State-Level Medicare For All ‘Doesn’t Appear Likely’ In Massachusetts

WASHINGTON – As Medicare for all “falters” in the U.S. Congress, some lawmakers in Massachusetts are pushing for a one-size-fits-all health care system run by the state’s government.  But concerns over the system’s high costs and elimination of patient choice and control are already plaguing its prospects.

The Boston Globe reports that the state-level “so-called Medicare for All legislation would raise taxes and eliminate private health insurance while putting the state in charge of all payments to doctors and hospitals,” and “calls for a series of payroll and capital gains tax hikes, to generate an estimated $15 billion to $20 billion a year.  For a middle-class family, that could be an additional $15,000 in taxes per year,” according to the bill’s author.

The state’s health care leaders explained the threat such a system would pose to Massachusetts patients and taxpayers:

“Mandating a one-size-fits-all, government-run health care system will eliminate health care options for patients,” Lora Pellegrini, president of the Massachusetts Association of Health Plans, said in a statement.  “At a time when most Massachusetts residents have health insurance coverage, the single payer debate only distracts from the critical work we must do to control health care costs for employers and consumers across our state.”  …  “The current ‘Medicare for All’ proposals — whether those under consideration in Washington or filed at the Massachusetts state level . . . put the viability of our crucial Medicare and Medicaid programs directly at risk,” Steve Walsh, president of the Massachusetts Health & Hospital Association, said in a statement.

And notably, while some national lawmakers and 2020 presidential candidates make unrealistic promises about the level of coverage and care Americans would experience under a national, one-size-fits-all system, Massachusetts lawmakers acknowledge the high costs and other tradeoffs it would require: “‘I just don’t want to set up this idea that if we go to Medicare for all, if we go to single-payer, that all of a sudden everybody’s going to have access to every single thing they need when they want it, if they want it,’ said [Sen. Cindy] Friedman, an Arlington Democrat.”

The Associated Press reports that a one-size-fits-all government-run system in Massachusetts “doesn’t appear likely in the near future.”

That’s no surprise, as high costs and unaffordable tax hikes have doomed similar plans to implement single-payer health care on the state level.  The New York Times editorial board acknowledged that “[i]n Vermont and Colorado, legislators dropped bids for a state-run single-payer system when it became clear that people would not support the tax increases needed to sustain such a program.”

And Roll Call reported that Peter Shumlin, Vermont’s Democratic former governor who campaigned on a platform of single-payer health care, later admitted that the 11.5 percent payroll tax and 9.5 percent income tax that were proposed to finance the system were too much for taxpayers to accept: “The final bill was too much for the state to bear, he said.  ‘The biggest problem was money,’ Shumlin said …  And he couldn’t promise lawmakers that they wouldn’t need to hike taxes again later to accommodate rising health care costs.  ‘I couldn’t with a straight face turn to them and say, no, we’ve got this figured out,’ he said.”

The Washington Post reported recently that the failed attempt to implement a costly single-payer system in Vermont “offers sobering lessons for the current crop of Democrats running for president, including Vermont’s own Sen. Bernie Sanders (I), most of whom embrace Medicare-for-all,” adding: “Then as now, many of the advocates shared ‘a belief that borders on the theological’ that such a system would save money, as one analyst put it – even though no one knew what it would cost when it passed in Vermont.  That belief would prove naive.”

The reality is that proposed government insurance programs – such as “buy-in” or “public option” schemes – are not moderate alternatives to Medicare for all; instead, they seek to expand Medicare, which is already at risk and should be fixed.  Americans will continue to learn of these plans’ negative impacts on patients and taxpayers, who would be forced to pay more to wait longer for lower-quality care.

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