I vote for single payer, the sustainable health care reform

A single payor system is the only way to assure access to care for everyone in the Commonwealth. I think we have made a mistake in assuming that having insurance is the same thing as having access to care. Clearly it is not. For too many people, the insurance is unaffordable, doesn’t cover the cost of premiums, co-pays and needed care.

I would concede that health reform is a step in the right direction, but it leaves in place a system of health insurance that spends far too much money on marketing, on finding ways NOT to pay providers for care and NOT to cover services that patients need. And not to state the obvious, we all spend way too much on billing, claims, adjudicating claims and other administrative nonesense that has nothing to do with needed health care.

You got my vote for Single Payer. How a payment system can limit care is an issue that will need to be addressed and prevented. However, I think that eliminating the duplication of so many insurers will reduce health care administrative costs.

Single payer is the way to go.

But, it is a necessary but not sufficient resolution to our dysfunctional health care system.
As advocates for health care reform we must look beyond access and reumbursement to the quality of health care and deal with the disparities that will ot be solved by changing the payment mechanisms.

Women are particularly vulnerable in our health care system. We must look at the social roles of women to see how the current system undermines their access to adequate and appropriate health care, if we want to have true health care reform.

The new health reform act is an important step in helping to get access for many uninsured people in Massachusetts. But the process has made only too clear the inequities in the care that is currently available for people of different income levels. We need to use this legislation to help convince the public that health care is a basic right and the only way to deliver it efficiently and equitably is with single payer insurance.

I read all the comments and still wonder why non-profits that have got all of their “soldiers” on board with petitions to go for Universal Health Care for All and a constiutional admendmentent stop short when the legislature “cave in” again to the greedy insurance companies who back their efforts with grants and only Support their efforts until they get what benefits their Corporate interests without regard to the cost to us taxpayers and how it comes up short in accomplishing what gives a “fair shake to Seniors.

I vote for single-payer. It is the only way to get quality health care for every Massachusetts resident at a cost that individuals and the Commonwealth can afford.

Chapter 58 has struck out. The three strikes are: access, quality, and cost. Chapter 58 is a giveaway to the industries (financial/insurance and biotech/pharmaceutical) that hold the power in our Commonwealth. These industries and the nonprofit mouthpieces that they endow are using that power to drain the lifeblood out of our health care system, while delivering much too little, way too late to our population.

On access. The problem of the uninsured is not being resolved, in fact the Connector has now admitted that the lowest-income 20% of the uninsured population in most need of help will not be getting any. The official position now is: maybe later. Strike one.

On quality. Leave those tough-to-deal-with uninsured to the side. The entire system of human beings caring for other human beings has been distorted by the drive to “optimize the loss ratio,” otherwise known as the profit motive. Employer-based insurance was never a reliable way to deliver high-quality care when needed. Now, industry intrusion into the privacy of the clinical relationship has become an extreme sport. Patient privacy is a joke. “Pay for performance” now leaves caregivers in a no-win situation with the overall effect of denying needed and timely care to the insured and uninsured alike. Strike two.

On cost. When “universal access” equates the poor being forced to purchase commercial insurance with huge out-of-pocket payments, or huge premiums, or else face state-imposed penalties, you can hear the industry saliva flowing in Boston, even from way out here in Western Mass! Overall spending estimates are increasing as we speak under Chapter 58, here in the most expensive state in the most expensive country in the history of the world of health care. Strike three.

It is not at all surprising that industries marshal their resources and allies, behaving on behalf of their self-interest; that’s capitalism! For those in the trenches trying to care for people, the shame is ours alone for not calling this dog by its real name.

It is beyond time for us to step up to the plate and demand a new game! Only government has the long-term incentive to assure access, quality and cost control for all residents for all time. That means single payer. The Connector for Single Payer! Elmer Freeman for Connector Chair!

Greetings from New Mexico – We all know that single payer is the way to go for Massachusetts, New Mexico and the nation. Keep up the good work there and I will try to do my part in New Mexico.

The obvious answer is single payer with government as the insurer.

Single-payer care should be part of human services. Let’s catch up with the rest of the world!

