious but welfare programs (where the exact same scenario happens), it’s A-OK!

Yep. The elderly and those with serious chronic conditions are left out of private plans and either go on medicare, medicaid or state high risk pools.

Not only that but people too sick to work can’t get health insurance through their jobs. So the system already selects out the healthiest among us because only people healthy and high enough on the socioeconomic totem pole can get decent health insurance through work. The elderly, disabled and those with terrible habits aren’t able to get private insurance.

It is atrocious because it is plutocratic socialism. You privatize the rewards and socialize the risks. People who are healthy get to pay $600/month in private insurance premiums for insurance they will rarely use, but once they become sick they are forced onto public plans like medicare or state high risk pools.