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Vermont’s Pioneering Healthcare Movement

On May 26, Vermont Gov. Peter Shumlin signed a law  that creates a path for a universal, publicly financed healthcare system in Vermont, making it the first state in the country to move toward such a system.

Legislators and advocates alike have compared Vermont’s role to that of Saskatchewan, which half a century ago spearheaded the establishment of universal healthcare in Canada.

The law states that Vermont will create the publicly financed Green Mountain Care to provide comprehensive coverage as a public good for all Vermont residents, regardless of income, health status or employment.

Yet the struggle for universal healthcare is far from over. Green Mountain Care will be implemented only after a number of conditions are met, including the requirements of the federal health reform law. Some key decisions have been postponed to future legislative sessions, such as a financing mechanism for the system and the design of a health benefits package. The timeline calls for financing proposals by January 2013, a federal waiver application by 2015 – earlier if Congress allows – and implementation by 2017 at the latest.

The pioneering nature of Vermont’s health reform was rooted in a people’s movement, which caused reform efforts to be driven by principles, rather than political calculation, industry interests, or professional advocates and lobbyists. The vision of healthcare as a human right captured the public imagination and created the political space for action by elected officials. Observers credit this achievement to grassroots organizing by the Healthcare Is a Human Right Campaign, led by the Vermont Workers’ Center, which engaged thousands of Vermonters in demanding their human right to healthcare.

The campaign built a broad movement guided by principles such as universality and equity, rather than by specific policy proposals like single payer. By shifting the focus from cost containment to collective needs and rights, the campaign placed people at the center of policy and practice. When viewed as a human right, healthcare becomes a unifying concern for everyone, not just for the uninsured, “consumers” struggling to pay their bills or workers seeking to hold on to benefits.

Embedding human rights principles in public and political discourse has advanced the goal of treating healthcare – and potentially other needs – as a public good, financed through taxation, rather than being purchased as a market commodity.

The success of this organizing model became apparent in the fight against a last-minute amendment to exclude undocumented people from the plan. The campaign mobilized hundreds of Vermonters to stand up for the human rights principle of universality, and after days of phone calls, protests and a large rally, the exclusionary amendment was struck.

If excluding undocumented people presented a clear line in the sand, the maneuvering of private insurance companies has been harder to detect and defeat. The industry and its corporate allies are a formidable opponent with deep pockets and well-honed patience. Insurance companies, whose business model depends on restricting access to care, managed to keep a foot in the door, as they persuaded legislators to remove a clause prohibiting the sale of private plans in the new public system. Therefore, the most important struggle ahead will be for financing Green Mountain Care as a public good, through equitable contributions from all of Vermont’s people and businesses.

Human rights campaigners are prepared to take on corporate forces. While the Healthcare Is a Human Right Campaign has not relied on legislation to boost its organizing, it has grown with each legislative success. As people across the country study Vermont’s achievement, it may inspire them to help build the movement for healthcare as a human right. Such an impact could rival the significance of the universal healthcare bill itself.

Anja Rudiger is the Human Right to Health Program Director at the National Economic and Social Rights Initiative.

A version of this article was originally published on The Huffington Post.