Single-payer health care is the most logical way to provide health care.
It is the most compassionate way to provide health care.
And guess what? It’s also the most cost-effective way to provide health care.

Let’s do it here!

Single Payer: We need to start from the point that as a society we provide high-quality health care to all residents. We certainly have the brains and resources in this wealthy nation. We do not start from the point of assuring high profits to insurance companies
The resources now directed to administration and overhead will be utilized providing primary care, affordable medication, life-long wellness enhancement and appropriate care in illness.
Nations around the world provide single-payer at a fraction the cost that we pay. The only difference is the will and leadership to craft a bold single-payer system that has the person/patient at the center.
I urge the Legislature to take the best of what exists in other countries, tweak it to make it the best in the world, and remove an enormous burden from families, business and municipalities.

I value the attempt to address escalating health costs, but our society and its politicians must eliminate the expensive middle man, insurance companies, to achieve real health care reform and get affordable universal coverage.

I am still amazed that we can continue to call this reform! To force people who already had assessed that can’t afford health insurance to buy health insurance or face penalities with their taxes as a way to so-called universal coverage still strikes me as very wide of the mark. This frightful piece of legislation may get used as part of a national model. And what will it acheive? How much increased health coverage? How much guaranteed profit for the insurance companies? How much continued financial hardships for already strapped families? And how much health care in the final analysis. I still think we need to work for universal, single payer. Period. We are killig ourselves with these alleged compromises.

There’s no doubt in my mind that single payer is the way to go. While we’re all working toward it, however, please, let’s not forget about our fellow MA residents who are undocumented. (I work in a health center with a large number of undocumented people among its clients.)

Undocumented immigrants come here to work and send money home to their families. They work in low-paying (by our standards) jobs that the rest of us would rather not do. Some people would say that by being here without papers, they shouldn’t be eligible for any benefits. But there are no savings to be had by forcing undocumented people to get care from emergency rooms in a last-resort scenario. When single payer becomes a reality, it must be so for ALL Massachusetts residents.

Universal health care Must Be SINGLE PAYER HEALTHCARE. I think John McDonough has it backwards that government administrated health care is the “wolf in sheep’s clothing.” We, the people, are the government – or at least we should be. Since every other developed country has a form of single payer, government administrated, health care, could it be that all of them are a “wolf in sheep’s clothing?” I don’t think so, and neither do the statistics. The US has the highest health care cost, and it’s citizens are the least healthy – of 24 developed countries, the US ranks 23 (just above Rumania, if I remember correctly) in the health of it’s citizens.
We have two real wolves to worry about – the insurance companies, and the pharmaceutical companies. I find it amazing how the insurance companies are invited to help shape an “affordable” universal health care. What they are doing is figuring out just how much government money in premium support they can get, while playing a shell game with deductibles.
We are the only country that is dependent on paying a gatekeeper insurance industry, which delivers nothing but administrative overhead to private interests.
We must throw out the broken system we have, eliminate health insurance companies altogether, study what works (or doesn’t) for other countries, collectively bargain down the cost of prescription drugs, eliminate advertising for drugs and medical services, and eliminate the labyrinth of payment for medical services. Let’s focus on fair payment for those who provide medical service, and adequate coverage for those who need them. We will Never be able to take that step if we have the health insurance industry, it’s lobbyists – or it’s “wolf in sheep’s clothing” lobbyists – dictating health care policy.

- Sharon Shea

It’s not gonna happen.

Cliché as it sounds, companies run the show now. The insurance companies are not going to walk away from their bread and butter; it’s their whole reason for being.

The officials you elected don’t answer to you. (Surprised?) And the lobbyists (who were once elected officials themselves) don’t get paid by you, and don’t work for you (although they’d like for you to believe through nomenclature that they do).

The corporatization of government that began during the Reagan years is a Pandora’s box whose contents were allowed to take root only because citizens felt powerless to stop it (while at the same time also insidiously noticing that the economic sun didn’t fail to reappear the next morning, as it had the prior one, albeit incrementally less bright).

It will get worse in the next 10 to 15 years, as health industries are not the only ones now who–hoping that citizens roll over for this–will lobby government for other ways to force, by law, the purchase by citizens of private goods and services. Corporate adventures, into the increasing of their markets this way, will also become more overt.

