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Hospital executives are beginning to think ‘single payer’

November 27, 2019

Topics: Quote of the Day

By Priyanka Dayal McCluskey
Boston Globe, November 26, 2019

When Senator Elizabeth Warren released her detailed Medicare for All plan this month, a coalition of insurers, hospitals, and pharmaceutical companies denounced it as an unaffordable government takeover that would force Americans to pay more and wait longer for medical care.

But Dr. Eric W. Dickson thought it was the best health care plan he had seen all year.

Dickson, who runs UMass Memorial Health Care, a large Central Massachusetts hospital system, said a national single-payer program could remedy many of the problems in American health care, including the lack of affordable coverage for millions of people, the wide variation in hospital prices, and the administrative burden that is exhausting physicians.

“Medicare for All could definitely address those three things,” said Dickson, whose affinity for single-payer care scored him a Twitter shout-out from Warren. “We have to look at this as an option.”

Dickson’s position on the issue — one central to the 2020 Democratic presidential race — may seem blasphemous for a hospital chief. But he and several other hospital executives and physicians see the debate differently than the lobbying groups to which they pay dues, reflecting a stark divide in the industry.

Kim Hollon, chief executive of Signature Healthcare, the parent company of Brockton Hospital, said a national health care program could ease the administrative workload of the current system, which includes numerous private insurance plans that each have their own rules and requirements for providers.

A single-payer system also could help level the vastly different prices that competing hospitals charge for the same services, Hollon said.

“We’d be fine,” Hollon said. “I’d love to have an equal playing field where we just compete for doing a good job effectively and efficiently.”

Similarly, Kate Walsh, chief executive of Boston Medical Center, said the reimbursement rates in Warren’s proposal would be “wonderful” for her safety-net hospital, which treats a large share of low-income patients on Medicaid.

Tufts Medical Center’s chief executive, Dr. Michael Apkon, spent several years running a hospital in Canada’s national health system and has called the quality of care in Canada “every bit as good as what I’ve experienced here.”

Apkon said he supports a public option — a government-run plan that would compete with private insurance plans — to help make health care more affordable and accessible for Americans.

“If we desire a single-payer system, I think the path to that is a public option that would allow government to set a minimum set of benefits,” Apkon recently told reporters.

Dr. Maryanne C. Bombaugh, president of the 25,000-member Massachusetts Medical Society, said single-payer should be among the options considered for achieving universal health coverage.

“We’re very open to anything that would improve the health of our patients,” Bombaugh said.

Andrew Dreyfus, chief executive of Blue Cross Blue Shield of Massachusetts, said: “It’s a grave mistake for the health care industry to criticize Medicare for All proposals. Instead, we should offer our own views on how to improve the American health care system.”



By Don McCanne, M.D.

It is encouraging to see hospital executives acknowledging that a single payer system may be the way we need to go to improve the health care system. Someday…

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About the Commentator, Don McCanne

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Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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