This letter by FCCPR member Susan Worgaftik appeared in the Greenfield Recorder, April 05, 2017.
In his March 31 column, Chris Collins described the presentation that Mass. Taxpayers Foundation President Eileen McAnneny made to the Franklin County Chamber of Commerce. Ms. McAnneny’s concern was the increasing cost of health insurance to the Commonwealth might result in the state not having sufficient cash reserves to cover government costs during an economic downturn. Certainly, this is a reason for concern.
The recent debacle known as “Trumpcare” points to the difficulties of developing a health insurance system that covers us all equitably and completely. But there is a solution … and one that is pending in the Massachusetts Legislature right now. It is single-payer health insurance. Yep, a government-run insurance plan that covers us all and is paid through taxes. It works in most other developed countries in the world; why not here?
So what does this single-payer bill do? It creates a single health insurance plan for everyone in Massachusetts, young and old, including those on Medicare and Medicaid. It would cover all medically necessary care, preventive care and dental care. There would be no premiums, no deductibles, no co-pays or co-insurance. Sounds almost too good to be true, doesn’t it? But this is exactly the kind of plan that is found throughout Europe, Canada and Australia. They have made it work for decades. Why can’t we?
Okay, I hear the voices now. “This is going to cost me a fortune.” Nope. Here’s how it would work. The employer and employee premiums that now come out of your paycheck would be replaced with a payroll tax. Neither you nor your employer would have to deal with private insurance companies. The tax would be: 7.5% paid by the employer and 2.5% paid by the employee.
So, what would that look like? Let’s say that you earn $40,000 per year. Your employer would pay $3,000 a year to the state insurance trust fund in regular (monthly? quarterly?) payments. You would pay a total of $1,000 over the course of the year, or $83.33 per month. If you are the breadwinner of the family, that is all you would pay and your spouse and children would be covered. If your spouse is also employed, your spouse would pay 2.5% on his/her income. That’s it.
The members of your family would have their insurance cards. Whether you need a check- up, an immunization shot, an operation or chemotherapy, you would just show your card to your doctor’s once and they would do the billing to the state insurance trust fund. You would not have to pay a co-pay, or worse, wait for a reimbursement for out-of-pocket expenses.
Too good to be true? Nope. It works because everyone is automatically included in the system. Young, healthy people pay into the same system as those individuals with serious illnesses. Federal funds from Medicaid and Medicare would be included in the trust fund as would the payments that seniors pay to Medicare.
Well, that’s fine for employed people and those on Medicare or Medicaid, but what about small business people — will they be losers? Well, that depends. If you are a small business person who does not provide health insurance for your employees, there will be an additional cost. But you may also and that your employees are not coming to work sick and that they are more reliably there because they can get preventive care rather than waiting until they or a member of their family has to go to the emergency room for treatment.
Employers and self-employed persons would not have the first $30,000 of their incomes taxed. The 10 percent rate would apply after that. So, an employer making $100,000 a year, would pay $7,000 a year because the first $30,000 of income is exempt. Considering that presently, family health insurance is often costing $1,000 per month or more out of pocket, this is a better deal even for those in the higher income brackets.
And what if you are retired and living o of Social Security and investment income? The 10 percent tax would not be applied to the first $30,000 of investment income and Social Security, pensions, and unemployment benefits would not be taxed at all.
But would this really work? A study by Gerald Friedman, professor of economics at UMass Amherst, estimates that this plan would save 15.75 percent of the current health care spending in the state. It does so by eliminating administrative waste in our complex private- insurance-run system. Savings would also come from the negotiating power of a single system to get lower prices for prescription drugs and medical supplies.
This single-payer system is in bills S.619 and H.2987 in the Massachusetts Senate and House, respectively. Similar bills are now in the legislatures of California and New York and other states. Senator Bernie Sanders is also submitting a bill into the Senate, but considering the horrors of the Trumpcare debate, that may be a longer road.
So once again, Massachusetts has an opportunity to take the lead in providing health insurance for its residents. Yes, should it be passed, there are a lot of details that will have to be worked out, but the opportunities are enormous. Everyone, regardless of where they work or what work they do, would have health insurance for all necessary treatment. What
Susan Worgaftik lives in Greenield and is a member of the Single Payer Health Care Task Force of Franklin County Continuing the Political Revolution.