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Jack Zaleski, Published January 09 2011

Zaleski: Blue and red of health care policy

Chelsea, Vt.

The people who preach that the federal government is too big and too intrusive are not necessarily conservatives. States’ rights warriors who believe – rightly – that states are the better crucibles of innovative and intriguing public policy ideas can be as conservative as most North Dakotans or – as I’m learning during an extended stay in this beautiful state – as liberal as most Vermonters. The notion of a ham-handed or unresponsive Washington, D.C., can stir blue emotions as well as red. The much-maligned liberal label does not always mean an automatic embrace of the cradle-to-grave federal welfare state. Sometimes a liberal state aims to do its own thing, if only the feds would get out of the way.

In Vermont the No. 1 issue on the Legislature’s agenda is health care. And not merely a debate about the new federal health care law but a genuine drive for a single-payer, universal-coverage, publicly funded system for this state. Gov. Peter Shumlin won election in large part because of his enthusiastic advocacy for such a state system. The idea has impressive support in the Legislature, which convened last week in Montpelier.

To no one’s surprise, groups with names like The Vermont Workers Center and Vermont Healthcare for All have lined up to push for a single-payer, publicly funded system. But it is a bit of surprise – at least from a North Dakota perspective – that a significant segment of Vermont’s homegrown business community also backs a public plan that will cover all Vermonters and decouple health insurance from employers. On the other hand, a business organization that counts among its members many large out-of-state corporations that do business in Vermont wants no part of a public plan, favoring instead a more competitive private health care and insurance system to drive down costs.

Ironically, Vermont’s biggest obstacle to state single-payer, coverage-for-all is Obamacare. The state would have to obtain waivers to several provisions in the federal law in order to proceed with a state plan. Most daunting, the state would need an act of Congress to secure an exemption from the requirement that all employers must insure their workers. Undeterred, the governor, legislative leaders and a coalition of advocates and business interests are developing strategies to circumvent the federal law.

Deep blue Vermont thinks Obamacare doesn’t go far enough; thus the drive for a state public plan. North Dakota, which blushed deeper red on Nov. 2, is among several states trying to undo a key element of Obamacare – the insurance mandate – in the federal courts.

Vermont politicians were elected or re-elected on pledges to support a single-payer, state-funded plan – which might cause Vermonters, who spent nearly $5 billion last year on health care, to wonder where the money will come from.

North Dakotans tossed out an 18-year incumbent congressman in large part because he voted for federal health care reform, which does not have a public option. The winner of that hard-fought race said his first priority is to roll back Obamacare – which might cause some North Dakotans to wonder where the farm bill and flood control funds for the Red River Valley rank on the congressman’s to-do list.

It is true: States can be crucibles of ideas, good and bad. Vermont seems determined to press on with a health care scheme that North Dakotans and most of the country view as a bad idea. But maybe it’s good for Vermont. Vermonters seem to think so. And what could be more conservative than letting a state chart its own course – even if it’s a liberal state.

Contact Editorial Page Editor Jack Zaleski, after Monday, at

(701) 241-5521.