Morning Read: Single-Payer and the Vermont Progressive Party in the NYT

“As Vermont goes, so goes the nation?”

That’s the question University of North Carolina professor of history Molly Worthen poses in an op-ed with that headline published in Sunday’s New York Times.

Specifically, Worthen ponders the possibility that if Gov. Peter Shumlin succeeds in his quest to provide Vermonters universal, publicly financed health insurance, the rest of the nation will follow the state’s lead.

“If the Vermont experiment works, other states will follow,” she writes. “American pragmatism will trump ideology.”

That ain’t exactly the boldest prediction ever made. 

As Shumlin often argues, and as many of his fellow governors would agree, states tend to serve as policy petri dishes. If Vermont’s quasi-single-payer experiment succeeds, elements of it will surely be appropriated by other states, and maybe even by the feds. If it fails spectacularly — or if Vermont politicos get cold feet and fail to follow through, which is a distinct possibility — not so much.

But Worthen doesn’t leave it at that. In fact, much of her op-ed focuses on the role a certain political party played in the passage of Act 48 — the 2011 law that set Vermont on a path toward universal health insurance — and how that mirrored the Canadian experience:

Mr. Shumlin is a Democrat, and the bill’s passage is a credit to his party. Yet a small upstart spent years building support for reform and nudging the Democrats left: the Vermont Progressive Party. The Progressives owe much of their success to the oddities of Vermont politics. But their example offers hope that the most frustrating dimensions of our political culture can change, despite obstacles with deep roots in American history.

Worthen appears to dwell on the Progs’ role in the bill’s passage in service of a somewhat strained comparison to post-war Canada:

A third party’s provincial experiment paved the way for national reform. In 1946, the social-democratic government of Saskatchewan passed a law providing free hospital care to most residents. The model spread to other provinces, and in 1957 the federal government adopted a cost-sharing measure that evolved into today’s universal single-payer system.

The implication, of course, is that, like Saskatchewan’s social-democrats, the Vermont Progressive Party will push America toward single-payer. 

It’s a nice theory, so long as you buy the premise that the Progs were responsible for Act 48. But that’s a premise Worthen doesn’t exactly prove. As evidence, she cites the 2010 gubernatorial election, during which, she notes, the Progs “promised not to play spoiler if the Democratic candidate supported single-payer health care.” 

There’s no doubt that the 2010 Prog-Dem detente helped Shumlin eke out a general election win over Republican lieutenant governor Brian Dubie. But it’s a stretch to say that Shumlin’s single-payer-or-bust campaign platform was motivated by the Progs. 

In fact, Shumlin pushed the issue hardest during the five-way Democratic primary, when he was trying to differentiate himself from a crowded field of candidates, many of whom — including Doug Racine and Matt Dunne — shared records in the Vermont Senate advocating for universal health insurance. 

And while many Progs presumably voted in the Democratic primary that year, you could just as easily argue that the debate over single-payer during that campaign was the result of a Democratic candidate trying to upstage other Democratic candidates to woo Democratic voters. Because, like Progressives, most Democratic primary voters also support single-payer.

There’s no question that Vermont Progressives have advocated more ardently than most over the years for universal health insurance. But they haven’t been alone. And as Worthen herself notes, it was a Democratic governor and a Democratic legislature that passed Act 48.

Not exactly Saskatchewan.

Read Worthen’s full op-ed here.

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