There are fifty sponsors of H 2127.  That is a significant number for any bill that comes before us and one has to ask why, after all these years this bill has been before the legislature in one form or another, does one quarter of our legislature still support this bill.  Looking down the list one sees the usual liberal members.  But there are also conservative members of the legislature that have signed on as sponsors.  Why?

Can it be that health care premiums continue to go up even after significant reform in 2006?  Could it be that we continue to look to other industrial nations that have national, single payer health care plans that are half the cost of our national average?  Could it be that these other industrialized nations provide their citizens with better health care in spite of their lesser costs?  Could it be that the average health care premium in the nation has gone up by 130% since the year 1999 while wages have gone up only 38 percent and inflation 28 percent?[i]  Premiums are projected to hit an extraordinary average of $24,000 per family by 2019.[ii]

Could the reason this bill enjoys so much support by legislators be that only 60 to 70 percent of our health care dollars actually are spent on health care?  Could it be that legislators deal directly with much of the discontent of constituents with the current revamped system?  It covers more people but puts many into financial distress.

We should ask why out of all the possible methods of saving health care dollars, we, in Massachusetts and Washington, have not considered single payer health care systems?  If nothing else it’s a tribute to the lobbying power of the health care industry.  In Washington, there are about 6 lobbyists employed by the insurance and pharmaceutical industries to every legislator.  The money they are spending is fantastic.

This past July, we on the Health Care Finance Committee were handed the Recommendations of the Special Commission on the Health Care Payment System.  The report sounds the alarm and the need for payment reform. 

“While the U.S. has the highest health care expenditures per capita among other industrialized countries, Massachusetts has among the highest health care costs in the U.S. In 2004, health care costs per capita in Massachusetts reached $6,683 (DHCFP, MA Health Care Spending 2009) and based on recent history are projected to grow faster than for the U.S. as a whole (DHCFP, MA Health Care Cost Trends 2008).[i]”

And of course, according to the Special Commissions Report, we are not receiving better health care in Massachusetts in spite of our exorbitant costs. 

“…A study conducted by the RAND Corporation concluded that adults nationwide receive just 55 percent of recommended care; few differences were found between Boston and eleven other metropolitan areas (Kerr et al. 2004).  In addition, the Commonwealth fund state Scorecard on Health System Performance in 2007 indicated that fewer than half of adult diabetics in Massachusetts received recommended preventive care, and fewer than half of all adults over age 50 received recommended screening and preventive care (Cantor et al. 2007).

In spite of all these frightening facts, the Special Commission never considered the one thing that has been proven to save money the world over, single payer healthcare, the very same option that you are considering today.

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I sat in the Health Care Finance Committee hearing on payment reform for several hours and listened to party after party say, in some way or another, “…it’s not us that caused the problem of high costs…it must be the other party.”

Instead the Special Commission’s report goes on to recommend one of the most confusing and convoluted systems for keeping health care costs in check.  I dare you to read the report and tell me how it will work and if it will save money.  Granted it was a daunting task, under silly restrictions, they couldn’t consider single payer health care.  Consequently, the recommendations are less than clear.

Many of the methods I can agree with like global care and ending fee for service based payments.  I read the book, “Over Treated” by Shannon Brownlee, in which she lays down a dramatic indictment on the current system.  But all these types of problems go away with a single payer health care system.

The worst thing that can be said about single payer health care is that many people that work for the health insurance industry will lose their jobs.  However, the single payer system will be able to hire back many of these people, and they should and are given preference in the hiring as stated in the bill.

But we will not have CEOs with multimillion dollar salaries in a single payer system and we won’t have people and organizations earning a profit on the pain and suffering of their fellow human beings.