With the ACA under constant fire, it’s easy to think that single payer is off the table. Try getting that through Congress. Still, seems, here in Massachusetts, single payer supporters are not ready to give up.
On Wednesday night, Mass-Care invited former CMS director and gubernatorial candidate Don Berwick to a meeting on “What can be done legislatively to achieve Single Payer in Massachusetts.” An overflow group filled a small meeting room in the Downtown Crossing office shared by Mass Care and other progressive groups like The Women’s Institute for Leadership Development and the Industrial Workers of the World.
Berwick, who added single payer to his campaign platform, didn’t really need to make a case for the plan. He was preaching to the converted when he argued that turning the government into our insurer would help the country achieve “better care, better health and lower costs.”
It will have to happen on the state level, he said. “I don’t expect national leadership on this from either party.”
He cited the usual statistics – we spend 40 percent more per-capita than any other nation. Then he added a few more. While running for governor, he took a look at 15-year tends in the state budget. Funding was down for almost every item, he said. – local aid, parks, higher ed. For health care, state spending rose 72 percent in that period.
To pull that lens out a bit, he cited a recent Commonwealth Fund study that estimate the costs savings had the US had adopted a single –payer plan similar to one used in Switzerland: $15.5 trillion over 30 years.
None of these arguments has provided single payer with the kind of traction it needs to move into the mainstream.
“When you say, don’t worry, the state is going to be your insurer, that’s a hard sell,” Berwick said.
So, he and others are starting to emphasize another point – we are spending money on health care that could be better spent elsewhere. In other words, the co-pay may be so high on your knee surgery, you’re might not be able to pay the rent.
“There is a transfer of opportunity in society from other things to health care,” Berwick said.
Or pay for a week at the beach or a private college for your kids. As the discussion turned to how to sell the approach to the public, several people – including a group of medical students from BU – pointed out that high health care costs are not just a problem for the low–income and uninsured.
“How do we sell this to the middle class? “ asked Andy Hyatt, a first-year medical student at BU and a member of the school’s chapter of Physicians for a National Health Program. While it’s important to help the disadvantaged, he said, health for middle-income people “still sucks”
Just how to address that group is what these supporters of single payer health care are trying to figure out.
“We’re wondering what we as medical students can do,” asked Jawad M. Husain, also of the BU PNHP. “We want to practice in a system where we can treat people fairly.”
Berwick’s answer: “Political mobilization.” But he noted that the students will have to look outside the classroom for guidance on that. ” It’s not something I learned in medical school”