Forum On Single-Payer Healthcare System Packs House

By Karen B. Hunter
The Falmouth (Mass.) Enterprise, November 30, 2017

Massachusetts state Senator James B. Eldridge from the Middlesex and Worcester District has authored Senate Bill No. 619: An Act Establishing Medicare for All in Massachusetts.

On Wednesday evening, November 29, people eager to know more about the bill attended a forum sponsored by the Unitarian Universalist Fellowship of Falmouth.

Three guest speakers—Dr. Gordon D. Schiff, associate director of Brigham and Women’s Center for Patient Safety Research and Practice, associate professor of medicine at Harvard Medical School, and quality and safety director for the HMS Center for Primary Care; Dr. Robert J. McGowen, chief primary care services, Wareham Region; and Sen. Eldridge—spoke to a full house at the church off Sandwich Road.

A one-page summary of the bill, which is 38 pages long, was handed to people as they arrived.

“Access to health care is not currently a right in Massachusetts,” the summary stated. “A single-payer system would save an estimated 15.75 percent of our current spending on health care...and guarantee access to quality, affordable health care as a right for all residents of the Commonwealth.”

The summary stated that Massachusetts has the highest per-capita healthcare costs in the country, that they rise every year and that the commonwealth cannot afford to extend good healthcare coverage to all residents under the current health insurance system.

“Something is changing in the country,” Dr. Schiff said. “The majority of the country now favors universal health care, and I am hopeful about this sea change,” he said.

Dr. Schiff opened the forum by asking people to give their opinions about health care in Massachusetts.

Comments from the audience included that the current system is “dreadfully unfair and that many people cannot afford insurance”; that a single-payer system would be “more just”; that there should be “fairness and equal availability” within the system; that we need “realistic billing” and paperwork that are “honest and transparent”; and that costs should be “fair” and not just what the market can bear.

“It is shameful to be one of the wealthiest countries in the world and not provide universal health care,” one person said.

Dr. Schiff pointed out that the 25 wealthiest countries in the world all have universal health care, except the United States.

Speaking with a PowerPoint presentation, Dr. Schiff said the bill would create health care that is affordable for everyone; doctors and services that are available to everyone; the ability to choose one’s own doctor; continuity of care; a user-friendly, error-free, harm-free system where patients are treated with dignity and healthcare providers are not suffering from “burnout.”

“A single-payer system would put everyone in the same boat to share the costs; it would put an envelope around the entire population. It would be the embodiment of caring values, such as fairness, inclusion, cooperation, and caring,” Dr. Schiff said.

Dr. Schiff said the number of people dying for lack of health insurance is growing, as is the number of people who are under-insured. For many families, he said, even those with health insurance, any major illness can wipe out a family’s savings, making it impossible to pay the mortgage, to fix the car, for example. Unpaid medical bills are the most common reason for calls by collection agencies, he said.

“We have a broken healthcare system,” Sen. Eldridge said, noting that in many cases, the state Legislature has to pass legislation to protect citizens’ right to basic medical support and resources.

“The way our system is structured is flawed,” Dr. McGowen said. He has been a primary care physician for some 30 years. “It feels more and more that the profit motive drives care in the United States. We are reaching a tipping point where we are spending more and more and getting less,” he said.

“Thousands of Massachusetts residents still lack health insurance coverage of any sort and most residents are under-insured,” Senate Bill 619 states on page four. “Many people have little or no coverage for dental care, behavioral health, eye glasses, hearing aids, home health care, nursing home care, and other important needs,” it says.

This proposed single-payer healthcare system for Massachusetts would function for residents under the age of 65 much as Medicare does for residents 65 and older, but without premiums and co-payments.

The state’s healthcare system is currently controlled by for-profit corporations, accountable mainly to shareholders, and nonprofit companies with little accountability to patients or the public, Senate Bill 619 states.

To achieve the goal of universal access to quality, affordable health care, the bill proposes establishing a Massachusetts Health Care Trust, which would be the single-payer body responsible for the collection and disbursement of funds required to provide health care to every resident of Massachusetts.

The bill would replace current employer and employee premium payments with an employer and employee payroll tax.

Sen. Eldridge said that the passage of Senate Bill 619 would create a huge change in the healthcare system, and while he admitted that he does not have all the answers yet, he said that momentum toward a single-payer system is building.

He is hearing from an increasing number of doctors, he said, who say they are tired of the current system in which administrative work takes up much of their time, and they now support a single-payer system.

“Half of primary care physicians are seriously burned out,” Dr. Schiff said, citing billing requirements and production pressure as key reasons. “There is a loss of joy in the work. Doctors used to have relationships with their patients,” he said.

Every other country in the world that has achieved universal healthcare coverage and controlled costs has relied on a single-payer system to get there, the bill summary states.

“Most Americans agree that it is the responsibility of the federal government to ensure that all citizens are medically covered,” Dr. Schiff said.

When audience members asked what they could do to help, Sen. Eldridge urged them to encourage their elected officials to support Senate Bill No. 619.

“We have the expertise,” Mr. Eldridge said. “We just need the political will.”