I respectfully take issue with this ccaiahterrzation by Dr. Richter: If everyone sticks to their guns – Gov. Shumlin, legislative leaders, those of us acting in the public interest not self interest the first practical steps in a process that will stretch for years will be taken. The implication seems to be that those who oppose single-payer (or a hybrid thereof) are doing so out of self interest rather than out of the public interest. This could not be further from the truth. I personally advocate radical systemic reform, but not in the direction of single-payer, and I do so out of a sincere conviction that it would be best for my friends, neighbors, and fellow Vermont citizens; self-interest does not enter into it.I believe a system that insulates people from the costs of their healthcare choices is doomed to failure in the long-term, if not the short-term. One of the reasons for spiraling costs is that so many procedures and services being covered by insurance leads to greater use, which means prices shoot up much faster than the rate of inflation. A single-payer system will simply exacerbate that problem, and cannot control costs in the medium-term or long-term without draconian rationing of care. In this scenario, it's hardly self-serving for me to suggest that this is a bad idea; I'm actually advocating for the public good. Being self-employed, in fact, I would likely benefit from a single-payer system. But I don't believe it's right, either practically or ethically.I believe Vermont would be better served by allowing any and all insurance companies nationwide to offer insurance products of all types to Vermont residents, with no requirements about what must be covered. That way, we can buy whatever insurance meets our needs, and we would benefit from the simultaneous reductions in costs that would accompany such a change. With millions of healthcare transactions per year being subject to scrutiny by Vermonters who are now conscious of the costs of their decisions, costs would drop dramatically as competition takes hold.And of course no advocacy of any healthcare system is complete with the caveat that those who cannot afford the care they need *must* be subsidized by their fellow citizens, either through means-tested government programs, charities, or other means.So I would again emphasize that opposing single-payer is not self-serving, and nor is it amoral or immoral, as one of the replies on this page also indicates. It's possible to disagree with the leftward lean of Vermont as a whole and still be focused on the public good.