Single-Payer Health Care Movement in the Era of Obamacare

Last week, I testified before the Joint Committee on Health Care Financing in support of the single-payer health care bill I filed this session: S.515, An Act Establishing Medicare for All in Massachusetts. This legislation would guarantee that every resident has access to affordable, high quality health care, while also reducing costs for businesses and consumers. It was heartening to see legislators, nurses and doctors, labor unions, small businesses, social justice advocates, and students testify in support of the bill at the hearing.

It was an interesting time for the bill to be heard, as Congress ended the federal government shutdown caused by Tea Party Republicans trying to stop the implementation of Obamacare, and the media focused on the glitches found in the rollout of healthcare exchanges and

The discussion that has revolved around the implementation of the Affordable Care Act reminded me of 2006, when the Massachusetts Legislature and Governor Romney passed MGL Chapter 58, the health care law that provided nearuniversal heath insurance access to Massachusetts residents. A vote was also taken that year at the Legislature’s Constitutional Convention to include a proposal on the ballot to establish health care as a right.

I voted both for the 2006 universal health care law and the universal health care proposal on the ballot, although the ballot proposal was sent to a study by a vote of 118-76 on July 12, 2006. I voted for the universal health care bill because I strongly support any opportunity to expand health care coverage for more Massachusetts residents. For that same reason, I voted for the constitutional amendment because I believed that a universal health care system is the best health care system for society.

With the Affordable Care Act now being implemented, it is very exciting to hear about the prohibition of insurance companies removing consumers from their plan because of pre-existing conditions, young adults remaining on a parent’s plan until they turn 26 years old, the expansion of Medicaid, and greater access to birth control for women across the country.

However, the United States, including Massachusetts, will continue to have the highest health care costs in the world, with generally worse health care outcomes than other first world nations. Most health insurance plans still have significant gaps of coverage, especially mental health services and for long-term sicknesses and there continues to be a lack of access to quality health care in many poor communities.

After talking with single-payer health care advocates at the committee hearing last week, the question on everyone’s mind was, “What can we do to advance the bill?” I have a few ideas about the ACA as Massachusetts adjusts to Obamacare:

  • Labor unions need to play a greater role in the single-payer movement. Steve Tolman, the Massachusetts AFL-CIO President (who was the lead sponsor of the single-payer bill when he was in the Senate) can’t be the only labor representative testifying before the health care committee in support of S.515. In 2011, a key reason that the Vermont Legislature and Governor Shumlin passed the law declaring healthcare a public good is because the Vermont Workers’ Center had begun organizing around health care as a right in 2008.
  • Single-payer advocates need to more closely engage with the business community, especially small business owners. The more business owners that get on board with single-payer (recognizing the savings in costs, increase in worker productivity, and the reduction in paperwork), the more likely a break between big business (including health insurance companies) and small business will occur, something that legislators will respond to.
  • Amplify the voices of health care professionals who support single-payer health care. Doctors, nurses, and other health care professionals who are fed up with the current system, and already realize that single-payer is the way to go need to more fully organize in support of the legislation.

As the benefits and limitations of Obamacare come to light over the next couple of years, universal health care advocates will have the opportunity to make the point about how single-payer health care would be an improvement over our current health care system, including in Massachusetts. But we will never get there if the same people who were together in that State House hearing room last Tuesday just continue to talk to one another. Like every other “pipe dream” progressive issue, the organizing begins now. I look forward to being part of that movement going forward.


  1. Rachel Beadle says

    Great idea! And thanks so much for being the rare government representative who recognizes the advantages of a single-payer healthcare system.

  2. Elizabeth St. John says

    You’re a great proponent of SP Jamie. Let’s see if the NAACP Worcester, SEIU 599 health care providers and the Carpenters Local 107, Steel and Ironworker unions will come on board with this legislative push for SP. Be interesting to see if Tim would push it with the Greater Worcester Area Chamber too.

  3. William Ferguson says

    Great proposal but would be better if all states did the same thing.

  4. says

    So glad to hear that you are pushing for single payer Jamie. That is my feeling too as I watch the ACA flounder under the enormous red tape and Republican greed. I’m a co-steward for the SEIU at the mental health clinic I work at in Concord, MA. I do have one personal concern however with going with Medicare for all. As a Licensed Mental Health Counselor (LMHC) I am not allowed to be reimbursed for seeing Medicare patients under Federal law. Many of the universities in MA are churning out LMHC’s like myself to care for those with mental health issues. We have the same training and licensure requirements as social workers but we have not been able to get on the Medicare panels. It would be devastating for many of us and for many clients if all MA residents had only Medicare and this aspect of the law wasn’t changed. Thanks for keeping this in mind as you go boldly forward!

  5. Kip Cleaver says

    Jamie this is exciting to see support growing for this. If you look at western Europe, where the population has aged ahead of ours, what you see is single payer insurance, and they have been forced by the aging population to realize that even by eliminating a great deal of administrative costs and profits of insurance companies, costs will still go up for everyone. Its just a matter of time before the entire country awakens to this dynamic.

    But along with single payer systems must come more pressure to reduce costs. Its abominable that Medicare does not require 2nd or 3rd opinions especially for major procedures or drugs. And continued education and awareness about two key areas forcing our costs up – excessive spending late in life and enormous wasteful spending on non productive and even harmful testing and treatment of breast(via mammograms) and prostate cancer – will be critical.

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