Five Critical Lessons from Vermont’s Universal Healthcare Struggle


By James Haslam, Director, Vermont Workers’ Center

Reprinted with permission

[Note: This was written to share at our Summer Leadership Retreat and with our peers around the country. It has been a true honor to work with so many amazing and committed people. There were countless lessons learned in the past three years, these are five we wanted to lift up as valuable for our road ahead building a movement with our counterparts everywhere. They were earned by the tireless work of hundreds of people. ]

 On May 1, 2011 over two thousand people took part in a Healthcare Is A Human Right march and rally in Vermont’s state capitol, Montpelier. They were demanding the final passage of ground-breaking legislation that set Vermont on course to become the first state in the country with a universal healthcare system.

We will never forget that only three years before, when the Vermont Workers’ Center launched the Healthcare Is A Human Right Campaign, we were told by almost everyone that this couldn’t happen.

A few weeks after the rally, while we watched Vermont’s Governor Peter Shumlin sign “Act 48: Relating to a Universal and Unified Health System” into law we were struck by how far we had come in just a few years. Yet even as our dream is beginning to take shape in reality, we also realize how many more battles still lie ahead of us. With many deep-pocketed and well-connected foes plotting to defeat our people’s movement, we must scale up our grassroots organizing to build a broader movement for social and economic rights, involving even more people and allies, so that we’re ready to take back our democracy.

As our grassroots leaders and organizers reflected on our experience of three years of intense human rightsbased organizing, we identified five hard-earned lessons that may also be valuable to our counterparts around the country. We are very aware that our ultimate success depends on Vermont shedding its role as a unique and exceptional case and instead becoming a catalyst for victorious struggles elsewhere.

Just as the uprisings in Wisconsin have redefined what defensive struggles look like in order to ignite similar efforts around the country, so can Vermont’s example show how to build a proactive people’s movement that can change the political landscape in this country.

1: People’s movements can redefine political priorities. For decades, advocates have made a strong case for universal, single-payer healthcare. Founded in 1998 to fight for workers’ rights, the Vermont Workers’ Center supported many of these efforts. Unfortunately, past legislative initiatives often fell victim to political expediency as politicians declared themselves single payer advocates on the campaign trail but abandoned the platform once in office, pursuing what they saw as “politically possible” instead of championing what would actually meet people’s needs.

This is why in 2008, we launched a campaign to change what was politically possible. Through grassroots human rights organizing, we set out to demonstrate to every legislator that the majority of their constituents supported equal high quality healthcare for everyone. We showed ambitious politicians that championing healthcare reform was in their interest--and that ignoring the Vermonters who elected them would be politically costly.

Ultimately, our grassroots movement - led by the people most affected by the crisis - redefined political priorities in Vermont and made true healthcare reform possible.


2. Using a Human Rights Framework can be extremely effective for both organizing work and policy fights.

When we started the campaign many healthcare activists and political pundits questioned whether the idea “healthcare is a human right” would resonate with “middle Vermont” and rural communities. There was also skepticism whether the values-based human rights approach would translate into an effective policy framework.

But the failure of singlepayer arguments to receive a hearing in the national health reform debate, along with the debacle of Obama’s “Public Option,” demonstrated the pitfalls of relying primarily on a cost-efficiency narrative. In contrast, the human rights framework puts people at the center of policy and practice, thus shifting the discourse from costs to needs, from figures to values. Using human rights, we were able to engage Vermonters from all walks of life and focus the debate on real people, their healthcare needs and struggles, and our values as a community and country. The response to this peoplecentered framework has been overwhelmingly favorable. 

To guide policy discussions and assess legislative proposals, the campaign has deployed five human rights principles: universality, equity, accountability, transparency and participation. These were expanded into an analytical policy framework whose key elements were so persuasive that they made it into the statutory language of Act 48.

As we head down the road to a universal healthcare system, we will be able to use this framework to measure implementation proposals against human rights standards and develop policy alternatives.

The Healthcare is a Human Right Campaign has shown that the fight for the right to healthcare can unite communities long divided on other issues (more on this in #3 below). In using the human rights framework we set the stage for building a broader movement for all economic and social rights. We believe such a people’s movement is necessary to win the kind of democracy required to provide healthcare - and other services that fulfill fundamental needs - as a public good, shared equitably by all.

3. Be prepared to counter divide and rule tactics. Education with our members is a huge part of using the human rights framework. In the early months of the campaign, the Vermont Workers’ Center, in collaboration with the Bay Area-based Catalyst Project, held a series of anti-racism workshops for 170 of our members and supporters all over the state. Included in these day-long trainings was an organizing role play exercise about the divisive issue of covering undocumented workers in our universal healthcare system.

