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"So Let's Call it What it Is!" by Elmer Freeman

This article is more than 14 years old.

So, the anniversary of the first year of health reform, as we perceive it, has come and gone, and going into year two we have significantly increased the number of “insured” residents in the Commonwealth. We should and do take great pride and praise for being the first state in the nation to make a commitment to “health care for all” of its residents. Through expansion in entitlement to MassHealth and the “safety net plans” for classes of people too poor to afford market health insurance through Commonwealth Care and the affordable options of Commonwealth Choice we have moved ahead in increasing coverage. However we have done nothing, that even misconstrued, can be considered by any rational person to be health reform. So let’s call it what it is! Or is it what its not?

It is expansion of health insurance in its various iterations, employer based, individual and group, and government sponsored, to uninsured residents of Massachusetts. It is not health reform, and that’s the problem. It is increasing dollars spent on a broken system. It is not changing the system. It is giving people access to care. It is not improving care. It is investing more money with no return on that investment in terms of decreased cost, improved quality or increased accountability.

In a recent television interview, candidate for President, Hilary Clinton was being pressed by the reporter on whether she would call for an increase in taxes in order to institute the kind of reforms she envisioned in health care. She said no. He pushed her with candidate Edwards position that any candidate unwilling to admit that taxes would have to be increased for us to accomplish health reform, which to Edwards, like Massachusetts politicians think means universal coverage, was not being honest with the voters. Senator Clinton’s response, as someone who had occasion to study real health reform, was that she would refuse to invest any more dollars in what is obviously a broken system. Exactly the opposite of what we have done in Massachusetts. We’re pumping more money into a system that’s becoming increasingly more expensive, with decreasing quality, and will not improve the health of the citizens on Massachusetts. The only winners in Massachusetts health reform are the insurance companies and health plans.

Who would dare to speak against universal coverage? However, how many of us wonder at what cost? For example, how much money is being spent on advertising, marketing, outreach, enrollment, and all the "administrative" costs associated with the creation of the “quasi” governmental Connector as yet another layer of administration, and the implementation of only the affordable access aspect of Chapter 58? Could this money be better utilized to decrease the costs of health care and support real reform through a single payer system?

The group, Physicians for a National Health Program, suggest taking advantage of this moment in time … with a Presidential election on the horizon and the heightened visibility of the American health care system crisis, as a result of Michael Moore’s film, “Sicko”, to organize a national campaign promoting a single payer system. On the national level they have sponsored legislation, HR 676 General Resolution, that calls for creation of a US National Health Insurance system, giving everyone access to affordable quality health care paid by saving $300 billion, according to Harvard researchers, in administrative costs.

The group suggests organizing on the state and local level to have state legislatures and city governments pass resolutions supporting HR 676. They also suggest organizing events to coincide with showing of the movie; scheduling grand rounds at hospitals and health centers; panel discussions in communities; securing Representatives and Senators to co-sponsor single payer legislation; and becoming politically active in the Presidential primaries and challenging the candidates to address real health care system reform.

We in Massachusetts are uniquely positioned to step out in front of this movement, just as we did some forty years ago with the beginning of the community health center movement here in Boston, another movement for health access, equity and justice. To paraphrase a favorite son of Massachusetts … if not us, who … if not now, when.

National Health Insurance Bill:
HR 676 Resolution Campaign:

Elmer Freeman, Executive Director, Center for Community Health Education Research and Service, Northeastern University; Co-Chair Critical MASS.

This program aired on July 13, 2007. The audio for this program is not available.

Martha Bebinger Twitter Reporter
Martha Bebinger covers health care and other general assignments for WBUR.