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Give States an Option to Lead on Single-Payer
Sep 04, 2009
The goal of real reformers is clear: a "Medicare for all" single-payer national healthcare system.
Getting there could be a little tough this fall.
But America will get there.
The current system is broken; it fails to serve 45 million Americans
and underserves another 45 million. It costs too much and it delivers
too little to a country where life expectancy rates are rapidly falling
below those of developed nations with universal healthcare programs.
The compromises of a weak "public option" or less are insufficient
to the point of being laughable, and potentially more costly than the
current monstrosity.
So we will get to single-payer.
The only question is how and when.
One answer, perhaps the best, is offered by Congresswoman Tammy
Baldwin, D-Wisconsin, who has proposed and promoted the idea of
allowing states to experiment with different healthcare systems.
Under Baldwin's plan, a progressive state such as Oregon or Vermont
could develop a "Medicare for all" program within its borders. At the
same time, a more traditionally conservative state such as Mississippi
or Alabama could muck around with so-called "medical-savings accounts"
and other gimmicks developed by the insurance industry and its
political mouthpieces.
Then it would be a case of may the best state win -- with the evidence of which model works best developing over time.
Canada went this route, experimenting first with single-payer in Saskatchewan.
Slowly, other provincial governments recognized that the "Medicare
for all" model delivered quality healthcare at affordable prices and
adopted it. And, eventually, the reforms initiated in once province
went national.
Baldwin has introduced a House resolution expressing the determination of the Congress
to facilitate state-based innovation in national healthcare reform. And
she has encouraged moves -- by Congressman Dennis Kucinich, D-Ohio, and
others -- to insure that this sort of flexibility is a part of any plan
that comes out of the House.
This is important, since federal rules regarding Medicare and other
programs can limit the options for states. And a mangled healthcare
reform plan passed in rush by legislators who just want to "do
something" could further constrain progressive initiatives.
Baldwin's gotten a number of co-sponsors for her resolution --
including a few Republicans. It's important that single-payer backers
sign on now, as part of the broader push to make sure that if the feds
fail us, states can lead.
Washington may not give us real reform this year. But it should at
least give progressive states a chance to move in the right direction.
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© 2023 The Nation
John Nichols
John Nichols is Washington correspondent for The Nation and associate editor of The Capital Times in Madison, Wisconsin. His books co-authored with Robert W. McChesney are: "Dollarocracy: How the Money and Media Election Complex is Destroying America" (2014), "The Death and Life of American Journalism: The Media Revolution that Will Begin the World Again" (2011), and "Tragedy & Farce: How the American Media Sell Wars, Spin Elections, and Destroy Democracy" (2006). Nichols' other books include: "The "S" Word: A Short History of an American Tradition...Socialism" (2015), "Dick: The Man Who is President (2004) and "The Genius of Impeachment: The Founders' Cure for Royalism" (2006).
The goal of real reformers is clear: a "Medicare for all" single-payer national healthcare system.
Getting there could be a little tough this fall.
But America will get there.
The current system is broken; it fails to serve 45 million Americans
and underserves another 45 million. It costs too much and it delivers
too little to a country where life expectancy rates are rapidly falling
below those of developed nations with universal healthcare programs.
The compromises of a weak "public option" or less are insufficient
to the point of being laughable, and potentially more costly than the
current monstrosity.
So we will get to single-payer.
The only question is how and when.
One answer, perhaps the best, is offered by Congresswoman Tammy
Baldwin, D-Wisconsin, who has proposed and promoted the idea of
allowing states to experiment with different healthcare systems.
Under Baldwin's plan, a progressive state such as Oregon or Vermont
could develop a "Medicare for all" program within its borders. At the
same time, a more traditionally conservative state such as Mississippi
or Alabama could muck around with so-called "medical-savings accounts"
and other gimmicks developed by the insurance industry and its
political mouthpieces.
Then it would be a case of may the best state win -- with the evidence of which model works best developing over time.
Canada went this route, experimenting first with single-payer in Saskatchewan.
Slowly, other provincial governments recognized that the "Medicare
for all" model delivered quality healthcare at affordable prices and
adopted it. And, eventually, the reforms initiated in once province
went national.
Baldwin has introduced a House resolution expressing the determination of the Congress
to facilitate state-based innovation in national healthcare reform. And
she has encouraged moves -- by Congressman Dennis Kucinich, D-Ohio, and
others -- to insure that this sort of flexibility is a part of any plan
that comes out of the House.
This is important, since federal rules regarding Medicare and other
programs can limit the options for states. And a mangled healthcare
reform plan passed in rush by legislators who just want to "do
something" could further constrain progressive initiatives.
Baldwin's gotten a number of co-sponsors for her resolution --
including a few Republicans. It's important that single-payer backers
sign on now, as part of the broader push to make sure that if the feds
fail us, states can lead.
Washington may not give us real reform this year. But it should at
least give progressive states a chance to move in the right direction.
John Nichols
John Nichols is Washington correspondent for The Nation and associate editor of The Capital Times in Madison, Wisconsin. His books co-authored with Robert W. McChesney are: "Dollarocracy: How the Money and Media Election Complex is Destroying America" (2014), "The Death and Life of American Journalism: The Media Revolution that Will Begin the World Again" (2011), and "Tragedy & Farce: How the American Media Sell Wars, Spin Elections, and Destroy Democracy" (2006). Nichols' other books include: "The "S" Word: A Short History of an American Tradition...Socialism" (2015), "Dick: The Man Who is President (2004) and "The Genius of Impeachment: The Founders' Cure for Royalism" (2006).
The goal of real reformers is clear: a "Medicare for all" single-payer national healthcare system.
Getting there could be a little tough this fall.
But America will get there.
The current system is broken; it fails to serve 45 million Americans
and underserves another 45 million. It costs too much and it delivers
too little to a country where life expectancy rates are rapidly falling
below those of developed nations with universal healthcare programs.
The compromises of a weak "public option" or less are insufficient
to the point of being laughable, and potentially more costly than the
current monstrosity.
So we will get to single-payer.
The only question is how and when.
One answer, perhaps the best, is offered by Congresswoman Tammy
Baldwin, D-Wisconsin, who has proposed and promoted the idea of
allowing states to experiment with different healthcare systems.
Under Baldwin's plan, a progressive state such as Oregon or Vermont
could develop a "Medicare for all" program within its borders. At the
same time, a more traditionally conservative state such as Mississippi
or Alabama could muck around with so-called "medical-savings accounts"
and other gimmicks developed by the insurance industry and its
political mouthpieces.
Then it would be a case of may the best state win -- with the evidence of which model works best developing over time.
Canada went this route, experimenting first with single-payer in Saskatchewan.
Slowly, other provincial governments recognized that the "Medicare
for all" model delivered quality healthcare at affordable prices and
adopted it. And, eventually, the reforms initiated in once province
went national.
Baldwin has introduced a House resolution expressing the determination of the Congress
to facilitate state-based innovation in national healthcare reform. And
she has encouraged moves -- by Congressman Dennis Kucinich, D-Ohio, and
others -- to insure that this sort of flexibility is a part of any plan
that comes out of the House.
This is important, since federal rules regarding Medicare and other
programs can limit the options for states. And a mangled healthcare
reform plan passed in rush by legislators who just want to "do
something" could further constrain progressive initiatives.
Baldwin's gotten a number of co-sponsors for her resolution --
including a few Republicans. It's important that single-payer backers
sign on now, as part of the broader push to make sure that if the feds
fail us, states can lead.
Washington may not give us real reform this year. But it should at
least give progressive states a chance to move in the right direction.
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