The take home message was that according to human rights principles our campaign would be committed to a truly universal system in which everyone is included regardless of immigration status. Since then, the Workers’ Center has greatly expanded our commitment to leadership development, and hundreds of members and supporters participate in organizing and political education workshops like this one each year.

As expected, our workshop scenario eventually unfolded on the very real stage of the 2011 Statehouse floor.

After the healthcare reform bill had already passed the House and Senate healthcare committees, a last minute amendment for excluding undocumented workers from the healthcare system was introduced in the full Senate and passed with a large, bi-partisan majority. Fortunately, through our past anti-racism and organizing trainings and our emphasis on the human rights principle of universality, our campaign leaders were crystal clear on this issue: when we say universal, we mean everyone!

Despite being told by Senate leaders that there was no chance for removing this divide and rule amendment, we immediately got to work demonstrating to the legislature and the governor that the people of Vermont would only accept a truly universal and inclusive bill. On May 1st, days before the final bill was passed, 2000 Vermonters converged on the Statehouse for our annual May Day rally, signed petitions against the exclusionary amendment, listened to speeches from undocumented farm workers, and chanted the message that “Universal Means Everyone, Everywhere.”

As a direct result of this groundswell of Vermonters unified in their commitment to human rights and healthcare for all, by May 3rd the Senate reversed course and struck the amendment.

4. It’s not just about having convincing arguments, it’s about getting our communities organized to demand justice.  

It certainly can be useful to have facts and statistics to back up what we are fighting for, but ultimately what matters most is having the people power to convince decision makers to act on the will of their constituents. For years, advocates demonstrated that single-payer financing could cover everyone and still save money.

Yet cost-effectiveness was not enough to drive legislative action; we had to put pressure on our elected officials with an active statewide, grassroots network that created the political space for action. We built this with a mass grassroots organizing campaign that involved thousands of people throughout the state. We now have organizing committees in every region whose members mobilize their neighbors to make calls, send letters and come to rallies and events.

Everyday we are holding our legislators accountable to ensure that they serve the needs and priorities of Vermont’s communities.

5. We need to tell our own stories. Many, if not all, people’s movements have learned this lesson. Politicians and most media outlets will go out of their way to overshadow the role of a people’s movement in fighting for and securing positive social change. Throughout the coverage of Vermont’s universal healthcare breakthrough, the media has focused on a handful of politicians, policy experts, and doctors while largely ignoring the people’s movement that drove the reform effort. The opinions of individual elected leaders or prominent community members were highlighted while the collective voice and unified action of thousands of Vermonters went unmentioned.

Unfortunately, the mainstream media--beholden to the advertising revenue of corporate interests--routinely marginalizes people who come together to demand basic rights and justice in their communities. It’s always easier and politically safer to credit elected officials and a select few individual “heroes” for the hard work of thousands of organized community members.

This serves to contain and potentially neutralize the policy wins we’ve made, and to lull community members into passivity - someone else will be taking action for us.

 Since we cannot depend on the mainstream media to cover our mobilizing efforts, values, needs, and demands, we have learned that we must tell our own stories. We tell our own people’s history of how human rights were won for future generations. We tell this history so that people understand that without their own action, change will not happen. There is no hero that will come and save us.

The challenge ahead: We realize that the success of our struggle is tied up with that of other struggles across the country in this historical moment. It will not work if Vermont merely seeks to become an exception. Our opponents will not tolerate the development of dangerous examples, such as providing universal healthcare as a public good.

Public policy around healthcare and our other basic economic and social rights is not about meeting people’s fundamental needs and fulfilling human rights obligations, but instead driven primarily by market imperatives which create and deepen systemic inequities. Those that profit enormously from the current system may be small in number, yet also extremely deep-pocketed and influential. To overcome this difference in power we have to get the many of us organized into a powerful people’s force triumphing the basic moral values our communities share - taking care for one another and having everyone be able to a dignified life.

We have learned that to do this we need to develop a large group of committed leaders and organizers who are as united and sophisticated as our opponents.

 On the heels of our success on healthcare, the Vermont Workers’ Center launched a new ambitious campaign called Put People First! The People’s Budget Campaign to tackle this long term problem about the misplaced priorities that puts profits over people. We have learned that it is not only possible but necessary for grassroots movements to launch ambitious campaigns around bold visions for systemic change.

We will ensure our breakthrough on healthcare was only the beginning of a sustained struggle for our rights, and we look forward to sharing and learning lessons with our peers in the days, weeks, months and years ahead.