Berkshire delegation on board with single-payer health legislation in Mass.


PITTSFIELD — Berkshire lawmakers are helping to push consideration of a single-payer health care system in Massachusetts.

"I believe that changes like this are more likely to start in a state than in the federal government," said state Rep. Tricia Farley-Bouvier, D-Pittsfield. "Just like universal coverage started here, so could single-payer."

Farley-Bouvier, who represents the Berkshires' Third District and is the co-chairwoman of the House Progressive Caucus, is not alone in thinking the future of the American medical system is on the left, not the right.

The entire Berkshire delegation to the Statehouse, all Democrats, supports a single-payer system. And each member is co-sponsoring legislation to that effect this session.

In a single-payer health care system, government facilitates the provision of care to the public. Detractors claim that state-run health care leads to long waits and increased costs.

The United States is one of the only industrialized countries without such a system. Instead, private insurance companies provide coverage through employer or individual plans, while the government offers programs, including through the Affordable Care Act, to reach others.

But that may be about to change, said Ture Richard Turnbull, director of MassCare, a health care nonprofit. The political tide is turning toward single-payer, he told The Eagle, and he's seen that across Massachusetts.

"When we go across the commonwealth and attend local events," Turnbull said, "Health care and especially single-payer is a topic at all of these meetings and gets the largest applause."


At the federal level, U.S. Rep. John Conyers, D-Mich., and Sen. Bernie Sanders, I-Vermont, have introduced legislation to provide a single-payer system to Americans.

Their bills aim to establish a Medicare for all system, expanding the health program from only covering those over 65 to the entire population. This year the legislation is getting more attention and support from fellow Democrats in the House and the Senate.

That follows a failure last month in Congress to pass the American Health Care Act. The legislation would have repealed the signature Obama-era legislation, the Affordable Care Act, which itself was modeled on Massachusetts' health care system.

That failure has resulted in a surge in public support for universal health care.

That rise in popular support should be turned into action, said state Rep. William "Smitty" Pignatelli, D-Lenox.

"We want serious talk on the national level," said Pignatelli. "People are talking about it, sure. But they have to get something done."

Massachusetts isn't waiting for Washington.

A number of bills advocate a single-payer system at the state level and each one has Berkshire support.

In the Massachusetts system of government, the House and Senate run joint committees in the General Court, or state Legislature. Members of either branch can cross over to sponsor each other's legislation.

That's why S.619, a bill introduced by state Sen. James B. Eldridge, D-Marlborough, to establish Medicare for all in Massachusetts, is co-sponsored by both Pignatelli, who represents the Berkshires' Fourth District, and state Sen. Adam Hinds, D-Pittsfield, who represents the Berkshire, Hampshire, Franklin, and Hampden Senate District.

The House version of the bill, H.2987, is co-sponsored by state Rep. Paul Mark, D-Peru, and state Rep. Gail Cariddi, D-North Adams. The bill was introduced by state Rep. Denise Garlick, D-Needham.

Farley-Bouvier has co-sponsored H.596, introduced by state Rep. Jennifer Benson, D-Middlesex, which will evaluate the cost-effectiveness of a single-payer system before instituting the policy.

"It's taking it step by step," Farley-Bouvier said.

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With support across the region and the state for a single-payer system, Cariddi said, the legislation will move forward one way or another.

"We just need to get everyone on the same page," she said.

Hearings on the bills will begin later in the session.

Turnbull said he's hopeful that Massachusetts will move forward on single-payer. It may not happen this year, he said, but could within the current two-year session.

Mark told The Eagle that Massachusetts can lead the way on health care once again at the state level.

"I think this is a great time for Massachusetts to lead, as it has done so often in the past," Mark said, "and make single-payer universal health care coverage a reality."


That process could start in Western Massachusetts.

Turnbull told The Eagle that the entire Berkshire delegation has provided consistent support and leadership on the issue for years. The region has "great leadership," he said, singling out Pignatelli and Farley-Bouvier.

Pignatelli is a "solid leader," Turnbull said, while Farley-Bouvier's new ascendancy to the leadership of the House Progressive Caucus has led to positive changes for MassCare and other left-leaning organizations. It's easier to approach the group now, said Turnbull.

Farley-Bouvier said she has some hesitation in supporting single-payer after living in Uruguay. But she said that even discussing universal health care is a positive move.

"Just saying we want single-payer is a big leap forward," Farley-Bouvier said.

Mark, who represents the Berkshires' Second District, watched the debate last month over health care repeal at the federal level with concern.

"It was clear that we would have lost over one billion dollars in federal money to our state level health care services" if the GOP plan had gone through, he said. The cost of health care, even with Massachusetts' system, is one of the drivers of his support for a single-payer system.

"Our government already spends more per person on health care than any nation that does have a single-payer system," Mark wrote in an email, "and it is time to recognize that basic health care coverage is a utility that needs to be open to all residents as a matter of good fiscal policy, good social policy, and good public health policy."

Hinds described the health care system in Massachusetts as "unsustainable" due to cost — the commonwealth spends 40 percent of its annual budget on health care. That's burdensome for both the private and public sectors, said Hinds, and he hopes to find a solution.

"That is why I have looked at efforts that can start to address efficiencies and cost, including a single-payer system," Hinds wrote in an email. "I look forward to this continued conversation this session."

Legislation must figure out how to cover the cost of single-payer.

"I have supported single-payer as general concept for many years," said Cariddi, who represents the Berkshires' First District. "It's a more efficient funding mechanism for health care."

But Pignatelli, the delegation's longest-serving member, urged caution on that front. Single-payer, he said, will cost money.

"That's the unknown," Pignatelli said.

The Berkshire County branch of the Republican Party did not respond to requests for comment.

Reach staff writer Eoin Higgins at 413-496-6236 or @BE_EoinHiggins.


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