The implications of a single-payer health care system like Medicare for All were the focal point for a virtual panel discussion on Tuesday.
The event was the first in a two-part series sponsored by the state Legislature’s Medicare for All Caucus, Mass-Care and Western Massachusetts Medicare for All.
State Sen. Jo Comerford, D-Northampton, Senate chair of the Joint Committee on Public Health, was joined by Dr. William Hsiao, professor emeritus at Harvard University; Sameen Ansari, a medical student at the Oakland University William Beaumont School of Medicine; and Olivia Sonderman, a medical student at the University of Nebraska Medical Center.
In her opening remarks, Comerford said that although discussions on universal health care have been necessary for generations, they are especially pressing during the COVID-19 pandemic, “whose stranglehold on our communities has exposed the gross and groaning inequities along race, ethnicity, class lines.”
Ansari agreed, noting that affordability of health care is an issue for 48 percent of Massachusetts residents.
In a single-payer system, according to Ansari and Sonderman, health care is considered a universal right.
“We’ve seen that single-payer can be a trigger word. There can be people that are completely for it and people completely against it based on their emotional preconceptions. It’s important for us to strip that away, and focus on public health and what people in Massachusetts need,” Ansari said, describing the coverage gaps for people who are uninsured, underinsured or who can’t afford health care despite having insurance.
In discussing this system, Ansari and Sonderman focused on a public health transformation. Sonderman detailed how the health benefits of a single-payer system include preventable hospitalizations from assured primary care and an integration of mental health coverage.
Both Ansari and Sonderman reported that transitioning to a single-payer system would improve access and equity, and maintain coverage without gaps.
According to Hsiao, 97 percent of people in Massachusetts have health insurance, but with varying benefit packages, a lack of access to health care in certain communities and a Health Policy Commission that is only focused on controlling the annual growth rate.
“Massachusetts is still spending money inefficiently and ineffectively,” he said.
Hsiao discussed the transitional steps toward a Medicare for All single-payer system, saying that it “would vastly reduce waste, inefficiency, and fraud and abuse, which amounts to 30 percent of total health care expenditures.” According to several projection models, Hsiao said, 30 percent is equivalent to $18 billion that would be saved in a single-payer system. He emphasized the importance of incorporating target programs to remedy underserved and low-income communities.
The panelists addressed how one key barrier for transitioning to a single-payer system is public perception.
“The public has to understand the advantages of single-payer and that they will actually get more income although they may have to pay higher taxes,” Hsiao said. “Meanwhile, they won’t have to pay anymore out-of-pocket costs, premiums or deductibles.”
Hsiao noted that pushback would likely come from interest groups such as insurance and pharmaceutical companies. A key step, he said, would be to establish a purchasing alliance to bargain with pharmaceutical companies for lower prices.
“For exactly the same drug, we are spending two to three times of what Europeans pay,” Hsiao explained.
Nonetheless, Hsiao said he is hopeful that Medicare for All will become a reality, for two reasons. First, because “health care costs continue to rise faster than the wage rate increases. It imposes such a pressure on the state and local government budgets, as well as companies.”
Secondly, Hsiao said, physicians are changing their views on Medicare for All. He said roughly 47 percent support a single-payer system.
“The success of any health-care system, including a single-payer system,” Ansari said, “depends on lawmakers’ and legislators’ ability to come together and develop an equitable benefits package that addresses the needs of the population.”
Comerford agreed.
“I do think there is a role at the state level to push on this in a lot of different ways,” she said.
The next virtual panel is scheduled for Tuesday, Oct. 14, at 2 p.m., and will be livestreamed from the Legislature’s Medicare for All Caucus Facebook page.