Forget the feds: Pennsylvania could institute a single-payer health care system on its own

Legislation should be introduced in both Pa. chambers soon.

Demonstrators gather outside of Sen. Pat Toomey's office earlier this year in support of keeping the Affordable Care Act.

Demonstrators gather outside of Sen. Pat Toomey's office earlier this year in support of keeping the Affordable Care Act.

Jasmine Goldband / The Incline
Sarah Anne Hughes

As Republicans regroup after another failed effort to repeal the Affordable Care Act, Sen. Bernie Sanders is leading the charge to implement a single-payer health care system at the federal level.

Sanders’ “Medicare for All” bill would provide universal coverage for Americans by expanding that government insurance program, a change paid for by higher taxes.

“Private insurance would largely become nonexistent,” the New Republic reported. “The bill would eliminate deductibles and copayments. It would also overturn the Hyde Amendment by including access to abortion insurance.”

The bill has the public backing of 16 Democratic senators, Pennsylvania’s Bob Casey not among them.

Conventional wisdom states that Sanders’ bill is DOA in the Republican-controlled Senate. But Pennsylvanians who want a single-payer system don’t have to look to the federal government to get it.

Pennsylvania could provide universal health care to its citizens by creating its own plan — a change some state legislators have been trying to enact for more than a decade.

A single-payer plan

In the near future, Philadelphia-area state Rep. Pam DeLissio plans to again introduce a bill that would establish the Pennsylvania Health Care Plan.

DeLissio’s predecessor introduced previous versions of the single-payer bill, the representative told The Incline, and advocates approached her about taking up the issue.

“I had been a proponent of a universal type of health care,” she said, adding that she had calls every other week or so about the proposal with a “very dedicated group of volunteers.”

That group is called HealthCare4AllPA, which has been advocating for a single-payer system and refining a plan for one since 2006, President Bob Mason said.

Here’s how the Pennsylvania Health Care Plan would work: It would replace private insurance and finance nearly every Pennsylvanian’s health care needs (including vision, dental and prescriptions) through a state-run system. There would be no deductibles or co-payments. The plan would not cover procedures deemed “medically unnecessary” like cosmetic surgery.

The plan would be paid for, in part, by a three percent tax on residents’ gross income and a 10 percent payroll tax on businesses. Per an impact and implementation study commissioned by HealthCare4AllPA, 80 percent of Pennsylvanians would pay less for health care under the plan.

The study, conducted by a University of Massachusetts at Amherst economics professor and released in 2013, also claims big benefits for businesses by both reducing the burden from premiums and fostering a healthier workforce.

Both DeLissio and Mason said one of the biggest misconceptions about single-payer is that it’s government run. While health care would be financed through the state, health care facilities wouldn’t be owned by the government, and doctors, nurses and other health care professionals would still be privately employed.

Critics of single-payer, like the Heritage Foundation, say it gives the government too much control over health care, increases wait times for care (a problem in Canada) and harms physicians’ livelihoods.

DeLissio said she refused to introduce the bill in 2011 when the ACA was being rolled out, worrying that people would be confused by the competing plans. She said single-payer advocates have used the past couple of years to hone their message and discuss strategy.

“The ACA was still an insurance-driven product,” she said. “An insurance-driven product will never successfully meet the needs of people.”

Could it actually happen?

Like Sanders’ bill, DeLissio’s has approximately no chance of passing in the ultra-conservative House.

The partisan nature of the debate around single-payer frustrates Mason, he said.

“We are a non-partisan organization, and we really see this as a non-partisan issue,” Mason continued, adding that the plan is progressive, because it provides “health care to virtually everyone,” and also “conservative in that it’s the best use of tax revenue.”

The group’s former president is Dave Steil, a small business owner who served as a Republican in the Pa. House for 16 years.

“Many will reject this option without ever looking at the facts. That is regrettable and intellectually dishonest,” Steil wrote in a 2013 op-ed. “This is not just a health care management plan, but a major job creation engine. If the business community rally’s [sic] behind this proposal it will happen, because we, collectively, carry a powerful voice.”

While he’s frustrated by the politics, Mason does think the U.S. is at “a tipping point” for single-payer: “It’s going to happen within the next three or four years.”

DeLissio said she thinks now is a good time to reintroduce her bill, as people are “paying unbelievable attention” to health care. Still, she doesn’t know how much support she can garner for the idea; last session, her bill had just five co-sponsors.

The representative noted that she had no idea if medical marijuana could pass in Pa. (it did) and has similar questions about single-payer health care. She added that she plans to “work hard to have conversations with my colleagues to help them understand how this is helpful for my constituents and businesses.”

That dialogue included a town hall in July that dozens of her constituents attended.

DeLissio will at least have company in the other chamber this session. Taking on the cause near and dear to former Pittsburgh state Sen. Jim Ferlo, Philly state Sen. Art Haywood plans to hold a press conference Thursday to introduce his own single-payer legislation. Additional details were not available as of the publishing of this article.

Then there are the groups doing groundwork to build support, like the Pittsburgh chapter of the Democratic Socialists of America, which has taken up the cause and launched a canvassing effort; they hold meetings on the effort open to the public.

Mason said HealthCare4AllPA will continue to educate the public on the benefits they say single-payer would bring: getting coverage for people currently without it, lowering costs for the majority of Pennsylvanians, expanding choice.

Even if the bill won’t pass, Mason said it’s important for there to be “something very concrete out there that we can point at and explain how it would work.”