CommonHealthVolume 2, Number 1 ~ Fall-Winter 2005Universal Health Care Education Fund

Background

MASS-CARE is nothing more nor less than a coalition of ninety independent organizations in agreement on two things: the need to create a single-payer system in Massachusetts and the need for national health insurance. MASS-CARE is ten years old, having been launched in 1995 in the wake of 1994’s successful round of local non-binding ballot questions in support of a single-payer system for Massachusetts, spun off from the Jobs with Justice Health Care Action Committee. Over the years many organizations, small and large, local or statewide, single-issue or multi-issue, joined. MASS-CARE’s direction, within the scope of its mission, is set by those who attend the monthly Coordinating Committee meetings. Every participating organization has one vote, and every individual who shows up has a voice. Some groups have lent their name to this endeavor while never sending representatives. And some have clearly put the winning of a single-payer system on their front burner. Each group obviously decides its own agenda for itself.

A generous grant from the estate of Dr. Ben Gill allowed our movement to set up an office and hire staff. Every year we’ve honored Ben with a gala event in his name. This initial grant led us to set up the Universal Health Care Education Fund (UHCEF), a 501(c)(3) nonprofit arm to support educational work and research.

Over the past decade, MASS-CARE has worked with legislators to file specific legislation to attain our primary goal. With the opening of each legislative session, we’ve filed revised legislation. Our current bill is S.755, An Act to Establish the Massachusetts Health Care Trust, with Senator Steve Tolman and Representative Frank Hynes as lead sponsors. Last fall’s revision of our bill included specifics on the funding mechanisms and more attention to the democratic governance of the projected Trust, with eight directors to be elected across the Commonwealth.

Photos by Janne Hellgren & Rand Wilson

2005

On March 19th, speakers’ training was held, followed by our annual Ben Gill event, honoring our lead sponsors Senator Tolman and Representative Hynes. Senator Dianne Wilkerson came to present the award to her senatorial colleague. Dr. Quentin Young of Physicians for a National Health Program was the keynote speaker, explaining the ethical and legal implications of “everybody in, nobody out.”

On June 8th, members of our hardworking Legislative Committee presented our case to the Joint Committee on Health Care Financing, even though the day was officially devoted to all the incremental bills.

On June 15th, aided by Sen. Steve Tolman (above), Rep. Frank Hynes and Dr. Alan Sager from the BU School of Public Health, we briefed a contingent of legislators and their aides on S.755, The Massachusetts Health Care Trust. This educational session on the universal, single-payer solution to our healthcare crisis also featured Drs. Patricia Downs and Leo Stolbach, the Reverend Judy Deutsch, and MASS-CARE Chair Sandy Eaton, RN.

Testimony on S.755 was presented to the Joint Committee on Health Care Financing on July 20th, with a broad array of labor, community, senior, provider, policy and municipal representatives speaking out for a just healthcare system. Peggy O’Malley, RN, chair-emerita of MASS-CARE,

2005 continueddelivered fresh information from Congressman Tierney’s office on how to obtain waivers to allow Massachusetts to tap into federal revenue streams as we construct our new system here.

Driven by the mounting pressure from below for fundamental change in health care as reflected in the campaign to amend the state constitution to make access to affordable health insurance a right of all who reside here, and by the need to renew a ten-year-old Medicaid waiver, every legislator, it seems, has felt obliged to come up with or support some legislation that purports to cover everyone. So we’ve seen the emergence of the Moore, Travaglini and Romney bills, in addition to the Tolman bill. Modeled after the gargantuan Roadmap to Coverage proposal authored by the Urban Institute and issued by the Blue Cross-Blue Shield Foundation on October 7th, the House has issued its “omnibus” health reform package. As we write, it sits in conference committee, along with its Senate counterpart.

It’s exciting to see so much grassroots ferment around health care right now. We admit to some frustration at some sloppy reporting that refers to any of the other bills as “universal” (since none are), and some literature that compares these complex bills without including S.755. Granted that the insurance lobby is very powerful on Beacon Hill, nevertheless, the honest thing to do would be to compare all the major proposals. Single-payer supporters have developed several four-way comparisons. One comparison uses the five principles developed by the Institute of Medicine in a report to Congress and the public last fall: health coverage should be universal; health coverage should be continuous; health coverage should be affordable to individuals and families; health insurance

strategy should be affordable and sustainable for society; and health care coverage should enhance health and well-being by promoting access to high quality care that is effective, efficient, safe, timely, patient-centered, and equitable. Another compares the four bills using the three aspects of access, affordability and quality.