With no cost controls on the mandatory, fiat-created health-business, you’ll be soaked for increasing amounts every year. 175.00/mo. (and 400.00/mo. for the many others they don’t want to advertise about), is just the beginning. Your masters won’t stop building; they won’t stop marketing patent-medicines from the back of the wagon cart, they won’t stop commissioning ever-more-opulent interiors, and grandiose landscape elevations. The locals who purchsed HCA for $33,000,000,000 (that’s 33 with 9 zeros, i.e., billion) must see profits where you never anticipated they would: by forcing you to purchase a corporate product in America).

This is America now.

You will not have savings. Many of you, employed for the moment now, will not even have jobs to ease your way into a far worsening economy and loss of the currency’s value.

The main problem with the Connector, as I see it,is that it does absolutely nothing to reduce the cost of our health care system’s administrative overhead. In fact, it increases it. The Connector is basically a means test system, and the problem with a means test system is that we have to pay people whose job it is to tell some poor person that he or she makes $5.00 a year too much to qualify for some form of a subsidy. The two most popular governmental programs in the history of this country are Social Security and Medicare. This is because everyone participates in it and the vast majority of people will receive some form of benefit. The main reason these programs are so succesful is because the adminstrative overhead is so very low, estimates running from 1-3% Single payer health care will be a system similar to these programs. Remember, the special interests are not worried that Single Payer will fail, they are worried it will succeed.

Streamlined financing called “single payer” reform gets my vote. It is the most cost effective way to create affordable universal coverage that will be sustainable over time.

It retains the private delivery system but provides public accountability for how our healthcare dollars are spent. With this in place we can, as a true “Commonwealth”, begin to seriously address cost, access and quality of care issues in a systematic way.

Streamlined financing using the single payer model definately gets my vote. And it gets the vote of my health professional organization: the Massachusetts Nurses Association that has 28,000 members.

To learn more visit http://massnurses.org/single_payer/index.htm

I vote for single payer.

There are so many flaws in the mandate/proposals on the table./..first..the patients are completely confused and paralyzed as to what to do…the providers..ie me..a caring doctor, for the first year in 28 years in practice is thinking of ending my primary care practice after being happy/content for so many years…why…how would you feel when your patient is at LDL goal on lipitor, with no side effects, and because zocor became generic you are asked/pushed/required depending on the plan to switch a stable at goal patient to another med just because of money even though presented as evidence based quality of affordable care…crap..it is bean counter nonmds looking at their list and prompts trying to force change with no knowledge, and all about saving money for their gipper…anyone who would rx amoxil for amoxicillin is dumb as it is same drug and chemical structure..the statins are same class but somewhat different, and when i receive a request/demand to switch say from lipitor in pt at goal patient to simvistatin, i have anxiety…why…if i fill out the form will my patient ever be explained the change and by who…i have had three patients, switched back in the day from zocor(used to be so expensive..check out medical letter few years ago)to lipitor when they were both brand name.one of whom had 10 times increase of lfts..now that only lipitor is brand name, it is egregious of insurance carriers to flip without disclosure that it is all about money to put my patient at risk, though uncommon but not rare of myalgias or liver enzyme abnormalities from the generic zocor..why tamper with peoples health when they are successfully treated by a drug already…who takes the liability or does that depend on whether i write a nasty comment to the forces that want me to switch and when i do..the larger my threat or deflecting responsibility on the plan, the more likely my preferred drug is approved….more egregiously is the issue of ssris in the treatment of anxiety and mood disorders..iam a board certified internist, and specialty trained in a fellowship in psychosomatic/biopsychosocial medicine…..the ssris are structurally dissimilar, they are metabolized by different cyp450 enzymes, they have different drug-drug interactions..for some uniformed worker to request a change of ssri to the cheaper and structurally different generic in a patient who is doing well is what will make me quit primary care and be a consultant…how dare some insurance company in bed with a drug company suggest anything about ssris to the provider who just went thru a crap shoot to find a drug that helped their patients panic disorder, generalized anxiety disorder, ocd, ptsd, social anxiety disorder and a host of anxiety/ depressively based diagnoses,..or help depression at all….and think the monetarily driven suggestion/demand of change has anything other than TO DO WITH $$$$$$$…OPUTRAGEUOS….single payor system, with even and fair drug rules or consortium of speialists who know their stuff will link quality with economics in a positive way as the deciders will hopefully be informed, well versed doctors and not drones who read off of lists while they have the arrogance to write transparently disingenuos letters to busy pcps who might reflexively sign off on it to unburden their list or pile of crap that continually erodes their ability to practice humanistic medicine unless they are stubborn and work longer hours…5 times a day i am presented prior auths, rejections of rxed drug, requests/ demands to change drugs with the patient left out of the loop..ocassionally the patient is in the loop and says they do not have the funds and then of course you rx simvistain..others have the money and ask “what would you do”,,,,all of this takes time from the provider/patient interaction and is intrusive, potentially harmful, and so inappropriate to have economics hiding in the facade of “quality care”..being intrusive into my healing/caring/non biotechnical/medical but rather biopyshosocial, humanistic, caring at expense of money/ practice/calling…these intrusions, especially for providers who care are absurd and can adversely influence outcome..sorry for being so talkative..i usually dont comment but i felt like vomiting up my feelings tonight…respectively and open to comment..Barry Poret…pobabear@aol.com

