Physician calls for single-payer health care system in NH

By Garry Rayno
The Union Leader (Manchester, N.H.), Feb. 3, 2015

CONCORD, N.H. — “Who do you want to pay?” was the question a Dover physician asked in supporting a bill for a single-payer health care system in the state.

Pushed by Granite State Physicians for a National Health Program, House Bill 686 would provide health care to all the state’s residents who fill out an application form while doing away with private carriers.

Supporters told the House Commerce Committee members Tuesday the bill would better allow the state to control health care costs while every citizen would be covered.

But opponents said the bill would double the state’s budget, raise taxes and cripple key industries in the state.

“This is not a not ready for prime time bill,” said Americans for Prosperity NH Director Greg Moore, “This is a bad bill.”

But the bill’s prime sponsor said it is an opportunity for the state to control costs and provide health care for all its citizens.

“This will fix health care in New Hampshire,” said Rep. Richard McNamara, D-Hillsborough. “We know our people, we know what our needs are.”

Under the bill, every New Hampshire citizen would be eligible for health care after filling out an application. There would be no co-pays nor deductibles.

Hospitals would receive a lump sum monthly payment negotiated by the state.

A health services governing board would oversee the program and a health services trust fund would be established to pay providers.

There is no mechanism to pay for the program in House Bill 686, which would go into effect 60 days after it passes, which is unlikely this year.

At the public hearing, family physician James Fieseher of Dover told the House Commerce and Consumer Affairs Committee the current health care system is broke.

“I don’t like to waste money. I don’t like to waste my money and I don’t like to see the state waste money,” he said. “We need to do something about a broken system we cannot afford. The system is a leaking boat.”

He said the current system requires health care providers to treat people who cannot pay for their care, and that drives up the cost for everyone.

“That’s like mandating supermarkets give away free food to those who cannot afford to pay,” Fieseher told the committee. “You drive up costs for everyone.”

With the state overseeing the health care system, he said, health care costs would go down. The people who cannot afford it now will continue to have health care, but providers will be paid for their services, he said.

Currently, the average health insurance plan costs about $15,000 a year with copays and deductibles, Fieseher said. “That is a private tax, not a government tax, paid to a private company with no investment to make the system cheaper,” he said. “The question is who do you want to pay?”

But Moore told the committee Vermont recently canceled its plans to move to a single-payer system because of costs.

He noted the plan would have cost $2.6 billion, and with Vermont about half the size of New Hampshire, the projected costs here would be $5.2 billion, which is almost equal to the current annual state budget.

Moore said one of the reasons the Vermont plan was scrapped was the cost on business and individuals, an 11.5 percent tax on payroll and an up to 9 percent tax on individual income.

The owner of Sugarbush ski area said the plan would have increased his health care costs by 61 percent, said Moore, and that would be true for all seasonal employers.

“That would be a huge hit on our tourism industry,” Moore said. And, he added, he has concerns about out-of-state coverage for state residents.

“There are a lot of fundamental problems,” Moore said, “The biggest is how to pay for it.”

The committee did not make an immediate recommendation on the bill.

Garry Rayno is with the State House Bureau.