Bernie Sanders is now the Democratic front-runner, but to win the party’s nomination, he must convince moderate primary voters that his signature policy, Medicare for All, is a worthwhile venture. But before he can do that, he must prove that it’s realistic, too.
Sanders’s home state, however, is proof that it’s not.
Vermont was supposed to pave the way for a single-payer healthcare system. The Democratic-controlled state legislature drafted the bill in 2014, and Democrat Gov. Peter Shumlin was ready to sign it into law. But then Shumlin realized he had a problem: He couldn’t pay for it.
The 11.5% payroll tax on small business and sliding premiums of up to 9.5% on people’s incomes “might hurt our economy,” Shumlin admitted.
“These are simply not tax rates that I can responsibly support or urge the Legislature to pass,” the governor said at the time. “In my judgment, the potential economic disruption and risks would be too great to small businesses, working families, and the state’s economy.”
The system Vermont’s bill proposed would also have added even more administrative complexity to an already complex system. It made certain exemptions for large businesses, reducing the funding necessary to get the program running. And it was never clear whether or how citizens already enrolled in federal plans, such as Medicare and Medicaid, would have been integrated into the system.
In short, Medicare for All was too expensive and too complex for Vermont.
This should be a red flag for proponents of Sanders’s policy: If an individual state was unable to implement a single-payer system, why should we believe the federal government will be able to?
Politically, there were very few obstacles standing between Vermont and Medicare for All. The problem is that Medicare for All is an obstacle in and of itself. Unfortunately for Sanders, the factors that guaranteed the bill’s failure in Vermont have not changed: It’s still too expensive and too complex.
The simple truth is that the majority of Americans still prefer to choose their healthcare plans, especially when higher taxes and increased regulation are the alternatives. Medicare for All might be more popular today than it was several years ago, but not by much. Sanders doesn’t seem to care, but if he wants his campaign to progress, he’ll need to.