Elected officials keep saying “Single Payer isn’t politically viable.” It’s up to us to show that they work for all of us, and OUR votes are needed to elect them, not the support of Beacon Hill insiders.
We also need to figure out what system for raising and distributing the funds for single payer would be used, to gain the trust of most voters. They’ve got lots of reasons to distrust government as they know it! I vote for single payer and a transparent way to fund and run it.

I vote for single payer. Chapter 58 is simply unaffordable. At $7,200 per capita, the U.S. currently spends twice as much as other advanced nations on healthcare and yet does very poorly on healthcare outcomes in comparison with these same nations. Massachusetts currently spends $9,100 per capita, more than any entity in the world. The current Chapter 58 patchwork fix will only add to that burden and will never achieve universal coverage. By adopting this bill, Massachusetts has only added further complexity at increased cost to a system which will continue to ration healthcare benefits by income. Those at the bottom of the income scale who require the most support will have to cope with high out-of-pocket costs as a result of being mandated to purchase plans with barebones benefits, plans which may cause them to go into bankruptcy.

Under a single-payer plan, we would be able to reduce the huge administrative costs of both the public and private insurance systems in Massachusetts and no longer subsidize the huge amounts of money now spent by private insurance companies on the marketing and administrative costs of competition. The money saved would then enable us to provide everyone with a comprehensive, affordable healthcare plan funded by a Massachusetts Healthcare Trust to which everyone would contribute.

Under such a plan risk would be spread over a large and diverse population, thereby reducing the claims volatility currently experienced by both employer-provided and private plans. The result would be the elimination of the volatile inflationary premium increases we now experience from year to year in our present private/public insurance systems.

Not only would we have a healthier population under a single-payer system, we would be able spend more of our tax dollars on other state priorities such as education. – Rhondda Tewes

For over 20 years my late architect husband, Paul Grayson, was an advocate of Universal Design and Single Payer Medical Insurance. It is gratifying to me that the momentum is growing and hopefully will reach a tipping point of realization.

Single payer is the only moral, sane and economic solution to the crises in health care in our state and country.. Lets not forget that our MA legislature studied health care costs in our state and found that administrative costs in MA account for 39 cents of every dollar spent. That factors in the low costs to administer the veterans and Medicaid programs, so what do we get by supporting the private insurance bureaucracy??

We must have a single payor system. The current competitive system leads to administrative waste and profits for the organizations. It does not provide health care for all citizens and unduly burdens the medical providers with administrative work.

I am enormously cheered to read the overwhelming support for single payer health care. As many have noted, it’s the ONLY way to control costs and cover everyone efficiently and effectively. Eleven Cape Cod towns passed a non-binding resolution last year, to explore a single payer, community owned health program for everyone on the Cape. Cape Care task forces are now working on actual plan development. For information, see http://www.capecare.info. Let’s not just talk about it, let’s do it!

