In a move that will no doubt cheer conservative states-rights advocates (OK, I'm kidding), the Vermont Senate passed a bill yesterday that will move the state toward a single-payer health system. Since it had already been passed by the state House, the two bills just need to be reconciled, and then Vermont will be on its way to creating its socialist health-care dystopia. What, you thought all the state-level action on health care was about suing to stop Obamacare?
This is just the start of a process in Vermont -- many questions are left to be answered by a commission, including how the funding will work. The system could end up looking something like what they have in France: a basic public plan that covers everyone, with most people buying supplemental private insurance on top of that. The most important change may be that Green Mountain Care could cut the link between employment and health care.
If it succeeds, it could become a model for other states. Maybe not all other states, though. After all, other countries have varieties of single-payer systems that are cheaper, cover everyone, and result in better health outcomes than ours, but that has made no impression on conservatives. And to the average Republican in, say, Alabama, Vermont might as well be France. Nevertheless, it's an important reminder that for many, many people, the biggest problem with the Affordable Care Act was that it didn't go far enough.