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Single-payer health care: dead in Washington, but alive in the states

Insurance companies may be winning the fight in Washington, but California and Vermont are on the cusp of comprehensive reform.

By Michael Corcoran / September 10, 2009


President Obama delivered a stirring address to Congress last night, but the federal government's inability to truly overhaul our broken healthcare system – which now leaves more than 46 million uninsured – is becoming all the more apparent.

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Speaking before a joint session of Congress, Obama declared that a public option to compete with private insurers, considered vital by many liberals, was merely a "means to an end," and not essential to healthcare reform. Earlier this summer, a New York Times/CBS poll showed that 72 percent of Americans support a government-run healthcare plan. But Obama's speech last night indicates that while a bill will probably pass, prospects for comprehensive reform – the kind millions of Americans voted for – have dimmed rapidly. Insurance companies, which have given large donations to both political parties, are winning the fight in Washington.

The inability of a popular president with substantial majorities in Congress to pass a progressive health bill is immensely frustrating to healthcare activists, and to all who gave Obama a mandate for change.

But their cause is not lost – they just need a new strategy.

Given the corporate world's disproportionate influence over Washington, it is time to take the fight for public healthcare away from Congress and into statehouses across the country.

State governments are typically far more democratic that the federal government and the public has a much greater ability to penetrate the debate. Moreover, in some states there are already legislatures and grass-roots movements that are working to make a statewide "single-payer plan" – similar to Canada's national health coverage – a reality.

Two state legislatures – Vermont and California – have, in fact, passed single-payer legislation in recent years only to have them vetoed by Republican governors. But California Gov. Arnold Schwarzenegger (R) is ineligible to run for a third term and Gov. Jim Douglas (R) of Vermont has decided not to seek reelection. Either of these states could soon become the first to pass a statewide, public healthcare system that covers everyone.

"I think it makes sense to push for single-payer on a state-wide level," says Dr. Deb Richter, founder of Vermont Health Care for All. "It looks pretty grim in Washington ... so we are mobilizing our forces."

Healthcare activists in Vermont are now advocating for single-payer bills in the Senate and the House and plan to highlight the issue for the 2010 gubernatorial campaign. The Vermont Workers' Center is more than a year into a "Healthcare Is a Human Right" campaign that is releasing reports and organizing rallies all over the state.