Single Payer System Solves Health Care Problems
In the November 4th election, the local ballot initiative supporting single payer health care reform and opposing individual mandates passed by landslide margins in all 10 legislative districts where it appeared.
Sponsored by Mass-Care, leader in the campaign for single payer health care reform in Massachusetts, the measure passed with margins ranging from 66 percent in the 5th District of Middlesex County to 82 percent in the 3rd District Hampshire County.
Ballots Cast
But what does this overwhelming victory for single payer reform mean for the new legislative session beginning in Jan. 2009?
Up until now most legislators have been firmly committed to the new health care law that was passed in 2006 and touted by Sen. Ted Kennedy as the model for a national health plan. But there are serious problems with this law that hurt businesses, municipalities, families and individuals.
The major problem is lack of cost control measures allowing the total cost of health care to rise faster than the GDP making our current law unsustainable in the long term. As Susan Dentzer, editor in chief of the prestigious journal Health Affairs puts it, “How can the costs of covering hundreds of thousands of uninsured people be sustainable over time, especially when the underlying rate of growth of health care costs is not?”
The cost of the commercial health insurance premiums continues to rise at 10 to 15 percent annually, the high out-of-pocket costs of co-pays, deductibles, and co-insurance reduce access, and the cost of prescription drugs is often unaffordable. In addition, the cheapest policies may have gaps in their covered benefits particularly for preventive care, causing increasing underinsurance. There are still more than 300,000 uninsured in Massachusetts and the stiff fines for being uninsured add to the misery of the most vulnerable people.
Bridging The Gap
Single payer reform is more than bringing efficiencies to health care by ending the fragmentation and waste of the commercial insurance system. Having one single system will allow cost control with global budgets, prioritization of health expenditures, public health initiatives to promote healthy lifestyles, and removal of the burden on businesses to provide health insurance plans for their employees. It provides the biggest risk pool possible, the entire population, that spreads medical risk widely so no one will lack coverage when they are sick or old. It will also create a health delivery system that rewards cost effectiveness, evidence-based medicine, and good medical outcomes.
Only a single payer system can guarantee universal coverage. Funding for single payer is based on a health tax that would be a substitute for the premiums and out-of-pocket costs that people pay now. Other funding would come from a payroll tax that would be lower for small companies and would be predictable. Single payer will cost less for individuals, families, municipalities, businesses, and the state.
Dr. Steffie Woolhandler, a founder of Physicians for a National Health Program stated, “In district after district Massachusetts voters voiced their overwhelming support for single payer health insurance.”
Only a single payer program can simultaneously expand coverage and control costs.
The voters are ready. Will our leaders follow?
Dr. Patricia Downs Berger is co-chair of Mass-Care. Visit www.masscare.org.
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