Those familiar with the history of our friendly neighbor to the north know that single-payer in Canada became a reality on a province by province basis. Given the current political reality in the United States, which means that single-payer will probably not be happening anytime soon on the federal level, it looks like America may be headed down a similar path.
So far, Connecticut has already approved a robust public option called SustiNet and, perhaps more exciting for progressives, Vermont is poised to begin the transition to single-payer health care in a few years.
It is thus worth noting that a senior Deval Patrick administration official -- the individual in charge of Medicaid -- in Massachusetts is now saying that single-payer may be a better option for his state than their current RomneyCare system, basically the PPACA 1.0. The Boston Herald reports:
“I like the market, but the more and more I stay in it, the more and more I think that maybe a single payer would be better,” said Terry Dougherty, director of MassHealth – the state-run Medicaid plan that insures nearly 1.3 million Massachusetts residents – when lawmakers asked for his “personal view” on a single payer system.
Dougherty, of course, remarked how big-profit insurance carriers spend a shit ton more money on administrative costs than government-run insurance programs -- like Medicare or Massachusetts' Medicaid program.
Dougherty noted that MassHealth, by far the largest program in state government, spends just 1.5 percent of its $10-billion-a-year budget on administrative costs – compared to about 9.5 percent by the private market, according to studies by the state Division of Health Care Finance and Policy. That figure won plaudits from several lawmakers on the panel, including some who have supported implementing a statewide single payer system.
Dougherty also cited other benefits of a single-payer plan, including that the heads of government-run insurance programs don't earn millions and millions of dollars each year and work in fancy, designer buildings.
“It’s got to be better than this devil-may-be marketplace,” he said. “We don’t build big buildings. We don’t have high salaries. We don’t have a lot of marketing, which makes, to some extent, some of the things that we do easier and less costly than some things that happen in the marketplace. Overall, my point is, we have individuals who work in state government in MassHealth ... who are just as smart, just as tactile, just as creative as people who work in the private sector, but they work for a lot less money.”
Have you guys ever wondered why the guy at the federal level in charge of Medicaid and Medicare can survive on less than $200,000/year but Angela Braly at WellPoint and Mark Bertolini at Aetna require salaries in the tens of millions? WHY?! There's your waste - there's your 16 percent of GDP wasted on health care spending in the United States.
Were Massachusetts government to move forward with a single-payer plan, it would find great support.
Hundreds of thousands of Massachusetts residents have endorsed the approach. In fact voters in 14 House districts –including five that backed Scott Brown for U.S. Senate – voted overwhelmingly last year to support a non-binding ballot question that asked, “Shall the state representative from this district be instructed to support legislation that would establish health care as a human right regardless of age, state of health or employment status, by creating a single payer health insurance system like Medicare that is comprehensive, cost effective, and publicly provided to all residents of Massachusetts?”
Note, though, that many Massachusetts residents already support their current PPACA-style RomneyCare, which means that single-payer supporters aren't just pulling data out of their behinds when they argue that those who like PPACA would probably like single-payer health care even more.
Ultimately, it would also be interesting politics were Massachusetts to trade RomneyCare for a single-payer system. How could President Obama tell single-payer supporters they can't stay at the table when the "model PPACA state" has junked its exchange-based, big-profit insurance program?
Regardless, let's keep pushing: in Massachusetts, in Vermont, in California, in Connecticut, in Washington. We need progressive, humane states to prove to the rest of the country that single-payer is not the second coming of Stalin.
We'll arrive at single-payer, but on a state-by-state basis, just like Canada. You know, that reminds me of something: