Volume 16, No.4, Fall 2008
(The phrase “single-payer healthcare” normally is associated with national coverage plans such as exist in virtually every other industrialized country in the world. In the United States we do have the Medicare model to cover our elderly population, plus state-oriented Medicaid (MassHealth in Massachusetts) to protect the neediest. There also are some statewide programs. Massachusetts recently instituted its own version of Health Care For All, but it does contain coverage gaps and has been facing financial strains as well.
(Here on the Cape, an organization called the Cape Care Coalition is striving to create a regional Health Care For All program that would make coverage available for all Barnstable County residents on a voluntary basis. It would be an alternative to the state program and cover “working poor” who fall in the gap between Medicare and MassHealth. The following article provides an update on their progress.)
By James R. Garb, M.D.
The winds of change are blowing from Bourne to Provincetown in the form of the Cape Care Coalition–a grassroots movement to bring better healthcare coverage to Cape Cod.
The Mission Statement of the Coalition is “to create a regional, community-owned healthcare system to provide all Barnstable County residents comprehensive and affordable healthcare, delivered through the current and expanded network of providers.” This plan would be called Cape Care.
Since late 2003, a group of concerned citizens and professionals from the medical and human service fields has been working together to make this goal a reality. Support for Cape Care is growing. In 2006, the Barnstable Town Council and 10 Town Meetings across Cape Cod voted to support the development of this plan. Last year, the Barnstable County Assembly of Delegates came aboard. Non-government support has come from such groups as the Cape Cod Foundation, the Bank of America Charitable Foundation, Inc., and the Unitarian Universalist Fund for a Just Society, as well as from many individuals.
Cape Care’s Model Plan is still being finalized, but the current draft can be viewed at the Coalition’s website, www.capecare.info. Essentially, it recognizes healthcare as a basic human right that should be accessible to all, regardless of income, employment or health status. It parallels other available services such as police, fire and rescue, and schools. Membership in Cape Care would be voluntary.
Cape Care would be not-for-profit and locally controlled, and would drastically cut the high administrative overhead—up to 30 percent—charged by most other health plans. This, coupled with other savings, would allow Cape Care to cover the entire population of Barnstable County for the same amount that currently is being spent on healthcare. At the same time it would provide an expanded menu of covered services.
The “single payer” part of the model is what distinguishes Cape Care from what we have today.
Rather than the preposterous complexity and inefficiency of hundreds of competing health plans, a single payer model would eliminate unnecessary red tape and paperwork for all involved—patients, doctors, hospitals—to streamline care and eliminate unnecessary costs. If successful, Cape Care would benefit working families on the Cape, and actually help business by attracting a larger labor pool. It would benefit the Cape’s doctors and bring more primary care providers to Cape Cod by lowering overhead costs and providing better reimbursement.
The feasibility of this model has been demonstrated in functioning healthcare systems around the world and in studies in many states. It would provide more care for all, at a lower cost than what we now spend and with much greater control over the content and quality of that care. Some health economics experts now believe that a regional model, such as Cape Care, might be a better first step in this country, rather than trying to implement the single payer model on a wider scale. If successful, Cape Care could serve as a demonstration model for the whole country.
At this point, the Cape Care Coalition is trying to increase awareness and understanding of this plan among Cape residents. We are also preparing to file enabling legislation in the next session of the Massachusetts legislature in January. But the road ahead is long, and the entrenched powers in the insurance and pharmaceutical industries will muster their forces against it. The Coalition, in contrast, must counter with the help of private contributions to spread its message.
Nothing will help move our legislators more than strong grassroots support. Interested citizens can start by checking out our website, www.capecare.info.The next open quarterly meeting of the Cape Care Coalition is December 13, 9:30 a.m.-noon at the Harwich Community Center.
(Dr. Garb is a member of the Cape Care Coalition Steering Committee.)