Single-Payer Healthcare 101

Rose Roach, executive director of MNA. Photo from MNNurses.org

            Several weeks ago, I was fortunate enough to be able to attend a public discussion on the concept of single-payer healthcare. The St. Paul meeting had around 100 citizens, some well-versed in public health policy, but many more that were like myself: eager to learn more.

            I’m still in awe that government-subsidized healthcare is a form of public health policy many industrialized nations have long ago adopted-but not the United States. The United States spends roughly $3 trillion per year based on our private health insurance-driven system, according to a 2015 Center for Medicare and Medicaid study.

            After the discussion, Rose Roach of the Minnesota Nurses Association agreed to an online interview. Roach, a St. Paul native, serves as the group’s executive director and was in attendance that day to help answer questions from the audience. Interview edited slightly for length:       

The Minnesota Nurses Association has seen the negative effects of our current system:

“The Minnesota Nurses Association believes that every Minnesotan must have the healthcare they need when they need it without regard to their ability to pay. Nurses see what happens when patients don’t receive the healthcare they need when they need it and end up hospitalized. If we agree that healthcare is a human right because healthcare is a human necessity and that all Minnesotans must have access to care when they need it, then a publicly-financed system is the most economically efficient way to achieve that goal.”

What is happening right now? How would single-payer healthcare work?

            “People’s premiums are skyrocketing, but single-payer would stabilize healthcare spending and finance it through affordable premiums based on income. No more $10,000 deductibles because we wouldn’t have deductibles at all. No more expensive copays on prescription drugs because patients would not have to pay any money at the time of care. They pay premiums based on their income with no out-of-pocket expenses so that no one is unable to afford the healthcare they need when they need it. Businesses would continue to pay premiums for their employees, as well, with most businesses actually saving money under single-payer.

            “We cannot reduce the total cost of care until we take control of the payment system. With the purchasing power of a publicly-financed system, we can pay public and private providers fair rates, negotiate prices for prescription drugs, and set global budgets for hospital improvement and maintenance. We can invest in preventive care by paying providers a monthly rate for each patient to coordinate care from the beginning. And by removing profit-driven insurance companies from the picture entirely, we can save on excess administrative expenses from both the insurance companies and from providers who have to hire administrative staff just to fight for reimbursements. Single-payer is the only reasonable way we can reduce costs in our healthcare system.”

On how single-payer healthcare and Minnesota mix:

                       

“Minnesota is ready to lead on Single Payer healthcare, as we have always led on healthcare. MNA fully supports Senator John Marty’s bill entitled the MN Health Plan which would enact a single payer, publicly financed, and privately delivered system here in MN.  We already have a nation-leading program called MinnesotaCare for people earning below 200 percent of the Federal Poverty Level, and we could use that as the infrastructure to finance healthcare for everyone.

Does our current private health insurance system harbor insurance company middlemen?

“By doing so, we could remove health insurance companies from the system entirely by expanding the direct-contracting programs the State of Minnesota has with providers. We have the program in place, let’s get the superfluous HMO’s out of the program, improve and expand it so it can serve all of us.

            “Nurses know that patients are coming into the hospital sicker and sicker.  They listen to patients who say they're cutting pills in half to save money or declining tests or treatment because of the cost.  

“Nurses care about healthcare finance reform because we see what happens when patients don’t receive the care they need and end up in our hospitals. People delay care because they don’t have insurance or can’t afford the deductibles. Then they end up in the hospital when the situation is much more serious.  It’s being pennywise but pound foolish.  It’s not ethical, and it’s certainly not cost effective.

“Sicker patients aren't just a problem for nurses; it's a problem for hospitals— and all of healthcare for that matter.  It costs the system more to treat these patients who can't afford or won't get care.  We all pay for that.  Single-payer manages those costs by allowing patients to get preventative care, afford medications, and see the doctor they need, not just the one who's in their network.”

Minnesota state senator John Marty was mentioned earlier as a lawmaker attempting to take action on single-payer healthcare in our state. Any others?

            “MNA has proudly endorsed Rep. Erin Murphy, RN, for Governor. As a nurse, Erin knows what patients need. She knows that healthcare decisions should be made by patients and their healthcare providers, not insurance companies. Erin believes in a single-payer system that serves all Minnesotans. Minnesotans trust nurses, and nurses trust Erin. That’s why we support Erin Murphy for Governor.

            “[Regarding others] MNA does occasionally endorse on the local level. One of our endorsed candidates for Hennepin County Commissioner, Marion Greene, is a strong supporter of single-payer healthcare. As Chair of the Health Committee on the county board, she helps manage Hennepin Health, which is an innovative healthcare program for Hennepin County residents on Medical Assistance and MinnesotaCare. They bring together many county services to provide the best care based on a patient’s needs. It could be an excellent model for single- payer healthcare in Minnesota.

 Other comments for our readers? 

“We encourage you to attend our events that we hold with partner organizations like Health Care for All Minnesotans (www.healthcareforallmn.org); the Main Street Alliance (www.mainstreetalliance.org/minnesota), which organizes small business leaders around Single Payer healthcare; the Land Stewardship Project (www.landstewardshipproject.org), which organizes agricultural workers and folks in rural Minnesota; Isaiah, a faith based organization working on issues of racial, social and economic justice (www.isaiahmn.org)and Take Action Minnesota (www.takeactionminnesota.org).

“Single-payer is the only reasonable way we can reduce costs in our healthcare system, and we cannot afford to wait any longer. Waiting will literally cost us billions of dollars more than we should be spending on healthcare, and more importantly it will cost lives. People die because our current system fails them. It’s inhumane and immoral, and we must demand change. Working to achieve a guaranteed healthcare system in Minnesota is just one more way nurses are fighting for their patients.  Please join us!”