As Congress moves forward with reform of our costly and dysfunctional health care system, it looks increasingly less likely that a single-payer plan (like the Canadian system) has a chance. The health insurance industry and other large corporate health care providers are heavily lobbying Congress to preserve the current system, with a few reforms that will allow them to continue doing business. One ray of hope, though, is that we can advance the opportunity for those states — like California — who want to adopt this most efficient and affordable approach to universal health care.

Under a single-payer system, there would be government funding and administration, with private delivery of services. Patients could choose their providers, and doctors could determine treatments without first having to get permission from insurers, as currently is the case in our mostly private, for-profit system. Individuals would pay for their health care through payroll contributions — just like they currently do with their Social Security and Medicare payroll deductions. No one would be denied care, no exclusions based on pre-existing conditions would be allowed, and women could not be charged higher rates because they use the system more for maternity and preventive care — as happens currently in the private individual market.

A handful of states — California, Pennsylvania, Illinois and others — may be ready to seriously consider state legislation that would establish just such plans. California has already passed two separate single-payer bills, but Republican Gov. Arnold Schwarzenegger has vetoed both. Advocates promise that they will pass another single-payer bill once the governor leaves office.

Rep. Kucinich wants to make sure that states can adopt their own single-payer plans. His amendment indicates that the single-payer system would “provide comprehensive health benefits to all residents of the State using progressive financing and provides measures to assure free choice of providers for covered services, to promote quality…”

Private insurers would not be able to offer insurance duplicating benefits provided under the state single-payer plan, and Health Maintenance Organizations (HMOs) would have to be non-profit entities. Sen. Sanders’ amendment, reportedly, is similar to the House amendment, which currently has 65 supporters. Support in the Senate is uncertain, but earlier this year 37 senators signed a statement supporting a “public plan option.”

It is difficult to predict exactly when these amendments will come up in committee, but please send your messages now urging your Congress members, especially the Democratic members of the House and Senate, to vote for these amendments and let their colleagues know of their support.