SANDERS, THE POLITICAL SHEPHERD
By
Richard Davis

GUILFORD- Senator Bernie Sanders recently introduced a bill that would allow five states to become laboratories for health care reform. The official description of bill S. 2031 is “To amend the Social Security Act to provide grants and flexibility through demonstration projects for States to provide universal, comprehensive, cost-effective systems of health care coverage, with simplified administration.”
The bill recognizes that the history of social progress on many fronts in this country is rooted in the models that states have created. Sanders knows that waiting for a national health insurance plan to be enacted is not the best approach to health care reform. His bill also mandates that one of the five states use the single payer model for its project.
The big question is about the bill's chance of passage through Congress and eventually onto the desk of a President willing to sign it. Rep. John Tierney-D- Massachusetts has introduced a companion bill in the House and that should provide momentum for both bills.
In the world of politics things generally move slowly. Before Sanders introduced the bill he invited me and a few other Vermont activists to discuss the bill and to hear his view of what the bill means. We had a chance to see the bill before introduction and to offer suggestions.
This bill gives Vermonters one more example of why Sanders continues to receive such overwhelming support from his constituents. He delivers on his promises and has somehow figured out how to provide principled leadership in a place where principles and leadership seem to be in short supply.
Sanders knows that it will take some time before his bill hits the main stage. That may be a good thing, because we will need a new President to minimize the chances of a nearly certain veto from the current office holder. Sanders also knows how to use the system in Washington in the service of pragmatic efforts to move this country closer to a day when universal health care is established.
Vermont will also need a new Governor and administration before we can apply to be one of the state demonstration projects. Unless the bill funds a market driven health plan in line with Governor Douglas' reform ideology, the state will never apply for something so bold as a single payer plan under his tenure.
Many of us in the more liberal camp of Vermont health care, as well as Sanders, know that Vermont is already close to having all of the elements in place to demonstrate how the current “system” could become a single payer system.
Catamount Health, the new insurance plan that will begin November 1, will attempt to insure as many of Vermont's 63,000 uninsured as possible or have them apply for other programs such as Medicaid. Once Catamount is up and running the state must then figure out a way to make comprehensive insurance affordable for the underinsured and for all of Vermont's businesses as well as for all of Vermont's taxpayers.
If Sander's bill becomes law, Vermont would be in a perfect position to move beyond Catamount and to develop a plan that could become a model for efficiency and cost-effectiveness for the entire country. It would require a Governor with vision, a governor who is more concerned with improving the quality of Vermonter's lives than preserving the solvency of health insurance companies.
S. 2031 would remove many of the impediments to state-based reform that have given politicians easy cover for saying they want reform but that their hands are tied because of Federal regulations. One of those obstacles has always been ERISA, a federal law that applies to self-insured plans. About 40% of Vermont insurance policies are governed by ERISA and that means any reform would not apply to that big chunk of the market. Sander's bill would wave application of many of current ERISA restrictions.
Sander's bill provides one of the most promising potential developments in national and state health reform in many years. In order to succeed we cannot wait for the stars to align. We must align the stars ourselves and that means that we must change the faces of those holding power in the White House and in Montpelier.
Once that happens we will be able to cast off the disgraceful U.S. distinction of being the only industrialized country in the world that does not consider access to a basic level of health care an obligation that a government and a society has to its citizens.