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Community Voices: The good news about single-payer health care


Health care in the United State  is in a crisis. Our present health care system is fragmented between multiple private insurance companies and government programs such as Medicare and Medicaid. The system is controlled by the profit making insurance industry and based on each person’s ability to pay and not based on needed medical care. Fifty million people do not have insurance at all. At least 25 million people are underinsured and do not have their medical needs covered. Some plans won’t cover important services, such as prescription drugs, and most plans impose out-of-pocket expenses such as co-payments and high deductibles. The costs of insurance premiums are rising rapidly and consume a huge part of the household budget, and medical costs have led to foreclosures and bankruptcy.

Our current system discriminates against low-income people and leads to poorer health in these communities. The U.S. spends more money on health care per person than any other country in the world, but the sad reality is that we do not have high quality care. Among industrialized nations, the U.S. ranks near the bottom in infant mortality, life expectancy, and the number of people receiving protective vaccines.           

The good news is that we can get out of this spiraling crisis by working together to create a system of single-payer health care that will cover everyone under a single publicly financed insurance plan. Single-payer health care will provide affordable, comprehensive health care, including vision and dental care. Everyone would be free to choose which doctors, hospitals and community health centers to use. All other developed countries have some form of single-payer health care, which has allowed them to guarantee health care for all their citizens and spend about half of what we spend in our country.

 The incentive for a single-payer health care system is to keep people healthy with access to preventive care and a focus on early intervention that would catch illness and injury before they become serious and difficult to treat. The incentive for the private insurance industry is to avoid taking care of sick people because it costs them money and results in less corporate gain. Insurance companies make their money by denying policies to people with pre-existing conditions, by dropping coverage for those running up a big bill or having a serious illness and by choosing to insure the healthiest.             

The promise of single-payer health care in Massachusetts is within our grasp. A single-payer health care bill called “Medicare for All Massachusetts” has recently been filed in the legislature. This bill would provide every resident with first class health care and reduce costs to the state, employers, and households.  It will create a comprehensive, public plan, like improved Medicare for all, saving 15.7 percent of Massachusetts’ current health care funding.  Costs would be controlled by eliminating the middle men and administrative bureaucracy of private profit-making insurance companies and by creating one large risk group that includes all the residents of the state to bargain for the best prices for medical services, goods and drugs.  There would also be less overhead costs for providers and hospitals that will no longer need huge billing departments to deal with paperwork. With the current system the administrative costs are about 30 percent of the money spent on health care.  Medicare already works for senior citizens, with a 3 percent overhead cost.  Administrative savings, plus a small payroll tax as well as federal and state money already being used for Medicare, Medicaid and other programs, can fund single-payer health care and save money!

Let’s have Medicare for everyone! Imagine having a health insurance card granting you a full range of medical benefits, with no out-of-pocket expenses and bills! Families of middle and low-income earners would take home 7.3 percent to 15 percent more income after lifting the burden of premiums and other health care costs from their pay.   Single-payer health care can happen if we become educated about it and understand how only single-payer health care can control skyrocketing costs. 

Maria Termini is a volunteer with Mass-Care, a coalition of more than 100 groups in Massachusetts working to make health care a right.