Politically, Vermont is easily the coolest state in the country. I wish that Patrick “It’s Okay That Dick Cheney Told Me to Go Fuck Myself” Leahy would retire, so we could get another worthwhile senator from there.

It is possible, if not likely, that federal law will be used to prevent the state from implementing a single payer system.

You can bet your ass that the insurance companies will be doing everything they can to make sure if it is possible, it DOES happen (none of this likely stuff). And if it isn’t possible, then the first “tweak” of the healthcare bill will be to make it possible.

I’ve been wondering why the northeastern states don’t band together and create their own regional single payer system. Perhaps there is some federal law preventing such an action? I’d be curious to see a citation, if anyone has one…

Vermont does have the most effective third party in the country. The Vermont progressive party.

both an issue of federal law, ERISA. and the power of the health industry stakeholders. The insurance companies have huge power in the statehouses.

Jon,

Thanks for the response. Maybe this is an opportunity for us to bond with the conservatives and fight the “oppressive federal government.” State’s rights, y’all….

Wow, if single payer goes through it would be a big deal, as it is cheaper and better than for-profit healthcare and that would soon become obvious to other cash-strapped states. Single payer in Canada started at the provincial level (pushed by Tommy Douglas of the NDP in Manitoba) and is still administered that way:

http://www.cbc.ca/greatest/

Single Payer has passed the California legislature a number of time to be vetoed by Arnold, if I recall correctly.

ERISA is the problem – it prohibits states from interfering with federal benefit protection law and forces the “option” approach unless single payer is layered on top of current situation via state general revenue with no look back at or taking from ERISA approved benefits.

It can be done but the state must use minimal benefits to make it affordable – and then grow it over time. The option approach works a bit more easily.

Economically it is a winner as it turns the state into a competitive – read lower wage because no cost for benefits – state for companies to move to. BUT – the corporations will fight using the appearance of fiscal excess as the movement of health cost to the state budget – even though the state is just transferring it back to the ins co’s for claim payment – appears to grow state government.

Without the Kucinich Amendment, it seems the private health insurance industry can indeed smother any attempt to make state single payer in red tape.

But the health care bill was a step to single payer, right???

We’re within two votes in both houses of having an override. JB hasn’t come out in support, but I don’t see him vetoing; I think he’d also fight the feds on an override. Meg would be another Arnie on this topic, presumably Steve would be as well, being an INSURANCE commissioner and all.

If we can get it in California, that’s a big camel nose under the tent, so there will be a lot of ‘outside cash’ flowing in to candidates this year from Big Med.

I don’t live in Vermont – but I have to thank the ‘publicans who fought for my right to purchase insurance across State lines. I want that Public Option now.

federal law will be used to prevent the state from implementing

Practically and politically speaking, if a state were to say “Eff you, our people want it and we’re doing it,” what could the feds do about it, and more important, would they? Realizing that much depends who’s in control at the time….

I truly wish a state or states would implement single payer health systems. But, thanks to the supposed “health care reform” bill, health insurance companies have even more power than previously. They will continue to either stop any single payer system from coming to fruition or make sure such a system fails. Until we get real progressive leadership in the White House and Congress, “we the people” will continue hurting. Next up on the agenda to further destroy the middle class…Social Security.

Nice!

If we can get it in California, that’s a big camel nose under the tent, so there will be a lot of ‘outside cash’ flowing in to candidates this year from Big Med.

From Big Med to Bid Meg.

And Obama suffocated it from any consideration. He appoints a commission for oil, and if nothing else he easily could have had one to study the options as they are doing in Vermont.

Each time he says it’s about getting the best ideas, no matter where they come from, my stomach turns.

Obama is a dog and pony show and little more.

“It is possible, if not likely, that federal law will be used to prevent the state from implementing a single payer system.”

If “whoever” uses federal law to block the enactment of single payer which would serve all people regardless of ability and class we have the no holds presentation of an openly abusive system. The thought that any “they” out there would actually do this and or be allowed to do this is like finding out your dad is a cereal killer or something.

If this happens the American people should go stark raving bat sh**. Seriously, the over bearing oppression is reaching comical proportions. When do people stand up and say enough to these unevolved infantile screaming me-me s. It’s like being forced to sleep with your boss’s retarded son to keep your job. When do people reach their limit?

Webmaster,
When I “edit” I lose my paragraph breaks.

Me, too. Makes me think twice about editing my own stuff.

One State at a time, or a populist revolt.

I just don’t believe we have much time left. After all, Kudlow and Co. are hedging ‘king dollar’ with gold, – openly, for chriissake!

Good luck to Meg. She’s spent almost $70M trying to convince her ‘base’ that she’s conservative enough for them; Jerry hasn’t spent anything and he’s still ahead of her.

Between running to the right and folks wondering why this is worth $150M to her, she has a tough fight ahead – assuming she even wins the primary. This will be a large-tub popcorn race.

There are actually several obstacles.

1. As you note, the federal pre-emption clause in ERISA radically limits the ability of states and local governments to implement programs that regulate private health insurance. San Francisco had to tie itself in knots to pass a “plan” that really isn’t insurance to avoid ERISA challenge, and that approach is not easily replicable in a rural state.

2. To create a true single payer system, one would need to fold the money for existing federal programs — Medicare, Medicaid, SCHIP — into the state plan. Congress has not created statutory authority to do that, although there are Medicaid and SCHIP waivers that might allow HHS to squint and give it the nod for those programs.

And of course there’s the politics. This isn’t the first time Vermont has started down this road. In the early 1990s, the state legislature similarly instructed the Administration to cost out several options for state reform. Despite explicit legislative instructions to do so, the state analysts simply refused to cost out a true single payer plan. Advocates were mystified by the bureaucratic footdragging. State staff simply refused to because the state’s largest employer went to the state’s progressive Governor, threatened to pull out of the state if they even sniffed at single payer, and said progressive Governor, author of the 50 state strategy, folded like a cheap suit.

Great.
Why haven’t they have done this before?
Why haven’t other states done this before?
Oh that’s right, Federal laws would have prohibited them from doing so.

I thought so too but you don’t actually lose them, it just looks like you do in the preview after edit. When you post, the paragraph breaks are there.

Weird.

Yep, the insurance companies got this muscle to extort provided courtesy of the federal government which passed a bill that allowed big insurance to not only retain but actually enhance their power over the American economy.

Just a technical note, Tommy Douglas was the Premier (similar to your Governors) of the province of Saskatchewan, not Manitoba. He passed on in 1986 and we still miss him. Medicare in Canada began with him and his political party in the province of Saskatchewan in 1946.

In 1957 the Canadian federal government introduced legislation that would pay for half of any provincial public health plan, beginning the national health program that Canadians love.

The program is not free. It is paid for with taxes. Physicians and all medical services are not public employees. The health system is a publically-funded insurance system. They negotiate contracts with provincial governments and generally are paid on a fee-for-service plan.

Please pen a diary about your experiences.
We could use some guidance.