A look into the single-payer healthcare bill proposed for MA

Photo courtesy of Flickr  Massachusetts residents are largely in favor of single-payer healthcare, and the state has its sights set on being the first to implement such a plan.

Photo courtesy of Flickr

Massachusetts residents are largely in favor of single-payer healthcare, and the state has its sights set on being the first to implement such a plan.


In 1948, the World Health Organization declared healthcare a universal human right. 71 years later, healthcare is currently a polarizing issue within the U.S. government. Single-payer healthcare, otherwise known as Medicare for All, is the United States’ approach to universal healthcare. According to CNBC, 70 percent of Americans are in support of single-payer healthcare, which roughly breaks down into 52 percent of Republicans and 85 percent of Democrats.

According to The Balance, a site for financial advising, universal healthcare is currently provided by 32 of the 33 developed countries in the world; the U.S. is the only one out of these that does not. Of those countries, 12 use the single-payer platform, which means that healthcare is paid for by the government through a mix of preexisting federal and state funding and an increase in taxes, mostly on businesses and the wealthy.

Massachusetts has set its sights on establishing a state-wide single-payer platform before the rest of the nation. According to Stephanie Strand, a teacher at the Gorse Children’s Center at Mount Holyoke and local healthcare activist, 65 percent of South Hadley residents who voted are in favor of single-payer healthcare. The proposed bill states that single-payer healthcare would ensure that every resident of Massachusetts would receive “equitable access to quality, affordable healthcare services [...] as a right, responsive to the needs of the Commonwealth and its residents, without coinsurance, copayments or deductibles, and be accountable to its citizens though the Trust.”

The bill would accomplish this partially by creating a Health Care Trust funded by a 10 percent payroll tax — 7.5 percent from employers, 2.5 percent from employees and a 10 percent tax on unearned income after $30,000 for all employers, small businesses and the self-employed. “Unearned income” refers to income that has been made on investments instead of employed work. Strand explained that the Trust would cover costs efficiently, “because we’d be operating as one very large family — the state of Massachusetts.” She explained that with a larger number of customers, the Trust would be able to pay significantly lower prices for drugs, devices and so forth than the current system of privatized healthcare allows. “No drug company would want to miss out on a whole state’s worth of customers,” she said.

According to Mass Care, a study conducted by the University of Massachusetts, Amherst, single-payer healthcare would save 15.75 percent of what Massachusetts currently spends on healthcare, amounting to $21 billion.

Opponents of the plan argue that it would cost the government an unfeasible and unsustainable amount of money. A report detailed by CNBC and released by George Mason University in July 2018 estimated that Senator Bernie Sanders’ (I-VT) Medicare for All proposal — a key component of his 2016 presidential campaign — would have cost the government $32.6 trillion over 10 years. A similar number was estimated by the Urban Institute, a Washington D.C. research institution, in a 2016 report.

Many who are against the single-payer system argue that this money will come in the form of higher taxes. According to Senior Vice President of Health Reform at the Kaiser Family Foundation Larry Levitt, opponents of single-payer argue that “it would give the government too much control over the healthcare system, that people would have to give up their current insurance plans and that it would increase taxes.” According to Mass Care, it is a misconception that under single-payer the government will control all aspects of a resident’s healthcare experience. The choice of care will still be up to the patient and doctors. But, on the national or state-wide level, it is true that the government would decide which baseline treatments would be covered.

The eradication of medical debt is one of the core issues that supporters of single-payer healthcare advocate for. In an article published by the Boston Globe, Massachusetts state Senator James B. Eldridge argues that the cost of healthcare, even when lessened by insurance, can be stifling for many Massachusetts residents, and even deter them from seeking care when they or a family member are ill or injured. “Health care costs keep rising for individuals, families and businesses, while access remains a problem for many Americans who forego treatment because of high co-pays, or are denied necessary preventative procedures by health insurance companies,” Eldridge said.

Adam Hilton, a politics professor at Mount Holyoke, echoed Eldridge’s frustration with the current American healthcare system. “The ramshackle mix of public and private healthcare programs the US has developed in the absence of universal care is extremely inefficient, costly and frustrating for consumers, leaving many without coverage, with inadequate coverage and astronomical medial bills — the leading cause of bankruptcy in the United States,” he said.

Eldridge will be co-chairing the single-payer healthcare caucus with state Representative Lindsay Sabadosa, who represents the 1st Hampshire District of Massachusetts. In an interview with the Daily Hampshire Gazette, Sabadosa said that the caucus is part of a five-year strategy. Sabadosa is currently the lead House sponsor for single-payer healthcare in Massachusetts. Doctors and other medical professionals are looking to Canada — which implemented a single-payer plan in 1968 — to predict the changes a single-payer healthcare plan could make to their salaries. While Mass Care predicts that salaries will change only slightly, the pay gap between specialities in hospitals and clinics will decrease.

Single-payer healthcare still has a ways to go before a final vote is passed in Massachusetts, let alone in the nation as a whole. However, Hilton believes the idea is gaining traction, and is one we may see come up in many presidential candidates’ 2020 campaigns. “All the candidates for the 2020 Democratic nomination have at least nodded toward this idea, even if they are still vague on the details,” he said.