Single Payer in Maryland

A letter to Senator Thomas McLain (Mac) Middleton

Chairman, Senate Finance Committee

Maryland State Senate       

Thomas Middleton    





Thomas Middleton

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.


5 Responses to Single Payer in Maryland

  1. Dr. Carol Paris says:

    It isn’t just patients who are frustrated and overwhelmed by our broken non-system of health care financing in Maryland; doctors are retiring early, going out on disability, or retraining in non-clinical fields because the personal and financial rewards of practicing medicine are gone.

    • jimmy1920 says:

      Thanks for your comment.
      I try to make that point right at the beginning. Patients and doctors, the very people the system is intended to serve, are the very ones who are complaining the loudest through word and action. That should be a clear signal that something is wrong.

  2. Sherry says:

    Just dropping by.Btw, you website have great content!

    Powerhouse Strategies And Tips To Increase Your Odds Of Getting Pregnant

  3. Hello

    When corporations hold back progressive legislation then we need to take
    political action and pressure GOP contributors into getting us the legislation that they have blocked through funding the GOP whose
    representatives and Senators who block legislation. Please discuss
    this with your colleagues and hopefully you will get citizens to
    take action. The usual past actions have not worked. How about doing
    something different for a change that might work?


    Send the following letter by fax to Senate Republican minority leader Senator Mitch McConnell. Tell other people to visit this site and have these people to get other people to visit this site.

    Go to which will have the letter
    shown below in the text box and the fax information for Senator McConnell. Just enter your name and email in the left hand box and fill in the captcha code and then click on the button that reads send free fax now. Remove any text for the minimum wage issue and the other issues if you like from the prewritten letter.


    I want the following actions taken and legislation enacted into law.

    Congress and the President must enact HR 676 single payer
    universal health care and set up a new prescription drug benefit
    in Medicare Part B covering 80% of the cost of all drugs with
    no extra monthly premiums, no extra yearly deductible, no
    means tests, no coverage gaps, and remove the means test for
    Medicare Part B and until that happens, I won’t buy
    ANYTHING from Republican contributor Rite Aid Pharmacies.

    The President must end the war in Iraq and until that happens
    I will not buy any products from Republican contributor and
    War contractor General Electric Corporation.

    Congress and the President must enact a $10/HR MINIMUM
    WAGE into law and until this happens I will not go to any
    Republican contributor Wendy’s Restaurants.

    In 2008 Brown-Forman of Kentucky, the maker of Jack Daniels
    Whiskey and Southern Comfort gave Mitch McConnell money
    for his campaign.


    Thank you.

    Also have people do the following:

    Call GOP contributor Rite Aid at 800 325 3737
    and tell the person to get the CEO to get congress
    to enact HR 676 Single payer health care and
    enact a new prescription drug benefit in Medicare
    Part B covering 80% of the cost of drugs
    with no extra premiums, no extra deductibles, no means
    tests, no coverage gaps, and remove the means test
    for Medicare Part B and until that happens, you
    won’t buy ANYTHING from Rite Aid.

  4. Nice post! Keep it real.I have looked over your blog a few times and I love it.

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