May 15, 2012
Boston —Several senators made a concerted push on Tuesday to put Massachusetts on a track toward single-payer health care, and though their plan failed it generated a level of debate on the topic unseen in recent years.
The Senate voted 15-22 against studying whether a single-payer, government model of health care could be more effective in reducing costs, but not before a bevy of Democratic lawmakers made the case that it would be a mistake to ignore a possible opportunity to make health care more affordable.
Rather than try to supplant the cost-control bill before the Senate with a proposal for a single-payer system, Sen. Jamie Eldridge filed an amendment that would seek to benchmark a single-payer system against the current model.
Though Eldridge said he believes single payer is the best way to reduce costs, he said his amendment allowed for the possibility that that may not be the case.
Sens. Sonia Chang-Diaz, Daniel Wolf, Marc Pacheco, William Brownsberger, Patricia Jehlen and Mark Montigby spoke at length in favor of Eldridge’s amendment, which would enable Massachusetts to follow a path being trod by Vermont and transition to a single payer universal health care system in 2015 if certain benchmarks are met.
Under the plan, implementation of a single payer system would be triggered in Massachusetts only if a state Institute of Health Care Finance and Policy determined at the start of fiscal 2015 that a single payer health care benchmark has outperformed the proposed cost growth benchmark included in cost containment legislation.
Brownsberger called the amendment “entirely consistent” with the thrust of the underlying bill that aims to shave $150 billion in health care costs over 15 years. Pacheco suggested the amendment represented a warning to the industry that he said has failed to control its costs by showing them that lawmakers were serious about alternatives.
Sen. Stephen Brewer, the Senate chair of Ways and Means, however, said he was “very nervous” by what the amendment proposed to do, warning that it could jeopardize an industry vital to employment in Massachusetts, and cast aside years of work aimed at reforming the private model. He noted that 84-year-olds from Canada come to Massachusetts for health care, rather than use the single-payer system in that country.
Sen. Richard Moore, the Senate co-chair of the Health Care Financing Committee, also panned the idea, predicting that most doctors would not work for the reimbursements he anticipated under a single payer system.
“There will be no cost control,” said Moore, warning of an “endless spiral of increasing costs.” Moore concluded, “It sounds great on paper but it isn’t realistic.”
But Moore left the door open a crack to return to this debate. After suggesting that Vermont will be unsuccessful in its efforts to control costs because older people from New York and New Hampshire will move to the Green Mountain state to take advantage of the system, he said if it does work it might be time then to revisit the subject.
Sen. Daniel Wolf, a Harwich Democrat and owner of Cape Air, suggested the proposal was a “pro-business” initiative, calling it worthwhile to look into single-payer as an option if it held the promise of reducing premiums for employers and families.
And Chang-Diaz called the bill “humble” because it did not pretend to know whether single-payer was an affordable and viable option. “Even though I think the evidence is that single-payer is our best bet, this amendment does not presuppose that’s right,” she said.
Chang-Diaz called it “foolish and stubborn” to refuse to study the possibilities, drawing on her recent trip to Florida for her father’s induction into the astronaut hall of fame for inspiration about what’s possible.
Though Montigny described himself as “skeptical” that single-payer would work on the state level, he lamented that the status quo has also failed and that special interests are too powerful to allow for a serious debate about alternatives.
“The first thing we have to do is admit right now in this climate the employer can’t pay their premiums and the insured cannot,” Montigny said.
Eldridge’s amendment drew support from more than a third of the 39 members of the Senate, with supportive votes coming from Sens. Brownsberger (D-Belmont), Chang-Diaz (D-Boston), Katherine Clark (D-Melrose), Cynthia Creem (D-Newton), Sal DiDomenico (D-Everett), Kenneth Donnelly (D-Arlington), Benjamin Downing (D-Pittsfield), Eldridge (D-Acton), Susan Fargo (D-Lincoln), Jehlen (D-Somerville), Thomas McGee (D-Lynn), Montigny (D-New Bedford), Pacheco (D-Taunton), Stanley Rosenberg (D-Amherst), and Wolf (D-Harwich).