Opinion Massachusetts Needs A Single-payer Health Care System

Everybody is talking about health care reform, from politicians and businessmen to doctors and patients. In recent weeks, Gov. Romney and state Senate President Travaglini have introduced bills they describe as efforts to extend health care insurance coverage to the state’s half a million uninsured citizens. 

In an editorial, The Berkshire Eagle recently opined that these bills should be seen not as solutions, but instead as an introduction to a dialogue about reform in the health care insurance system in Massachusetts. The paper is right.

The main problem with both plans is that they merely extend one more complicated and inadequate insurance plan to more people. Romney proposes a new ‘low-cost’ insurance product that could be bought with pre-tax dollars for about $2,400/year. With high deductibles and co-payments, this plan is scarcely a bargain for workers whose salaries are just above the poverty line that separates them from qualifying for Medicaid.

Travaglini’s plan would also let insurance companies offer a similar ‘lower cost’ product. In addition, it would put the onus on employers who have more than 50 employees to make a contribution to their employee’s health care, if they don’t provide insurance, through a ‘free-rider’’ surcharge paid by the employer. If either of these bills is passed, our state will have even more underinsured patients who will be unable to pay their deductibles and co-payments for services and medications, and who will still fall into bankruptcy as a result of medical expenses. And hospitals and doctors will still be left with unpaid bills.

The answer to the current health care debacle is not more complex and inadequate insurance product choices. Instead, the answer lies in a fundamental change in the health care insurance system itself, from for-profit private insurance to a government-funded and administered single-payer health care plan. The Massachusetts Health Care Trust is the bill in the Legislature which would provide single-payer health care in Massachusetts.

Single-payer health care would be universal; everyone would have a health insurance card. The burden of health insurance would no longer be placed on businesses; since coverage would not be tied to a job, it would be portable for patients who change jobs. All medical expenses from birth to death would be covered, including prescription medications, mental health and dental benefits, and long-term care. A single-payer plan is less expensive than the current array of private health insurance options, because the administrative costs of single payer is 3{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} as compared to 30{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} to 40{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} for private insurance. In Massachusetts alone, this administrative savings would amount to $11.4 billion, enough to provide comprehensive coverage for everyone in the state.

Unfortunately, both the Romney and Travaglini plans continue to support the high administrative costs of private insurance companies, with their corporate profits and egregious CEO salaries (William C. Van Faasen of Blue Cross Blue Shield of Massachusetts earned more than $3 million in salary and benefits in 2002). The annual report of Fortune 500 companies for 2004 listed health care insurance companies and managed care as second highest in their return to shareholders, at a whopping 51.4{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}.

Health care insurance profits were topped only by casinos, resorts and hotels in their returns to shareholders.

While patients are going without health care or falling into bankruptcy because of medical expenses, and while businesses and towns are struggling to cover health insurance costs, health care insurance investors are reaping huge profits. Corporate profits should not be a part of health care: they benefit only those in the corporation, at the expense of patients, the medical system, the general economy, and the health of our communities.

The debate about the current bills in the Legislature brings the inadequacy of the current private health care insurance system to the fore. Single-payer health care is the only plan that will provide a cost-effective way of extending full-coverage health care to every Massachusetts resident. If you are interested in reading the Massachusetts Health Care Trust legislation, ask for a copy from your legislator.

Dr. Suzanne King is a physician in Lenox, Mass.