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Vermont was supposed to be the beacon for a single-payer health care system in America. But now its plans are in ruins, and its onetime champion Gov. Peter Shumlin may have set back the cause. (Wheaton, 12/20)

After Gov. Peter Shumlin dropped his long-sought goal of a universal, publicly funded health care system this past week, key members of his health care team immediately got back to work picking up less ambitious pieces of the plan. Appearing Wednesday before reporters and two boards that had advised him, the second-term Democrat said there were steps the state can still take in a bid to reduce health care costs. The less ambitious steps described by aides include pushing hospitals and health systems toward "global budgets" in which they are given a set amount of money each year for serving the health needs of a certain population and away from the traditional "fee-for-service" system in which the more procedures are performed, the more health providers get paid. (Gram, 12/21)

But as the numbers got more concrete — as they closed in on the plan the governor actually wanted — the financial foundation began to crack. [Vermont's director of health reform Robin] Lunge knew by that Friday that the single-payer system Vermont wanted to build would require about $2.5 billion in additional revenue in its first year. In Vermont, this is massive: the state only raises $2.7 billion in taxes a year for every program it funds. Early estimates said that Vermont's single-payer plan might need $1.6 billion in additional funds — a huge lift. But $2.5 billion was impossible. "It was disappointing to me and my team that we weren’t able to make the numbers work the way that we had hoped," Lunge said. (Kliff, 12/22)