Importance of Boston City Council supporting single-payer health care reform

By Ture Richard Turnbull
Jamaica Plain (Mass.) News, Aug. 22, 2016

The Boston City Council will take a bold step on Wednesday, August 24, by passing a resolution reaffirming its support for a single-payer health care system.  The resolution calls upon the state legislature in the upcoming 2017-2018 legislative session to propose and pass a measure to achieve a single-payer system in the Commonwealth.

This resolution is an extremely important endorsement for true health care reform that would make health care a right for all Massachusetts citizens and “provide availability and affordability of healthcare for all Massachusetts citizens.”

In 2001 the Boston City Council passed a similar resolution supporting single payer (also known as Improved Medicare for All). In 2008 the Commonwealth adopted Chapter 58 in an attempt to cover more people by mandating that everyone must buy health insurance or pay a stiff fine; but it lacked the ability to control health care costs. We now have the Affordable Care Act (ACA) that is largely based on Chapter 58. It does cover more people, but it is still unable to control costs. In Massachusetts there are about 300,000 people who are uninsured and many more who have insurance, but the co-pays, deductibles, co-insurance and high cost of medications make it impossible to access the medical care they need.

We need to ask ourselves why our present health care system fails to provide everyone with affordable, high quality coverage. If we look at the money trail it is clear that the private health insurance companies, the pharmaceutical corporations, and the big hospital groups are stashing away billions of dollars while patients are struggling to pay for needed and routine medical care.

We have a profit-based or market-based system that basically allows the health insurance companies to make huge profits by skimping on medical care creating a large profit margin that satisfies their shareholders. The pharmaceutical companies are on a rampage to raise prices on their prescription drugs to the point that in some cases life-saving medications for HIV, hepatitis C, and cystic fibrosis will cost as much as $300,000 per year. These corporations say they need the money for research and development, but most of the money goes to the CEOs with obscene salaries and to payouts to satisfy their shareholders. We need a health care system that is patient-centered not market-based.

Why should Massachusetts move to a single-payer system?

• It guarantees access to medical care for everyone, up front, with no co-pays, deductibles, or high out-of-pocket costs.

• It is continuous from birth to death, no eligibility requirements if you reside in Massachusetts, with no loss of coverage if you change or lose a job, and no need to stay in a bad job just because of the health insurance it provides.

• Businesses and municipalities would benefit because they would no longer be responsible for providing health insurance for their employees. Instead they would pay a payroll tax that would be predictable for long-term planning and in most cases would cost less than what they pay now, allowing for growth in businesses and more funding for vital municipal programs such as schools and fire and police for towns and cities.

• A single-payer system would be funded by income taxes made as progressive as possible under Massachusetts law, a business contribution through a payroll tax, and possibly taxes on unearned income. State income taxes might rise for some people, but the rise in taxes would be in most cases much less than what we pay now for health insurance premiums (around $22,000?!?! for a family of four), co-pays, deductibles, co-insurance, all of which would be eliminated.

• Private health insurance companies would be streamlined to cover only things not covered by the single-payer system. This would eliminate the wasted money spent on unnecessary administrative functions and the profits that are siphoned off the system estimated to be around 30% of total health care expenses for the state. Pharmaceutical companies would be forced to negotiate their prices with the single payer administration. This would keep the cost of medications affordable and set better guidelines for development of new drugs.

• Hospitals and large medical groups would be funded by a negotiated budget for all hospital expenses. Capital improvements would have to be approved by the single payer administration to avoid duplicated services that aren’t necessary for the system.

• A single-payer system is a patient-oriented system that would reduce health disparities since everyone is covered, and improve the quality of care. It would also strengthen the healing power of the doctor-patient relationship by giving doctors the right to make decisions about medical care instead of insurance bureaucrats allowed full choice of doctors. A single-payer system is based on the premise that a healthy society promotes opportunities for the young, comfort and dignity for the elderly, and good health care for families that make up the workforce of the country.

The timing of the resolution by the Boston City Council is tremendously important. A single-payer system is being championed by candidates across the country and it is now a mainstay of the large and growing progressive movement. In Massachusetts there are many new candidates who will be added to the strong group of legislators who already support a single-payer system. The primaries will be held September 8th and it is extremely important for everyone to vote and to support the candidates who will vote for a single-payer system. Cities and towns across the Commonwealth have the incentive now to follow the Boston City Council and make resolutions of their own to support a single-payer system. The 2017-2018 legislative session will show whether we have the political will to achieve what almost all the other countries in the world already provide, a single-payer (Improved Medicare for All) system that covers everyone with high quality care, is affordable, sustainable, and equitable.

Thank you Boston City Council!

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Ture Richard Turnbull is the executive director for Mass-Care. Mass-Care’s mission is to establish a single-payer health care system in Massachusetts.