DEDHAM, Mass. — Leo Stolbach says he’s working to advance a single-payer health insurance system for Massachusetts because he sees what’s happening to patients now.
“Patients are getting shortchanged. And this fallacy that we have the best health care in the world, that’s wrong. It isn’t. And we’re paying twice as much for not having the best health care in the world,” says Stolbach, a semi-retired medical oncologist, who lives at NewBridge on the Charles.
On the ballot Nov. 2 is Question 4, a non-binding question that asks voters in the 11th Norfolk District whether they want to instruct their state representative, Paul McMurtry, “to support legislation that would establish health care as a human right regardless of age, state of health or employment status, by creating a single-payer health insurance system like Medicare that is comprehensive, cost-effective, and publicly provided to all residents of Massachusetts?”
So-called “Medicare For All” would provide consumers free choice of doctors and hospitals; universal, comprehensive care for life; control costs; and help job growth, according to Mass-Care, the group which is pushing the measure. Establishing a single-payer system is the mission of Mass-Care, which was formed in 1995. It has been an uphill fight.
The main goal of the ballot question is merely to get the Massachusetts Health Care Trust bill out of committee and onto the floor of the House, Stolbach says: “Each year we testify for it, and it doesn’t get out of committee.”
In 2008, Mass-Care had a similar ballot question in 10 legislative districts – and it passed in all of them.
This year it is in 14. Two hundred signatures are needed to get the question on the ballot in each district; Stolbach said he gathered 126 just at NewBridge. He also went to supermarkets and “stood in front of the Community Theatre.”
Its owner and Dedham’s representative, McMurtry, says that since he was elected one of his priorities has been to support affordable, quality health care.
He says of Question 4, “If that’s what the majority would want, then again I would look at additional information and make an educated decision should the matter come before us,” in the Legislature.
McMurtry says that though the state and nation have begun to address their health care concerns, “it’s certainly not a perfect system, and there’s always room for improvement and added efficiencies.”
Stolbach says the current system is “significantly wasteful.”
“It looks at health care in a way that says ‘how can we maximize our profits?’ rather than how can we best deliver care,” he says. “Physicians are paid to do certain things, and not necessarily to take the best care of the patient. And that’s the problem with the fee-for-service (system) that we’ve got.”
Stolbach’s last positions were as director of hematology and oncology at Saint Vincent Hospital in Worcester and as a professor of medicine at UMass Medical School. He is not seeing patients anymore, but is still involved in research projects, teaching, and medical record reviews.
He doesn’t like to use the term single-payer, explaining, “A lot of politicians have painted single-payer falsely. They claim that it’s socialized medicine.”
In doing so, they lump together Britain, which has socialized medicine, and Canada, which does not, says Stolbach. He worked as the head of oncology at the largest hospital in Ottawa for three years, when he had an appointment at the University of Ottawa. “I saw how well a single-payer system can work.”
Meantime, the U.S. health care system is far down the list in terms of outcomes, while the percentage of America’s gross domestic product that goes toward health care keeps going up. “The present system is not sustainable” because of the rising costs, including double-digit premium increases each year, Stolbach says.
That includes Massachusetts’ comprehensive health care law, signed by Governor Mitt Romney in 2006, he says: “The difficulty with it is it’s still being run by insurance companies. You can see that these increases are not sustainable.”
Massachusetts had one of the lowest uninsured rates in the country before the comprehensive law took effect, of about 8 to 10 percent, yet is having budget problems now as it tries to provide coverage based on the law, Stolbach says. Texas has about 27 percent uninsured, according to him.
“If we here in Massachusetts are a billion dollars in the hole, then what’s going to happen to these other states if they have a similar kind of program to ours?” he asks.
Under single-payer health care, the Massachusetts Health Care Trust board would represent consumers and providers. Providers would negotiate with the health care trust for patient care, and collect premiums, “but the system would be a lot simpler. It wouldn’t require patients to only go see a doctor in their network, for instance,” Stolbach points out.
He says advocates still have yet to work out exactly how a single-payer system in Massachusetts would be paid for, but that all of the analyses show that the new system will cost businesses and patients less.
“It’s a complicated issue,” he says. “I’m not saying that single-payer will take care of all of the problems, but it certainly will cost less because of administrative costs and overhead.”