When Barack Obama announced a few months back that he would waive the ACA for any state that could do better, many on the left thought he was caving in to the Republicans, giving them their way again.  I called that one right and credited him for putting the onus on Republicans, showing them up, because they would be unable to do better  without a public option or single payer care.  I knew that Republicans would not go there, but Vermont has done just that. http://www.politicsplus.org/blog/?p=4692

In a historic vote on Tuesday, the Vermont Legislature created the enabling legislation for a first-in-the-nation universal health care system. The state Senate approved the visionary plan for a single-payer system in a 21-9 vote after four hours of debate. The split was largely along party lines.

Gov. Peter Shumlin, a Democrat, campaigned on a promise to create a single-payer system in Vermont that would contain health care costs and give all of the state’s residents universal access to medical care. On Tuesday, Shumlin made good on the first step toward fulfilling that promise, and just five hours after the Senate vote, he marked the legislative victory in an appearance on MSNBC’s “The Rachel Maddow Show.”

The Shumlin administration was heavily involved in drafting the bill, H.202, though by the time the legislation reached final passage it had changed somewhat from its original incarnation, which was based in part on recommendations from Professor William Hsiao, the renowned Harvard economist who created a single payer system for Taiwan.

The legislation sets the state’s health care system on a new trajectory. Instead of continuing to use an insurance model for covering the cost of care, the bill moves the state toward an integrated payment system that would be controlled by a quasi judicial board and administered by a third party entity. The system would be funded through a broad-based tax.

The universal health care system would be implemented in 2014, if it clears 10 very high hurdles, including the receipt of a federal waiver. Otherwise it wouldn’t kick in until 2017… [emphasis added]

You come home to discover your house is on fire so you call 911.  The operator asks who carries your fire department insurance, and you tell her you have none.  She asks why, and you tell her you couldn’t afford to pay it.  She reminds you that, under the Republican plan, you could have gotten a fire department voucher.  You explain that, due to preexisting climate conditions, your voucher would cover only a small part of the cost.  She sighs, says she is sorry that there is nothing she can do to help you.  You watch your home burn to the ground.

Ridiculous, isn’t it?  What makes it ridiculous is that we have single payer fire department care.  What I just described is what would happen of the Republican approach to Medicare were applied to fire department care.  People would not stand fore that because they know fire protection is too important to privatize.  Given that truth, it makes no sense to leave health care to companies for whom profit trumps health every time.

Kudos to Vermont!