Massachusetts' health plan is not single-payer
By Matthew W. Petty
Op-Ed, The Forum (Fargo, ND)
May 4, 2006
The single-payer national health insurance system described by Josh Swanson in his April 23 opinion in The Forum is the best solution to America’s health care crisis. Unfortunately, the Massachusetts legislation Swanson describes is not single-payer, nor does it solve the health care crisis.
The Massachusetts proposal mandates that people buy their own coverage - with little or no help from employers - or pay a hefty fine. Swanson compares health insurance to auto insurance, arguing that if every driver is required to buy auto insurance, it is fair to make every person buy his or her own health insurance. But this argument ignores the critical fact that people have a choice to own a car but no choice about being an all-too-human mortal.
Extending the auto insurance argument to social policy fails to address real crises. For example, no one wo uld suggest ending homelessness and hunger by mandating that all homeless people buy a house and all hungry people buy food.
Requiring the uninsured to purchase health insurance will simply result in a proliferation of health insurance policies not worth the paper they are printed on. A 2005 Harvard study shows that three-quarters of people bankrupted by illness had health insurance when they first became ill. That percentage could skyrocket if the country adopted a Massachusetts-style individual-mandate law thanks to cheap and skimpy insurance policies.
Swanson is correct that many studies show single-payer to be the most cost-effective solution to the health care crisis. Unfortunately, the Massachusetts plan only adds to the health care system’s administrative waste. Massachusetts’ health care system already devotes $13.3 billion to billing, marketing, and other administrative costs. If the state devoted the same percentage as Canada’s single-payer system to bu reaucracy, the state’s health care system could save $9.5 billion annually, enough to cover all that state’s uninsured and to improve coverage for everyone else.
The Massachusetts health care proposal purports to provide health insurance to nearly all state residents. In reality the proposal promotes shoddy coverage with more holes than Swiss cheese. Insurance will remain unaffordable even with tax subsidies, forcing state residents to spend as much as 20 percent of their income for health insurance. The proposal will do nothing to stop employers from dropping coverage for workers, control costs, or reduce paperwork.
Nations with single-payer systems (e.g., Canada, Sweden, Norway, Germany, etc.) have better health outcomes while spending less per capita. Adopting a true single-payer system is the real solution to America’s health care crisis.
Petty is a 2001 graduate of Fargo’s Shanley High School and a 2005 graduate of Northwestern University with a bachelor’s degree in social policy and specialization in health policy. He is currently office manager and research associate with Physicians for a National Health Program, a 14,000-physician-member national nonprofit organization based in Chicago. E-mail matt@pnhp.org.