Supporters: New debate amplifies need for single payer

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BOSTON — Backers of single-payer, government-sponsored health care on Tuesday told lawmakers that now is the time to adopt a "Medicare for all" system in Massachusetts, citing uncertainty over federal health care legislation and the burden of rising costs.

Supports of single-payer bills (H 2987, S 619) filed by Rep. Denise Garlick and Sen. Jamie Eldridge said the challenge of affording co-pays, premiums and high deductibles can keep people from obtaining preventative care or managing their chronic conditions, ultimately resulting in more severe ailments and more expensive treatment.

"We are working in a system that is still not only not patient-centered, I would say, but does not value health as much as it should," Rep. Jennifer Benson told the Joint Committee on Health Care Financing. "The best way to reduce health care costs is to make people healthier, and that sounds really silly, but it is so true."

Benson and Sen. Julian Cyr sponsored bills (H 596, S 610) that would charge the state with comparing projected single-payer system costs with current health care costs. The state's Democratic Party includes single-payer health care in its platform, but the issue has not emerged as a priority in the Legislature, where the Democrats hold super-majorities in both branches.

Benson's single-payer study bill has 46 other lawmakers signed on as co-sponsors, and 43 lawmakers are signed on to Garlick's "Medicare for all" bill. There are currently 197 people in the Legislature.

With the U.S. Senate expected to vote soon on its version of a GOP-backed health care reform bill that has already cleared the House, Benjamin Day of the national single-payer advocacy group Healthcare-NOW said it is "especially pressing" for states to ensure residents remain covered by health insurance.

"There's actually not that many states that have majority Democratic legislatures -- or supermajority Democratic legislatures with Republican governors, as is the case here in Massachusetts -- and actually are in a position to do so and enact an alternative that's moral, that's cost effective and expands access to care, but the states that have those Democratic majorities are moving towards single-payer health care."

He said single-payer bills have passed one branch of the New York and California legislatures, and Oregon has commissioned a study on what single-payer implementation would look like.

Rep. Jack Lewis, a freshman Democrat from Framingham who said he campaigned on single-payer "and can honestly say I won on this issue," told advocates before the hearing that fighting for single-payer would not be easy and would mean "working in some cases against people that are with us on other issues."

"The residents of our commonwealth are done with technical fixes to big issues," Lewis said at a rally on the State House steps. "They need us to take radical stances. They need us to make huge, changing decisions to bring us in line with the rest of the world."

The Massachusetts Association of Health Plans, which represents insurance companies, opposes the bills that came before the committee Tuesday, arguing that a government single-payer system "will limit access to care, undermine quality, and do nothing to address the cost of care."

"There are serious quality concerns associated with government-run, single payer systems," the association said in written testimony. "The evidence demonstrates that these systems fail to provide timely access to high-quality, innovative medical care to all individuals. Often, patients have less access to the latest medical technology and breakthroughs, fewer choices, and longer wait-times to receive basic and specialty care."

The Health Care Financing Committee did not advance single-payer bills to the full Legislature last session, instead grouping them in dead-end orders for additional study.

Dr. Patricia Berger, a retired primary care physician and co-chair of the single-payer campaign MassCare, warned the committee of "serious consequences" if the bills are rejected once again in the face of what she called "cruel and heartless policies" being considered in Washington. She said the American Health Care Act that passed Congress "will decimate affordable health care coverage for Massachusetts residents."

Berger said MassCare has been working for single-payer for over 22 years and said "sometimes it takes a crisis" to change something ingrained in society.

Single-payer health care is likely to become a topic in next year's gubernatorial race. Newton Mayor Setti Warren, one of three Democrats vying for their party's nomination, has made single-payer a major component of his campaign, calling it "the best way of ensuring healthcare is a basic right for all people."

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