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single-payer BY DONNA SMITH Vermont's lawmakers and its 620,000 citizens will have much work to do in the years ahead to truly secure their ultimate goal of making sure Vermonters can access high-quality healthcare with- out financial barriers by the year 2017. The plan that began with state-funded proposed designs for health system implementation, presented by Harvard University healthcare economist Dr. William Hsiao in late 2010, will require future pieces of legislation that con- tinue to build other parts of Vermont's system. As states, including Vermont, continue their work to provide more healthcare and stabilize state budgets, it becomes even more clear that a social insurance model works best for patients, for tax- payers, for healthcare professionals, and for budgets and business- es. Before long, we may be able to add Green Mountain Care to the list of marvelous things first experienced in Vermont. Donna Smith is a community organizer and legislative advocate for NNU. Nurses Pivotal to "One Payer States" Collaboration When the nation ultimately reaches the point of improving and extending a progressively financed, single-standard of high-quality care to all, the impetus to do so will have come through states where nurses have been at the forefront of advocating state-based reform and single-payer legislation. And the RNs of National Nurses United will have been count- ed as among those leading the charge. Formed in Wayne, Pa. on April 10, 2010, the "One Payer States" collaboration now brings together state-based, sin- gle-payer healthcare reform advocates from 24 states to share their common challenges and opportunities. As one of the groups that initially formed the group, NNU continues to offer support and guidance to the collaborative body and the leadership nurses can provide on state-based efforts. The group meets by telephone conference call twice each month and held its first face-to-face gathering in Denver, Colo., in June to celebrate a year of shared work and to con- sider even more powerful ways to advance state single-payer bills. Representing NNU at the conference were Cindy Young of California and Donna Smith of Maryland. Other states rep- resented in Denver included Colorado, New Mexico, Pennsyl- vania, Hawaii, Maine, Illinois, Wisconsin, Ohio, Washington, Oregon, New York, and the District of Columbia. California's nurses have led the way in terms of their sup- port for state single-payer bills—first with state Sen. Sheila Kuehl's S.B.#840 (which passed through the Legislature twice only to be vetoed twice by then-Gov. Arnold Schwarzenegger) and now with state Sen. Mark Leno's S.B.#810. Well before the 2010 passage of the most recent national healthcare reform bill, the Patient Protection and Affordable Care Act, CNA and the newly formed NNU pushed federal legislators to make sure the path to state single-payer bills was supported by the necessary federal waivers. This state-based, single-payer reform advocacy work and leadership by the nurses remains critical to its eventual suc- cess in California and beyond. The OPS collaboration has resulted in a synergy of effort on everything from the poten- tial for model legislation and economic impact studies for state-based reform to effective advocacy strategies for a broad range of political viewpoints and positions. Whether it is ultimately first achieved in Vermont or in California or Illinois or Maine or Hawaii, nurses are needed at the forefront of the struggle and within advocacy communi- ties like OPS where next steps are often conceived and for- mulated. Without nurses as advocates and among the architects of the state bills, those efforts are likely to fall far short. With our leadership, the day will come when one or more states actually reach the finish line. —D.S. N A T I O N A L N U R S E 17 NESRI Vermont_REV 2 10/11/11 9:23 PM Page 17