Health Care

After 40 Years, No One Has Produced a Workable Single-Payer Health Care Plan

Vermont passed single-payer legislation in 2011 and abandoned the plan after three years of failure. Why?

Veronique de Rugy | 6.4.2026 1:05 PM

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(Illustration: Midjourney)

Billionaire progressive activist and California gubernatorial candidate Tom Steyer recently remarked: "Health care companies only care about one thing: profits. Single-payer now." This is the same Tom Steyer who opposed single-payer when he ran for president in 2020. "Bernie Sanders was right," he says. "Boy, was I wrong."

He still cannot explain how to pay for it. Can anyone?

Single-payer health care has been the progressive left's signature domestic demand for four decades. It has generated presidential campaigns, mass rallies, congressional cosponsors, and an inexhaustible supply of Twitter righteousness. What it has never generated once is a workable legislative proposal.

Brookings Institution economist Jessica Riedl has spent years waiting for one. Her challenge is simple: Show us a progressive bill that specifies (a) a provider payment system that actually saves money under America's existing, already expensive health infrastructure, and (b) a financing mechanism to replace the roughly $32 trillion in private premiums and out-of-pocket costs that would need to be covered by federal taxes over the next decade.

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