A letter to Senator Thomas McLain (Mac) Middleton
Chairman, Senate Finance Committee
Maryland State Senate
In one way or another I have been associated with labor management benefit funds throughout my working career. For years, the multiemployer funds were my model of how a health care system based on employment could work.
But I have become convinced that the health care system is broken at its core.
I understand that the Maryland State Senate will be considering SB 881 in committee hearings on Wednesday, March 4th. I am asking you to join the effort to lead Maryland to a single payer solution to health care in Maryland and the nation.
Who should the system serve?
First, I ask you to pay attention to who is complaining the loudest that the current system is broken. It is patients and doctors. If all of the other stakeholders aren’t facilitating patient access to care and physician delivery of care, then their role in the process needs to be reexamined. A single payer approach begins a fundamental realignment of those roles. It does not need to eliminate their roles. It needs to make them secondary.
Broken at the core – let the buck stop here
I believe that the current health system is broken at its core because no entity accepts full responsibility for any portion of the bill. Listen in on any collective bargaining discussion to begin to appreciate that. Employers want to shift as much of the cost and responsibility on to employees as possible.
At the same time, the federal government doesn’t accept full responsibility for Medicare eligible beneficiaries. They push as much as possible on to private employers as possible.
And do state governments honestly think that Medicaid payments can sustain a delivery system? Who makes up the difference? Health care financing is like the card game, Old Maid. Who will be the last one holding the poison card?
A single payer system says “the buck stops here!” and ends the health care financing shell game that so distorts incentives for all stakeholders.
Broken at the core – level the competitive playing field
I believe the current system is broken at its core because it fundamentally distorts our competitive economy. The inequitable financing of health care distorts competition domestically and internationally.
You witness how competitive pressures have created a race to the bottom that has eliminated private pensions for many and threatens pensions for many more. The same is happening in health care. Look at the auto industry!
What is the incentive for private employers to take full responsibility for the health of their employees, their retirees, and their families if it puts them at a competitive disadvantage at home with employers who don’t assume the same level of responsibility, and internationally where health care costs are significantly lower?
A single payer system takes health care costs out of competitive considerations and allows companies to focus on their core competencies.
Broken at the core – empower the workforce
I believe the current system is broken at its core because it reflects poorly on the value we place on our citizens and their role in the economy. You must be familiar with the countless tragic stories of people with inadequate or no health insurance.
Those are not just stories of physical, financial and emotional stress. They are stories of people who have been denied the opportunity to become productive members of the economy.
By providing equal access to care, you are allowing equal access to work. By taking health care out of the cost of employment, you encourage those employment trends that struggle to gain a foothold in the current economy – less overtime, more part time, job sharing, phased retirement. How many creative ideas never come to market, because a creative individual is afraid to sacrifice his or her health insurance to risk starting a new business?
A single payer health care system is a work force and economic development issue.
We do not need more patches on a leaky and sinking health care boat. We need a newly designed boat that will steer the Maryland and the US economies and their workforces to less turbulent waters.
I hope you will listen to the many more detailed arguments supporting SB 881 put forward by Health Care NOW Maryland; that you will sign on as a co-sponsor of SB 881 and that you will enlist the support of your colleagues in this effort.