By Colleen Quinn
STATE HOUSE NEWS SERVICE
STATE HOUSE — Former gubernatorial candidate Donald Berwick hasn’t let his third-place finish in last September’s Democratic primary diminish his advocacy for a single-payer health care system.
On Thursday, more than four months after his campaign came up short, Berwick was on Beacon Hill, touting the benefits of a single payer system to lawmakers who plan to push the idea this session.
Berwick, who made single-payer a focus of his campaign, said the major switch is doable in Massachusetts if the public can be convinced it will improve their lives. Under the proposed system the government, rather than private insurers, pays for all health care costs.
“The care would be better. The system would be responsive. They would have more control, not less over their lives with people attending to their health and real needs, and costs would fall. The public is still suspicious about that, and I think the story really needs to be told in a way people can understand,” Berwick told the News Service after speaking at the legislative briefing.
Advocates from the Massachusetts Campaign for Single Payer Health Care (MassCare) say more than 272,000 Massachusetts residents still have no health insurance, despite the state’s 2006 universal health care law. MassCare contends that savings on administrative costs under single payer would be large enough to cover all the uninsured, eliminate co-pays and deductibles, and upgrade coverage for Medicare enrollees, without increasing health care spending.
In single-payer, the payment system changes but the care does not, with the government paying the same doctors and hospitals, according to Berwick, who is a former administrator of the Centers for Medicare and Medicaid Services (CMS) under President Obama.
“The government is not going to take over your care,” Berwick said.
As for the private health insurance industry, it changes, Berwick said.
“That is one thing we would have to plan for,” he said. “We would have to help the insurance industry, its employees, and its stakeholders through the transition.”
Berwick suggested some in the insurance industry could be “hired back” by the state to implement the new system, creating the payment and infrastructure system.
Opponents of single payer have concerns about a government-run system.
“It would undermine the efforts we have made to lower costs and improve care,” said Eric Linzer, senior vice president at the Massachusetts Association of Health Plans. “It would affect innovation in the state.”
Linzer said private health plans in Massachusetts are consistently rated among the nation’s best for quality and member satisfaction.
“Moving to a government-run system would undercut much of the innovation that has taken place. We should be very cautious about moving to a government-run system, given the failures of the state’s Health Connector website last fall, and similar problems at the federal level,” he said.
Linzer also pointed out it is unknown how much it would cost to implement a single payer system.
Twelve years ago, the Massachusetts Legislature commissioned a study looking at ways to expand health care coverage to more residents while developing legislation for the 2006 universal health care law. A report showed a single payer system would cost between $3 billion and $6 billion above current health care spending at that time, according to Linzer.
“Given it has been more than 12 years we would expect those costs would be even higher,” Linzer said.
After the gubernatorial campaign, Berwick returned to work at the institute he founded, the Institute for Healthcare Improvement, as a part-time fellow.
Asked if he would run for governor again, Berwick said, “I’m not answering right now.”
Lawmakers promoted bills related to single payer health care.
One bill, sponsored by Sen. Daniel Wolf (D-Harwich) and Rep. Jennifer Benson (D-Lunenburg), would require the state every year to compare the total health care spending in the state with projected health care spending if the Massachusetts implemented a single payer system. If after several years, the single payer model outperformed actual health care spending, the state would move toward implementing a single payer system. The data on actual health care spending would come from the Center for Health Information and Analysis (CHIA), according to Benson.
“I want to make an economic argument for single payer health care,” Benson said during the briefing.
“All this bill allows us to do is make a public, transparent case as to why single payer works for Massachusetts,” she added.
MassCare estimates that nearly half a million people in the state under age 65 are under-insured. They have health insurance coverage, but still spend a large percentage of their income on copayments and deductibles. Many more lack adequate coverage for long-term care or mental health services, according to MassCare.