Massachusetts doctors say single-payer or bust

Massachusetts members of the Physicians for a National Health Program released a report today faulting the state’s experiment with health reform for failing to achieve universal coverage, being too expensive and draining funds away from safety-net providers.

The doctors’ punch line is that the reform has given private insurance companies more business and power without eliminating vast administrative waste. In fact, it says, the “Connector” in charge of administering the reform adds about 5 percent more in administrative expenses.

In summary, nothing less than single-payer national health reform will work, according to authors Drs. Rachel Nardin, David Himmelstein and Steffie Woolhandler, all professors at Harvard Medical School.


The report criticizes the Urban Institute’s largely favorable report that found only 2.6 percent of Massachusetts’ residents 

were uninsured in mid-2008 because it failed to sufficiently reach non-English speakers in its survey.

Reports in Health Affairs this winter also found significant positive support for the reform among employers and the public. There was little evidence of crowd-out.

The PNHP doctors’ report says health plans people are forced to buy are not affordable and often skimp, making the mandate that individuals buy them regressive. And moreover, it says, peoples’ experiences have shown that insurance does not guarantee access to care. The Boston Globe chronicled the long wait for primary care last September.

A final criticism the 19-page report offers is that the reform is financially unsustainable, as it does “nothing about a major driver of high health care costs, the overuse of high-technology care such as CT scanners and surgeries, and the underdevelopment of primary care.”

Last winter, Himmelstein spoke about health reform to students at Johns Hopkins School of Public Health. I asked him if single-payer advocates would work against any national reform effort that wasn’t single-payer, as the single-payer camp did in California.

Himmelstein said that if the reform plan looked like the Massachusett’s reform he probably would prefer the status quo. He believes the reform has made most vulnerable patients in Massachusetts worse off.

It looks like health reform is going to be a battle on the Left and Right.

See Also: “Fear and Loathing over the Stimulus Bill” by Joe Flower.                 “The Stimulus Pregame” by Robert Laszewski.                 “Commentology