Single Payer Dreams Can Come True
The Boston Globe article “Dream Meets Reality” Jan 25, 2014 presented a superficial and one-sided analysis of Vermont’s attempted implementation of a state-based Single Payer health care system. Missing was the impact of powerful political and corporate pressures against reform and the choices made by Gov. Shumlin that raised the costs significantly while underestimating obvious cost savings.
Massachusetts can lead the nation in implementing a state-based Single Payer system but a fair and open process is key to achieving success. Here are some lessons for Massachusetts based on the Vermont experience.
1. There needs to be strong grassroots support for Single Payer to counter the powerful forces that oppose it.
2. Single Payer supporters must lead the state committee that decides on the specifics of the Single Payer plan.
3. The financial planning of the system must be thoroughly studied by CHIA and the CHP (MA commissions collecting data on healthcare costs for the state) with input from outside healthcare economists who support Single Payer.
Finally, Single Payer naysayers need to understand that without Single Payer we will continue to have a health care system driven by profit-making private corporate interests. Rising health care costs will continue to force cuts in vital programs including education, fire, police, infrastructure, public health. Businesses are reeling under health insurance costs that are rising 20 to 30% annually devastating their ability to innovate and grow. Families continue to face high out-of-pocket costs with medical bankruptcy and homelessness still a serious problem. As Don Berwick says on his website, “It is crucial that we lead, and show the rest of the nation that treating health care as a right, not a privilege, is sensible and successful public policy.”
Patricia Downs Berger, MD