Third-party persistence drove health care reform.
When most liberals hear the words "third party," they have nasty
flashbacks to Ralph Nader's spoiler campaign in 2000. The history
buffs among them might think of the populist Greenback Party's
feckless protests against the gold standard in the 19th century or
the five presidential campaigns of the Socialist Eugene V. Debs --
the last of which, in 1920, he ran from prison.
Third parties seem out of touch with reality, the refuge of
idealists with dreams too fragile for the trenches of major party
politics. But Democratic skeptics, at least, shouldn't be too quick
to judge. One state is now on the way to single-payer health care,
and a third party deserves much of the credit.
Three years ago, Peter Shumlin, the governor of Vermont, signed a
bill creating Green Mountain Care: a single-payer system in which,
if all goes according to plan, the state will regulate doctors' fees
and cover Vermonters' medical bills. 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
Green Mountain Care won't begin until at least 2017, but Vermont
liberals are optimistic. "Americans want to see a model that works,"
Senator Bernie Sanders told The Atlantic in December. (Mr. Sanders
is an independent, but a longtime ally of the Progressives.) "If
Vermont can be that model it will have a profound impact on
discourse in this country."
Before you dismiss that prospect as wishful thinking, consider:
That's how national health care happened in 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
It seems natural that America's experiment in Canadian-style
health care should begin in Vermont, a state with a long history of
cross-border contact. In Derby Line, Vt., the border runs through
the town library. Decades ago, pregnant women from Quebec often
drove to Vermont to give birth, preferring American hospitals. Not
anymore. When it comes to health care, two countries that share so
much have diverged profoundly.
Between 1870 and the Great Depression, Americans and Canadians
both worried about the growing gap between the mega-rich and the
poor. Their disillusionment fueled the rise of dissenting parties.
In Canada, the most successful of these, the social-democratic
Cooperative Commonwealth Federation, won control of Saskatchewan in
1944. Canada never passed reforms to match the New Deal, and the
C.C.F. capitalized on voters' frustration with the federal
government's inaction -- just as liberals in Vermont are now doing.
It's risky to compare 1940s Saskatchewan to Vermont today, but
"Vermont has some of the features that Saskatchewan had in the 1940s
and 1950s. It's a rural state in which voices from the left have
been more legitimate than in other parts of the country," said
Antonia Maioni, a professor of political science at McGill
University in Montreal. "Saskatchewan was the last place where you
would have expected to have this bold innovation. It was the
poorest, most rural, most sparsely populated province. And yet it
was the mouse that roared."
The Vermont Progressives have only eight seats in the State
Legislature, but they played a decisive role in the 2010
gubernatorial election. They promised not to play spoiler if the
Democratic candidate supported single-payer health care. …