Question 4 seeks local support for single-payer health care

Recorder Staff
Published: 10/23/2018 4:20:07 PM

So much attention has been given to the three statewide questions on the Nov. 6 election ballot that it’s easy to overlook Question 4.

The referendum question in the 1st Franklin, 2nd Berkshire and all three Hampshire House districts, is a non-binding measure that would instruct the legislator in that district to vote to create a single-payer health care system in Massachusetts.

Although single-payer legislation has been introduced every session for nearly two decades — most recently as a “medicare for all” bill co-sponsored by Sen. Adam Hinds, D-Pittsfield, and Reps. Solomon Goldstein-Rose, D-Amherst and the late Peter Kocot, D-Northampton — no bill has ever made it out of committee, according to Deborah Levenson, co-convener of Western Mass. Medicare for All, which is coordinating the referendum in six Western Massachusetts House districts next month, including one in Hampden district. 

The Senate did overwhelmingly endorse a study of how the costs of a single-payer health care model would compare to the state’s current health care spending, but the House failed to take up the measure. 

“A positive outcome on Question 4, though non-binding, will strengthen our representatives’ ability to move this legislation forward, and will encourage those still on the fence to get on- board,” said Levenson. 

The measure was approved in the Hampshire-Franklin Senate District in 2000 with nearly 69 percent of the vote, in the 2nd Berkshire District in 2008 with 75 percent of the vote and in the 1st Franklin District in 2012 with 72.3 percent of the vote.

In fact, of the 29 ballot referendums on the measure since 1998 around the state, it has always won a majority, and in the case of the two questions in Hampshire legislative districts in 2008, it won with more than 80 percent of the vote.

According to the measure’s sponsors, single-payer legislation would establish a publicly funded Health Care Trust to pay all health care claims in the state. The trust would provide comprehensive coverage for all medically necessary care, including vision and dental care, to every Massachusetts resident for regardless of income, employment, health status, age or other criteria. The trust would be administered by a publicly accountable board of trustees and professional staff.

Levenson said the measure, placed on the ballot  by petition through a network of “hubs” — including Franklin County Continuing the Political Revolution here — is focused on providing single-payer health care on the state level. 

Unlike bills in several other states, the Massachusetts model includes “a research-based financing plan” under which all payments to private insurers, including premiums, co-pays, deductibles and other out-of-pocket expenses, would be replaced by a payroll tax and a tax on unearned income over $30,000.

Supporters contend that nearly every resident in the state would pay less under a single-payer system and receive broader comprehensive coverage throughout their lifetimes.

Single-payer supporters say the current system of public and private insurance fails to adequately cover all people and squeezes family, business and government budgets. Opponents have argued patients could lose choices under such a system, driving up costs.

The Massachusetts Association of Health Plans, an insurance industry group, has argued that the single-payer question is a distraction from efforts to address the cost of health care.

In Franklin County, the referendum appears as a non-binding question in every town except Erving, Gill, New Salem, Orange, Warwick and Wendell. In Northfield, it appears as Question 5, because a town ballot question is listed as Question 4, according to the Secretary of State’s Office.

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