Will a legislative study put Massachusetts on the path to single-payer? Supporters head to Beacon Hill to push for it.

single payer posterTucked inside the health care bill passed by the state Senate is a provision to study the possibility of a  single-payer health care system.

The bill’s cost control measures are getting all the attention. From the Globe:  

The 100-page bill attempts to help struggling community hospitals by setting a floor for the reimbursements they receive from insurers. It also sets a benchmark for annual growth in hospital spending, estimated at 2.7 percent. If the hospital industry exceeds that benchmark, some hospitals would have to pay hefty penalties.

But MassCare, the state’s single-payer advocacy group, says the proposed study creates “a real path in the near future to create a Single Payer system for the Commonwealth!” They’re headed up to the State House this week to lobby House members. lobbyday-958x538

These folks are in if for the long haul, which, according to political scientist James Munroe of Brown University,  is the way to go on single-payer. Writing in the a recent NEMJ, he says:

It is a policy proposal designed to improve health care delivery, an ambitious claim about equality and social justice, and an effort to usher in a more progressive era in American politics. Each is a long shot, but Medicare for All and its advocates stand in a venerable reform tradition that has rewritten U.S. politics many times in the past. It would be a mistake to dismiss them now.

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Sen. Elizabeth Warren is backing the single-payer insurance proposal from Sen. Bernie Sanders. Does it have a chance?

From The Boston Globe:

From 2016  Boston rally: Alan Meyers, a Boston Medical Center pediatrician. Photo: Tinker Ready.

“There is something fundamentally wrong when one of the richest and most powerful countries on the planet can’t make sure that a person can afford to see a doctor when they’re sick. This isn’t any way to live,” Warren wrote, asking her backers to sign a petition expressing their support for the measure. “Health care is a basic human right and it’s time to fight for it.”

Warren’s endorsement is a high-profile boost for Sanders’ legislation, which the Vermont Senator readily admits faces a hard, years-long fight towards becoming law.

Here’s a link to Sander’s “Medicare for All” site. FYI, not an endorsement.

What does the public think? KFF poll this summer found a slim majority in favor 

It is worth noting that another Bay Stater, former CMS boss, gubernatorial candidate and top health policy analyst  Don Berwick, has also endorsed single-payer. 

For some perspective, Kaiser Health News has collected links to recent opinion pieces on the topic. This one from The Washington Post notes that a lot of Democrats are lining up for single-payer

So what lessons can we take from the experience of the ACA that might help Democrats as they move toward another enormous health-care reform?

  • It’s going to take years.
  • Disruption is frightening.
  • We need to think about the transition from where we are now to where we want to go.
  • Republican demagoguery is a certainty.
  • Beware the interest groups.
  • There will be winners and losers.
  • You have to be able to explain it to people.

The piece offers details on each bullet and suggests:

We should probably stop referring to what liberals want as “single payer,” because that suggests that the only system they’d accept is one in which there is one government insurer and no private insurers. That’s one possibility, but there are many other ways to get to universal, secure coverage that have multiple payers. I happen to think the best and most achievable system given where we are is one in which there’s a basic government plan that covers everyone — an expanded Medicaid, perhaps — plus private supplemental insurance on top of it, a hybrid system of the kind that works well in countries such as France and Canada. The point is that it would be much better to speak of “universal coverage,” which allows for a number of different designs as long as they achieve the same goal.

Single-payer lives — in my mailbox

Boston Health News doesn’t take sides, so we won’t be signing the petition to both Massachusetts senators that arrived in the mail yesterday.  But it is worth noting. The fat single payer posterenvelope features a quote from Bernie Sanders, a document entitled  “Myths and Lies about Single-Payer” and an appeal for donations to Public Citizen, the consumer group that has championed the cause for many years.

A group called Mass Care has been advocating for single-payer in the state, recently gaining a powerful ally, health policy heavyweight Don Berwick. This weekend, the group and its supporters will be gathering on the steps of the State House as part of a “National Day of Action for Improved Medicare.

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2016: Alan Meyers, a Boston Medical Center pediatrician, said Sanders has brought discussion of single-payer into the mainstream. “We’ve been waiting for this for years.”  They’ll be lobbying for Medicare For All , aka single payer.

The Washington Post reports that the failure of the AHCA has led to a resurgence of the idea.

Progressives, emboldened by Republicans’ health-care failure, are trying to shift the political debate even further to the left, toward a long-standing goal that Democrats told them was unrealistic. They see in President Trump a less ideological Republican who has also promised universal coverage, and they see a base of Trump voters who might very well embrace the idea.

Here in Massachusetts, health planners have moved beyond coverage to costs. Check out the latest on that from The Boston Globe.

 

 

Boston #Sanders marchers on #healthcare

Photos from 2/27 Sanders March in Boston.

 

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Alan Meyers, a Boston Medical Center pediatrician, said Sanders has brought discussion of single-payer into the mainstream. “We’ve been waiting for this for years.”
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Donna Kelly-Williams, RN, President of the Massachusetts Nurses Association and a maternity nurse at Cambridge Health Alliance.

 

Sanders nurse

File Feb 27, 3 46 42 PM

 

BHN reports: Push for single-payer lives on in Massachusetts

by Tinker Ready All rights reservedWith 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”

Berwick stays in the Massachusetts race for governor, supports single-payer

Former Medicare Chief and Democratic gubernatorial candidate Don Berwick apparently got a boost at a recent state convention, coming in third behind two front-runners.  Former political editor Peter Canellos writer notes Berwick’s support for single payer in the Globe’s new “Capital” section:

When his rivals claimed he wasn’t really offering anything new — just another health care commission — Berwick doubled down by calling it “Medicare for all,” a description that pretty much suggests he’d eliminate private inberwicksurance.

Now, with the Democratic race down to three candidates — Berwick, and two party regulars with histories of failing to excite voters — single-payer will finally get the attention it merits as essentially the only markedly different policy proposal to emerge from either party. A bold move to show the Obama administration what real reform looks like? A takeover that will roil the system? A vehicle for finally bringing about equality in health care? A threat to Massachusetts’ world-class doctors and hospitals? Single-payer could be all those and more. And if Massachusetts were to broadly restructure its health system, yet again, reverberations would be felt across the nation.

The Globe tagged along with him earlier this week, starting with a scene at the WBUR studios.

Can Berwick, who ran Medicare and Medicaid in the Obama administration for 1½ years, appeal to voters outside the left wing of the Democratic Party?

 He’d face the question twice more Monday, once from a Boston Herald reporter and again that evening at a Democratic gubernatorial forum in Jamaica Plain.

 For Berwick, the question is misplaced because, he says, it underestimates the liberal impulse of the entire state — a state that elected Governor Deval Patrick and Senator Elizabeth Warren.

 “This is a place where people really want to honor the idea that we are in this together, community by community,” he said in the WBUR interview. “And no, I don’t feel this is confined to some kind of fringe progressive wing.”

A bit here from Berwick on some of the Republican ideas for Medicare from out 2012 post.

 

 

 

 

 

 

Single-payer health reform advocates launch new website #HCR #mapoli

The unrelenting supporters of the single-payer approach to health reform  have updated their website. And, it is a quite an update. The old MassCare site was sluggish — infrequently updated and often lacking links to upcoming events. Check it out here or click below. Also in health reform, check out WBUR’s Q & A with David Seltz, the new head of the state Health Policy Commission.

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