NEWS

Universal Single Payer Health Care: Could Massachusetts be the First?
by Richard Mason,
Chairperson of MASS-CARE

Massachusetts has the opportunity to be the first state in the nation to institute a single payer health care system that would provide quality health care to every resident.  The Massachusetts Health Care Trust legislation that was submitted in the Massachusetts House and Senate on December 6, 2000 (click here for a list of co-sponsors) would create a trust that would could collect all revenues targeted for health care, including Medicare and Medicaid, and would act as the “single payer” for all health care expenses.  The governance body would have broad representation from consumers and providers.  The trust would also be responsible for determining the capital budgets for health care facilities throughout Massachusetts.  The delivery of health care services would remain in private hands and consumers would have complete choice of provider(s).

We all know that the health insurance companies are not going to give up such a lucrative market without a fight.  They outspent the proponents of Question 5, (a November 2000 Ballot initative that would have guaranteed universal access to healthcare for all citizens) which would have mandated universal health care, by at least 100 to 1.  But, there are a number of factors that proponents have going for them

1. Proponents of single payer health care were able to pass legislation (Chapter 141 in the Laws of 2000 -–Section 32) in the last legistative session that created an Advisory Committee on Consolidated Health Care Financing that is to study “a system of consolidated health care financing and streamlined health care delivery model accessible to every resident of the commonwealth.”  This Advisory Committee was provided with $250,000 to hire a consultant to study “consolidated health care financing”.  The consultant is also supposed to make recommendations on how such a system would be implemented in Massachusetts.  This Advisory Committee study could provide a blueprint for implementing single payer health care in Massachusetts.  We also expect the consultant’s study will come to the same conclusion that two studies done by the Massachusetts Medical Society came to, that a single payer health care system could cover everyone in Massachusetts with comprehensive benefits for the same money we are spending now, or less.  The Advisory Committee’s final report is due December 31, 2001.  MNA is represented on the Advisory Committee by Judith Schindul-Rothschild RN, PhD.

2. Representative John Tierney has introduced the States Right to Innovate in Health Care Act of 2000 into the U.S. Congress.  This legislation would provide waivers from federal regulations and financial incentives to 10 states to allow them to experiment with ways of achieving universal health care.  This would provide an excellent incentive for Massachusetts to move forward on implementing a universal single payer health care system.

3. The polling on Question 5 showed 60 to 70% of the respondents in favor of universal health care.  This was before the insurance companies and HMOs spent such outrageous amounts of money to scare the public into voting against it.  Even then, Question 5 only lost by a 48 to 52% margin.  In addition, universal single payer health care has been on the ballot in six legislative districts over the last two elections and has won by an average of 75 to 25%.

4. The fourth and final thing that proponents have going for them is something that nurses know better than any of us:  The health care system is so terribly broken, that it is going to require systemic change in order to fix it.  Massachusetts already spends over $6,000 per person health care, which makes it the most expensive health care in the world.  Despite that, we have as many as 500,000 uninsured in Massachusetts and many hundreds of thousands more with inadequate health insurance.  Six thousand dollars per person is more than enough money to provide every resident of Massachusetts with quality health care.  What we need to do is capture the money that is currently wasted on administration and profit in our present fragmented, multi-payer and market-driven system and use that money to provide quality care to all Massachusetts residents.

Every other industrialized country in the world provides health care to all of its residents with some variation of a consolidated health care financing system.  The most any of those countries spend on health care is 10% of their GNP, while the U.S. spends over 14% of its GNP.  It is time for the United States to catch up the rest of the world and to provide universal single payer health care to all of its residents and Massachusetts can help lead the way.

We are going to have to make it happen.  It is a given that the insurance companies and HMOs will come at us with all they have got.  They need to try to stop this in Massachusetts because they know that once it passes in Massachusetts it is only a matter of time before they join the horse and buggy. We have the truth and numbers going for us, but it won’t happen unless we organize to make it happen.

Over the next year and a half, MASS-CARE will be organizing public hearings, rallies and other ways of showing public support for universal single payer health care.  The first events will be this spring of 2001, and we could use all the help we can get to make these events as successful as possible.  MASS-CARE will also be urging more legislators to sign on as supporters of the Massachusetts Health Care Trust legislation. Please click here to see if your legislator is on the list.

Yes, we have the opportunity to make history in Massachusetts.  In order to do so we have to unite all of those who benefit from a universal single payer health care system and bring that collective pressure to bear on our leaders. The Massachusetts Nurses Association has been an integral member of the universal single payer movement since the beginning. Please call the MNA office and let them know that you want to get involved.