On September 1st, Boston’s historic Faneuil Hall witnessed an outpouring of support for HR.676, the Conyers Medicare for All bill, organized by the Health Care Action Committee of Jobs with Justice. The bulk of the testimony was organized around the three themes of access, cost and quality, which organizers of the event realized need to be addressed together. MASS-CARE was well-represented on the panels. Many MASS-CARE member organizations pulled out all the stops to maximize the impact of this event. Since this meeting was scheduled for a workday, the Massachusetts Senior Action Council takes the prize for mobilizing the most participants. Rand Wilson, currently on staff at IUE/CWA Local 201, wrote up this Congressional hearing and posted fifty-two action photos on the web.

Members of the Legislative Committee continue to have frequent meetings with key legislators.

While we welcome the expansion of Medicaid as a stopgap measure to cover more poor families, we know that this strategy ultimately leads to a dead end, shunting more money to the insurance and hospital industries while providing no vehicle for uniting people for negotiating with the pharmaceutical corporations to bring down drug prices. Inevitably, the next economic downturn will bring a flood of additional families pushed onto the Medicaid rolls just as the state tax revenues fall. As in the past, Medicaid will be cut when the need is greatest.

2006

MASS-CARE’s statewide meeting on November 19th outlined three areas to focus on in the coming year: an assessment of our legislative support; greater effort to reach out with editorial letters, op-ed pieces and appearances on talk shows, cable TV and before live audiences; and a strategic plan for the upcoming elections, insisting that all legislative and gubernatorial candidates support the people instead of the insurance industry. A subcommittee was appointed to flesh out the proposal to spin off an individual-member single-payer organization for the Commonwealth, to build our grassroots movement more deeply.

We’ve drafted an ambitious budget to support this ambitious plan. With the generous support of our member organizations and far-sighted individuals, especially right now, we’ll start the coming year with a bang. We’re expanding our grant-writing efforts, and we’ve begun planning for the next Ben Gill gala, slated for March. Thanks for all your earlier support, and for your ongoing faith in our prospects to build a just healthcare system!

Here’s what people are saying:

“Health care is on the minds of lots of people these days. The bad news is that insurance premiums are rising yet again. Many people are losing coverage altogether.” - Jean W. Dillard, RN, Lenox, Berkshire Eagle, April 15, 2005 “Enact the Massachusetts Health Care Trust legislation in order to provide availability and affordability of health care for all Massachusetts citizens.” - Boston City Council, July 13, 2005,

“For municipalities like mine, the escalating costs of providing health insurance have forced layoffs and reductions in city services.” - Northampton Mayor Mary Clare Higgins, July 18, 2005

"The single payer approach, by capping spending and committing to cover all residents of the Commonwealth, offers by far the best platform for spending money carefully, avoiding rationing by ability to pay, and reducing health care waste." - Alan Sager & Deborah Socolar, $1 Billion Per Week is Enough, July 20, 2005

“Steadily rising costs of health care in the US have become an intolerable burden on businesses and on local, state and federal government.” - Arnold S. Relman, MD, July 20, 2005

“Our market-based health care system is a colossal failure. It costs too much and provides too little. We need a single-payer system, just like every other advanced country.” - Marcia Angell, MD, July 20, 2005

“The private health plans cannot be relied on to ensure that health care would remain affordable to women who are having difficulties making a living wage.” - Catherine DeLorey, RN, PhD, Women’s Health Institute, July 20, 2005

“The healthcare system we have today fails people who work hard, play by the rules, and who want to do the best for their families and communities and their businesses.” - Christopher Poteet, Somerville, July 20, 2005

“Today in Framingham, one out of every seven municipal dollars is spent on employee health insurance.” - Katie Murphy, RN, Framingham, Chair, Framingham Board of Selectmen, July 20, 2005

“While throwing more money at the problem may cover a few more of the uninsured, it continues to fatten the insatiable special interests that are already feeding at the trough.” - Jobs with Justice, October 17, 2005

