The Employee Retiree Income Securtity Act of of 1974 means that only Hawaii can legislate employer mandates (10 steps down from Single Payer). Hawaii is unique for a whole bunch of reasons, but they have done better for decades than the rest of the states due to their excemption.

When the Fed didn’t step up, Hawaii did. Now that the California has yet to step, San Francisco is trying (can’t wait to see the author — Tom Ammiano — in the Assembly). Yet the same old ERISA complaint.

And the Consolidated Omnibus Income Security Act of 1985 pretty much means health care will suck (despite out of the best intentions) until we get real primary care.

ERISA did a lot of great things, but it should be amended. Of minimum, common sense revision would still not bring about single payer, but it would give local governments some parlay room.