Well, reading through the copious comments to date, the vote is overwhelming: all but one agree that single payer is the way to go. Jim, in what is essentially an abstention, caustically posts that “it ain’t gonna happen.”

I agree with those votes for a single payer system. As Tilly Teixiera points out, it “is the only moral, sane and economic solution.” I also agree with Jim that the current political-industrial complex with the insurance companies calling many of the political shots, makes it unlikely. If a positive, statewide referendum vote didn’t work, what will?

I don’t yet know but the real question to ask is: what plum will the health insurance industry accept to give up its profits from controlling people’s access to health care? If we can figure out an acceptable compromise response to this, then maybe we can achieve universal health insurance in this era of hyper-capitalism.

Then we can move on solving the real problem: the elimination of health disparities and the promotion of prevention so that people will remain healthy and not need to access classic, curative health care in the first place!

-”I don’t yet know but the real question to ask is: what plum will the health insurance industry accept to give up its profits from controlling people’s access to health care? If we can figure out an acceptable compromise response to this, then maybe we can achieve universal health insurance in this era of hyper-capitalism.”

Roseanne Barr once remarked to an interviewer: “The thing women have yet to learn is nobody gives you power. You just take it.”

Single payer is the right way to go…and maybe we’ll get businesses on our side when they are forced (as they must be if Ch. 58 is to get anywhere) to ACTUALLY subsidize the employees they don’t insure. The pittance they are penalized is no penalty at all.

FYI to all readers and to hcmgowan who posted a Comment (included below, at end) on April 27th, 2007 at 9:41 am

The activists supporting the healthcare constitutional amendment did not “stop short”. Our work continues to this day. The group “Health Care For All”, most disappointingly, did unendorse the amendment effort after the seriously flawed Chapter 58 health reform law was passed last April.

Equally important to point out is that NONE OF THE OTHER 130 orgnizations who have endorsed the amendment campaign across the state have pulled their endorsement.

Activists are still working for the amendment to be placed before the voters despite the legislature’s refusal to grant it its second required vote in Constitutional Convention. Most unfortunately, the media’s refusal to cover the health care amendment campaign and the legislature’s actions has contributed to misunderstanding about what happened and where things stand now.

I’ll try to briefly bring you up to date on it, plus you can learn more at the campaign website http://www.HealthCareForMass.org and use this link to read the one newspaper article that did cover what happened at the 1/2/07 “Con Con” http://www.metrowestdailynews.com/opinion/8999026738272927743

Currently, there is legal case pending before the MA State Supreme Court asking for a court-ordered remedy to the travesty of justice that occurred on 1/2/07 when 101 members of the MA legislature denied the citizens hc amendment its second required vote, a up-or-down on its merits so it would have a chance to be placed on the statewide ballot in 2008.

This travesty of justice — truly a crushing blow to health justice citizen activists, many of whom gave large parts of our lives to this effort over the past 4 years — took place at 6pm on 1/2/07. This occured with nary a peep from the media; that in itself is another disgrace, IMHO. Campaign leaders and supporting organizations vow to continue good faith efforts to secure the health reform goals set out in the Amendment. Hence the legal action being pursued.

The citizen activists who launched the MA healthcare constitutional amendment initiative four years ago (I myself am one of the original 10 signers) most certainly NEVER “stopped short” of working for a second required vote on that amendment. We welcome all those interested to join this effort. You can sign on for updates at http://www.DefendHealth.org

prior comment from hcmgowan:
“I read all the comments and still wonder why non-profits that have got all of their “soldiers” on board with petitions to go for Universal Health Care for All and a constiutional admendmentent stop short when the legislature “cave in” again to the greedy insurance companies who back their efforts with grants and only Support their efforts until they get what benefits their Corporate interests without regard to the cost to us taxpayers and how it comes up short in accomplishing what gives a “fair shake” to Seniors.

Doesn’t matter a fig that the U.S. has the highest “standard of living.” We certainly don’t have the best quality of life when you have to go bankrupt paying for your family’s health care or hospital bills or your kids’ educations. What ever happened to the national mandate to standardize forms and reduce administrative costs? Single payer is the only way to level the playing field and the only sensible solution for all.

Have we given up on Health care for all and surrender to the Commonwealth Connecter