Single-Payer Supporters Pressing at National, State Levels
U.S. Rep. Ayanna Pressley on Tuesday knocked what she called a “broken health care system that puts profit over people” as members of Congress explored issues around single-payer health care and steps the federal government can pursue to make health care more accessible.
“We must stop allowing the greed of insurance companies to outweigh the health of our constituents, of our community members,” the Boston Democrat said during a hearing of the House Committee on Oversight and Reform. “We must ensure that every person has access to quality care when they need it and where they need it.”
The committee’s chair, Rep. Carolyn Maloney (D-New York), said more than 27 million people in the U.S. are uninsured and some who do have health insurance still face high costs. She said she has supported “Medicare for All” proposals for a national, single-payer health care model since they were first introduced nearly two decades ago, and that Democrats in Congress “will continue to fight for every bit of progress we can make in moving our nation towards universal coverage.”
Along with testimony from patient advocates and others involved in health care, the hearing featured comments from lawmakers that illustrated ideological and partisan divides on both a “Medicare for All” model specifically and, more broadly, the best ways to improve America’s health care system.
In announcing the hearing, the committee said it would “evaluate the need for reforms that would expand access to affordable health care.” Ranking Minority Member James Comer (R-Kentucky) criticized the proceedings as “an attempt to find more ways to spend taxpayer dollars and expand the reach of the federal government.”
Amid what he described as “frightening attempts at government takeover of health care,” Comer said Republicans “are already working to develop common-sense proposals to increase competition, encourage investment in new cures and therapies, protect access to care for all Americans and ensure patients remain in control of their care.”
Rep. Cori Bush of Missouri said that while a Democrat is in the White House and the party has majorities in the House and Senate, “it is imperative lawmakers seize this narrow opportunity now to enact transformational public health policy and poverty-reductive policies like Medicare for All.”
“I have personally bore witness to the stark inequities faced by uninsured and underinsured patients during my tenure as a registered nurse,” Bush said. “For some people, it’s hard to imagine rationing expensive medication like insulin, skipping dialysis appointments, foregoing surgical procedures or refusing medical care entirely. People are having to choose between their life or lifetime of medical debt, and that’s not okay.”
Bush, Pressley and other Democrats on the panel described health care as a human right, and Arizona Republican Rep. Andy Biggs countered that preventing people from making individual health care decisions and “ceding those decisions to government bureaucrats” would violate fundamental human rights.
Biggs said he agreed health care costs are too high but placed blame for those expenses with the system created under the Affordable Care Act and its “regulatory environment.” He pushed back against the idea of comparing the U.S. to smaller countries that have government-sponsored health care.
“The Swiss system works fine for Switzerland,” Galen Institute President Grace-Marie Turner, a minority witness, replied to a question from Biggs. “It’s the size of Massachusetts. That is not something that we could impose on this whole country. We must have diversity.”
Jeffrey Sachs, director of the Columbia University Center for Sustainable Development, said the United States is “spending a fortune” on health care compared to other countries and ending up with worse outcomes, including lower life expectancy.
“We are broken,” he said. “We spend far more on health care, we get far less because we don’t even have a health care system. We have a hodgepodge of private, overpriced monopolies whether for profit or not-for-profit.”
Five members of Congress from Massachusetts — Pressley and fellow Democrat Reps. Katherine Clark, William Keating, James McGovern and Lori Trahan — signed on to Rep. Pramila Jayapal’s Medicare for All legislation establishing a national health insurance program, which has 121 cosponsors.
In Massachusetts, state-level Medicare for All bills (S 766, H 1267) now have 81 cosponsors, according to the advocacy group Mass-Care, representing support from just over 40 percent of the 200-seat Legislature.
The Health Care Financing Committee, chaired by state Rep. John Lawn and Sen. Cindy Friedman, faces a Wednesday deadline to advance or reject the bills, though the committee members can also opt for an extension.
The Massachusetts bills would eliminate co-pays, deductibles and coinsurance and set up a state trust fund to pay for the health care of Massachusetts residents and non-residents who work here at least 20 hours a week. The trust would be funded with new taxes, which supporters say would replace money currently spent on premiums and out-of-pocket costs.
Sara Collins, The Commonwealth Fund’s vice president of health coverage and access, told the congressional panel that national conversations about how to share health care spending responsibilities should be “not just about who pays but also about how much we pay and why and what we are getting for our spending.”
“By focusing only on who pays, the debate during the 2020 election missed an important opportunity to educate the public about the drivers of health care spending, and, in particular, why middle-income households feel increasingly squeezed by their health insurance and health care costs,” she said in her written testimony. “Looking forward, as we consider strategies to expand health insurance coverage and lower consumer costs and weigh the benefits of those strategies against federal costs, it is critical that that the prices paid to providers in private insurance be part of the discussion.”
