Move Over California, The Single-Payer Revolution Takes Off In Another Blue State

Created: 15 November, 2017
Updated: 17 October, 2022
3 min read

Mass-Care is the name of the Bay State’s campaign to bring affordable health care to all Massachusetts residents under a single-payer system. Such a system could serve as the archetype for all of the US. However, even making strides at the state level can be difficult in the current political climate.

Massachusetts lawmakers seem open to the idea. The State Senate recently voted 33-6 (with all Republican senators dissenting) to further explore the single-payer option after prolonged debate and several changes to the bill.

Understanding Single-Payer Care

Don't confuse the passage of this bill with the creation of a single-payer system. What the bill calls for is an investigation into the costs associated with a single-payer system. The controversial health care model, which conservatives have strongly opposed, is based around the presence of a single public authority that uses tax dollars to fund health care for all citizens.

Such a system relies on taxes for funding, which is the primary reason for the strong conservative opposition. In less wealthy nations, there have also been examples of patients suffering long waits for procedures. However, single-payer also shows great promise to improve the standard of care.

A Win-Win

With the complicated mess of private insurance brokers removed from the equation, medical professionals would get time back to devote to caring for patients. They would also no longer be incentivized to advise for or against a certain treatment or procedure based on the type of insurance a patient carries. Giving doctors back their autonomy has been shown to improve care and decrease misdiagnoses.

Supporters of the single-payer model say that not only does it allow for a higher standard of care, but it saves money. Even though new taxes would be incurred, the overall cost of health care to those covered in the system decreases because there is less waste incurred by administrative services from multiple insurance providers and out-of-network fees.

Even in a single-payer system, there would still be a small number of independent providers available. However, these insurers are specific voluntary treatments, such as LASIK vision correction.

So What’s in the Bill?

It would be foolish to think that any US legislative body would pass a bill built around a single, simple idea. The investigation of a single-payer system is only one tenant of the multi-tiered medical bill that Massachusetts passed.

Saving money is actually at the heart of the bill. It seeks to narrow the gap between the cost of care at large and small hospitals. Originally, the bill had contained a provision that would penalize the state's largest hospitals if they failed to keep costs below certain levels. However, pushback from Massachusetts's largest health care provider motivated lawmakers to remove that provision.

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Additional measures of the bill work against the rising cost of drugs by requiring pharmaceutical providers to submit pricing data to the state’s Center for Health Information and Analysis, and sets standards for hospitals to lower the number of patients re-admitted within 30 days.

The Cost of Single-Payer

Rounding out the bill is the single-payer provision, which requires the state to investigate whether the estimated annual cost to fund a single-payer system would be less than the overall cost of the existing, market-based system.

If the study suggests that Massachusetts could reduce overall health care spending through the creation of a single-payer system, the bill requires the state to then take steps toward implementing the new approach. It would be a revolutionary step in the United States.

Supporters of the bill are confident. Senate Ways and Means Chairman Karen Spilka has already projected a savings of $525 million in overall health care costs, and $114 million in expenditures from MassHealth, the state’s public health care provider.

What happens next could change the face of health care in the US forever. Single-payer works more efficiently on a large scale, so a functional system inside a single state would bode well for its use nationwide.

Photo Credit: Gerry Boughan / shutterstock.com

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