By Cynthia McCormick
Cape Cod Times, December 19, 2017
When he retired this year after nearly 40 years as a primary care physician in Provincetown, Dr. Brian O’Malley set his sights on fixing an ailing medical system.
A proponent for decades of a single-payer system — think “Medicare for all” — O’Malley is on the advisory board of MassCare, a Massachusetts organization campaigning for such a system in the Bay State.
“It’s my passion,” said O’Malley, 69.
“I’m of the belief single-payer will happen,” he said. “Health care has become a profit-driven industry. It’s becoming a budget buster.”
The state Senate recently approved a health care omnibus bill that includes an amendment proposed by state Sen. Julian Cyr, D-Truro, that would require the state to study the cost of a single-payer system.
“If it turns out single-payer would’ve saved us a bunch of money, we go to single-payer,” O’Malley said.
The amendment was adopted by Democratic state senators, 35-3, marking a breakout moment for single-payer, Cyr said. “We’ve really seen a groundswell of support.”
The state House of Representatives has yet to take up the bill, but Cyr said he expected that to happen by late winter or spring.
O’Malley has been an inspiration and model of an effective voice on single-payer, said Cyr, who was a patient of O’Malley’s late wife, pediatrician Wilsa Ryder, as a child.
Cyr said his parents went to O’Malley for their primary care for years.
“When you’re a primary care doctor in a small town, you really see from a delivery perspective all the challenges people in your community face,” Cyr said.
“Because (O’Malley) is a physician, his voice is heard at the Statehouse,” said Ture Turnbull, director of MassCare.
O’Malley comes from a “point of authority,” Turnbull said.
In decades past, O’Malley was involved in an effort to bring a single-payer system to Cape Cod.
The Cape Care Coalition floated an idea to charge a local tax to cover the cost of care, but the proximity to Boston health centers made the idea of cost containment impractical, O’Malley said.
“Boston’s too close, too tempting and too expensive,” he said. “The place for us to (bring about) single-payer is at the state level.”
O’Malley said single-payer would reduce health care costs by cutting much of the administrative overhead.
A single-payer model would also eliminate the battles with multiple insurers and pharmaceutical benefits managers that made his life and the lives of his patients increasingly difficult, said O’Malley, who in recent years had to devote his afternoons to paperwork instead of patient care.
Doctors now receive bonuses from insurers if they do well and “dings” if they don’t, he said.
But “doing well is a different set of standards for each insurance,” O’Malley said. “In single-payer, you’d have standards. You’d have goals. But they’d be the same for everyone.”
Not all Cape politicians are singing the single-payer song, however.
State Rep. Timothy Whelan, R-Brewster, said “it seems to be a precarious step to socialized medicine.”
Relatives of his from Ireland, which has a single-payer system, come to the U.S. for advanced care, Whelan said.
The Irish system seems to have turned into a two-tiered system, with people of economic means also purchasing private insurance that allows them access to a higher quality of care, Whelan said.
“We want the best medical care for everyone regardless of income,” he said. “We certainly have to find a way to make it more affordable.”
Neither President Bill Clinton nor President Barack Obama championed single-payer, O’Malley said.
But as health costs skyrocket, people are looking for an alternative method of paying for health care, and single-payer has a proven track record in other countries throughout the developed world, he said.
A former trustee of Cape Cod Healthcare and former head of the Cape Cod Preferred Physicians, a group of 400 doctors affiliated with Cape Cod Healthcare, O’Malley is not afraid to stick his neck out.
A longtime supporter of the environment and liberal causes, O’Malley helped his wife with the home births of their two children, Grace and Robin.
Ryder’s death at age 70 in October devastated him, he said in the office of the medical building he still owns at 30 Shank Painter Road.
Ryder ran the business end of the office while O’Malley met with patients at his wooden table desk.
“I’ve been kind of lost” since losing Ryder, just four months after his retirement, O’Malley said.
But he said he was optimistic about the future, having seen amazing turnarounds in medicine.
O’Malley diagnosed the first case of HIV in the community after recognizing a patient’s symptoms from an article he read about a mysterious new disease in the New England Journal of Medicine.
“I sent him up to Lahey Clinic. He was dead within days,” he said. “It was scary. Several funerals a week were happening.”
But thanks to antiviral treatments administered by specialists, O’Malley started seeing longtime survivors who came to him to control their cholesterol and weight.
O’Malley believes health care financing is reaching its own pivotal point.
“I’m a believer health care is a human right,” he said.
