Vermont is going full-steam ahead on its plans to establish a single payer healthcare program for its citizens. Last week, Harvard healthcare economist William Hsiao went before the full Vermont state legislature to present his ideas on how the state can implement a single payer system. Professor Hsiao most notably helped set up Taiwan’s single payer program. Below is a video of the entire presentation, filmed by Vermont Health Care For All. After the presentation, Hsiao and members of the Vermont legislature addressed reporters at a news conference, which you can access at

Hsiao’s proposal for Vermont is not a pure government-run single payer system, but a public/private plan run by an independent board. Although Dr. Don McCanne of Physicians for a National Health Plan has a few quibbles with Hsiao’s recommendations, he believes the plan is a good start. Writes McCanne, “Although advocates of the pure single payer model will find some problems with this report on a reform proposal for Vermont, there is very good news in this analysis. The report emphatically confirms the superiority of the single payer model in ensuring that everyone is included while containing health care costs.”

Predictably, the insurance companies are not happy with Vermont’s plans to spoil their party. It’s gratifying to see how helpless they are in the face of a single-payer friendly legislature, and their worst nightmare, a new governor, Peter Shumlin, who is a fierce advocate of single payer and ran on it in his platform. And the state is represented in the U.S. Senate by longtime single-payer cheerleader, Bernie Sanders. It’s as if the stars have aligned for Vermonters. It looks like Vermont may beat us here in California in the race to become the first state to embrace a single payer plan and be a model for the nation. If Arnold Schwarzenegger hadn’t stood in the way, California could have been first long ago. Watch Gov. Shumlin being interviewed below on Democracy Now! on Jan. 21:

Gov. Jerry Brown is up to his eyeballs in California’s intractable budget mess. Meanwhile, State Sen. Mark Leno soon plans to re-introduce SB 810 into our state legislature. After being passed in the legislature twice (and vetoed by Schwarzenegger twice), the bill failed last year to go through a third time. It’s still not yet clear whether Brown will sign it, even though he campaigned on single payer as a presidential candidate in 1992. So, what explains the foot dragging? The nature of California politics? The passage of federal reforms in Washington? Brown can’t possibly use the budget crisis as an excuse because single payer will save the state money. Maybe Professor Hsiao and Vermont can give him a nudge.

What’s so exciting about what’s happening in Vermont is that the single payer movement may finally get the laboratory it desperately needs right in our own back yard. The state still needs to get a waiver from the federal government to start the plan, something Shumlin and Sanders are actively pursuing. Vermont can show the skeptics that single payer is the most affordable and fairest way to deliver health care to everyone. And the naysayers will no longer be able to dismiss single payer as “foreign.” Vermont’s efforts can help propel our case forward here in California. It would be great if Sen. Leno could get Hsiao to do his presentation before Brown and our legislature. The skeptics would have no choice but to listen.