By Brian Steele
Masslive.com, August 19, 2014
Massachusetts lawmakers passed a universal health care program in 1988, but its implementation was repeatedly delayed and it was finally repealed when political power in the Statehouse swung away from Democrats and Republican Gov. William Weld was elected.
Decades have passed, but on Wednesday, Aug. 20, members of a group called Physicians for a National Health Program plan to rally before a gubernatorial health care forum at The Dimock Center in Roxbury, calling on all the candidates to agree to push for a new single-payer system if they’re elected.
The system would eliminate private insurance and replace it with a government agency that pays all medical bills with money collected under a progressive tax model. A program called “Medicare for All” was proposed in Congress in 2003 and periodically reintroduced, but never passed.
Jawad M. Husain is a second-year medical student at Boston University. He co-founded the student chapter of the non-profit physicians’ group, which is barred by law from endorsing candidates.
Husain said a single-payer system is about satisfying “a moral obligation to prevent suffering.”
“Forty-five-thousand people a year die because they don’t have health insurance in the U.S. That’s unacceptable to me,” he said. Even the Affordable Care Act, beloved by many liberals despite its well-publicized flaws, is projected to leave 31 million Americans without insurance by 2024.
“We need a pretty drastic improvement in our health care system,” he said. “I see health care as similar to education. … We, as a decent society, have an obligation to provide that to our citizens.”
An economist at the University of Massachusetts at Amherst argued last year that the money Americans spend on health care would almost instantly plummet under the single-payer model.
“The U.S. could save an estimated $592 billion annually by slashing the administrative waste associated with the private insurance industry ($476 billion) and reducing pharmaceutical prices to European levels ($116 billion),” wrote Gerald Friedman. “In 2014, the savings would be enough to cover all 44 million uninsured and upgrade benefits for everyone else.”
Friedman acknowledged that it would be expensive to pay unemployment insurance and retraining costs for every insurance agency employee in the country, and estimated the total cost of implementing the system at $391 billion.
Employers would no longer make contributions to employee health care, medical bills would become tax deductible and tax credits would be available to small businesses.
Advocates point to Canada’s health care system as a good example of the single-payer system in action. But in 2013, the average Canadian had to wait four-and-a-half months to be seen by a specialist for a medically necessary appointment, even after referral by a general practitioner.
That’s even longer than in 2012, according to the Fraser Institute, an independent Canadian think tank.
“Waiting has come to be a defining characteristic of the Canadian healthcare experience,” according to another Fraser Institute report. “Waiting for health care also has broader economic consequences. Increased absenteeism, reduced productivity, and reduced ability to work caused by untreated medical conditions and waiting can reduce overall economic activity.”
Longer waits also increase the risk that a medical problem will get worse.
In 2013, wait times in Massachusetts increased year-over-year for patients trying to get a first appointment with a new doctor, according to the Massachusetts Medical Society.
“We already have rationing. We already have wait times,” said Husain, who blames private insurance companies for choosing which patients are treated for which ailments, and how much doctors will receive in exchange. “Twelve cents of every dollar goes toward not providing care.”
He added that the only reason we know about Canada’s long lines is that the system is accountable to the taxpayers and such information is made publicly available. Under an American system, it would be the same deal, whereas insurance companies are accountable only to investors.
Still, even a single-payer system would require the administrators to make choices about who gets what. The model proposed by PNHP would cover only medically necessary procedures and medication, while supplemental insurance could be available for elective procedures, or the patient could pay out of pocket.
Private doctors and hospitals would remain private.