Of course implementing the law over the next 3-5 years is problematic, since it requires a waiver from HHS, and I don’t think that Obama will stop sucking up to the insurance and finance industries and allow that to happen:

In order to actually enact the system, the state needs a waiver from the Affordable Care Act health reform law. Currently, the federal government will start handing out state waivers in 2017 — three years after Vermont wants to implement its system. Rep. Peter Welch (D-VT) has introduced an amendment that would move the waiver date up to 2014, an idea that President Obama has endorsed.

While I am sure that Obama would love to have the ability grant a waiver moved up, he is as insistent of the prerogatives of the executive as Dick Cheney ever was, there is no way that he would allow Vermont to set in motion a series of events that would transform healthcare delivery nationwide.

Basically, if Vermont is allowed to implement single payer,  businesses will start to move there, because healthcare is such a huge part of their personnel costs, and other states will start to feel pressure to follow suit, which should, eventually, lead to something like single payer being implemented nation wide.