“All but S.755 maintain reliance on a bevy of competing commercial insurance companies.” - Sandy Eaton, RN, Quincy, MASS-CARE, Patriot Ledger, October 18, 2005

“Mandatory health coverage that forces low income people to buy bare-bones insurance and punishes those who can’t with tax penalties or garnishing wages is mean-spirited and abusive.” - Pat Downs Berger, MD, October 22, 2005

“The system continues to devour more and more resources without improving itself. This will continue until strong political leadership emerges to tackle these tough problems.” - James J. Callahan Jr., West Newton, Boston Globe, October 27, 2005

“Those of you who want S.755 enacted now should let your State Senator and State Representative know now. Calling 617 722 2000 will get you to the State House switchboard.” - Reverend Judy Deutsch, Legislative Chair, MASS-CARE, October 28, 2005

“The Tolman/Hynes bill, S.755, is the only ethical and economically feasible proposed legislation when judged on the basis of the Institute of Health's Five Principles for Expansion of Health Care.” - Kathleen Bridgewater, League of Women Voters Amherst, October 31, 2005

“Why don't we extend government insurance coverage to everyone, and eliminate the profiteering middlemen?” - Susanne King, MD, Lenox, Berkshire Eagle, November 1, 2005

“Attaining universal coverage is a worthy goal that would decrease the strain felt in hospitals and emergency rooms, where the uninsured go for care after their illnesses.” - Berkshire Eagle Editorial, November 2, 2005

“If we cut bureaucracy to Canada's levels, we could save $9.4 billion annually, enough to cover all of the 748,000 uninsured in Massachusetts and to improve coverage for the rest of us.” - Steffie Woolhandler & David Himmelstein, Cambridge Chronicle, November 3, 2005

“Is there anything in this [House] bill about streamlining the healthcare procedures? Is there anything about moving toward preventive care?” - Tim Macchio, Roxbury, November 4, 2005

"I'm not happy with [the House bill]. I haven't seen the final amendments. I have some concerns about it. I think it's more an insurance bill than a health care bill." - Secretary of State William Galvin, November 4, 2005

“We urge you to abandon your ill-conceived proposals for health care reform and to adopt, instead, a single payer program of universal coverage for the Commonwealth.” - 281 Massachusetts MDs and PAs, November 5, 2005

“The primary purpose of health insurance deductibles and coinsurance has always been to discourage utilization. ‘It's the insurance companies, stupid’.” - Art Mazer, MPH, Massachusetts Human Services Coalition, November 7, ‘05

“It's no longer reasonable to expect employers to take responsibility for employees' health, nor is it reasonable for employees to be at the mercy of differing health plans.” - Joan Goodwin, Jamaica Plain, Boston Globe, November 7, 2005

“Who will police the House's requirement that all who can will purchase private insurance? How will the state increase enrollment into MassHealth if it has failed?” - Marguerite Rosenthal, Jamaica Plain, Boston Globe, November 8, 2005

“I recognize that single-payer reform threatens the multi-billion-dollar insurance industry and would force down the high profits enjoyed by drug companies.” - Alice Rothchild, MD, Alliance to Defend Health Care, Boston Globe, November 16, 2005

“We work hard and scrape by. Other countries see our government as barbaric because of our lack of universal healthcare.” - Susan Tolbert, Greenfield, Boston Globe, November 20, 2005

“We should not have to trade one expensive system for a more expensive and more complex system that covers less. The single payer alternative is the most reasonable substitute.” - Frank Olbris, MTA, UMass - Amherst

“The Health Care Trust will cover every Massachusetts resident and will have no means testing or eligibility requirements other than Massachusetts residency.” - Reverend Judy Deutsch, Sudbury, League of Women Voters of Massachusetts

“Any solution that relies on maintaining a variety of different plans will only further exacerbate a system bloated with administrative bureaucracy.” - Beth Piknick, RN, President, Massachusetts Nurses Association, The Massachusetts Nurse, November-December 2005

Universal Health Care Education Fund (UHCEF)

c/o MASS-CARE8 Beacon Street, Suite 26

Boston, MA 02108P: 617-723-7001F: 617-723-7002

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