On April 10, MassCare hosted a community forum at the American Legion Post 440 to discuss universal healthcare in Massachusetts. MassCare is campaigning for Medicare for All in Massachusetts and organized the event to further educate the public on the benefits of single-payer healthcare.
Several panelists from within the healthcare field gave individual remarks in support of single-payer healthcare, arguing that the system in which the government acts as the insurer reduces overall costs and improves the quality of healthcare.
Panelist Donald Berwick, former chief of the Centers for Medicare and Medicaid Services in President Obama’s administration, said he is concerned about the current state of the American healthcare system. “We are by no means the healthiest population in the world, not even close. […] We are at the bottom of developed nations,” said Berwick.
Berwick said this deficiency is significant because higher spending on healthcare in the U.S. does not yield proportionately better healthcare outcomes. “We’re [not] buying better quality or better outcomes. […] We stand alone among developed nations in being able to say that premiums and out-of-pocket costs have soared,” he said.
According to the American Journal of Public Health, “By 2019, the eve of the COVID-19 pandemic, U.S. life expectancy ranked 40th among populous countries.” Additionally, according to the Centers for Medicare & Medicaid Services, in 2023 the United States’ health care spending reached $4.9 trillion or $14,570 per person. This accounted for 17.6 percent of the nation’s gross domestic product.
Panelist Gordon Schiff, quality and safety director for the Harvard Medical School Center for Primary Care, spoke about his experience as a primary care physician and highlighted issues he encounters such as patient discontinuity and high-deductible health plans, “Patients have little idea what they’re charged,” he said.
Schiff noted that the current Massachusetts healthcare system prevents him from serving patients who do not have coverage or are out of his coverage network. “[This raises the] problem with continuity, which for me as a primary care physician, is the most important thing. […] The patients just disappear,” he said.
Schiff advocated for comprehensive coverage for all and stressed the importance of building a movement to achieve meaningful healthcare reform, “Complexity is the enemy of access and sustainability. Single-payer says everybody should be a part of the system,” said Schiff.
The final panelist, Bruce Fleischer, a MassCare organizer, shared from his personal experience working in healthcare unions and how corporate healthcare has failed his local community. As an example, he described the closure of Quincy Medical Center in 2014. “[Steward Health Care, the former hospital’s parent company] decided the hospital wasn’t profitable enough and just shut it down. Quincy is now the largest city in Massachusetts without a hospital – another example of profits over community needs.”
The panel was followed by a question-and-answer segment with the meeting’s attendees. One of the questions was asked by Diane Tiernan, who works in pharmaceuticals and told Fig City News she recently signed up for Medicare Advantage — Medicare coverage that involves private insurers. Tiernan asked the panel about the regulatory process to get pharmaceuticals and medical devices on the market. Schiff responded, “A lot of what we’re hearing about unnecessary regulation and delays are really people doing due diligence saying the drug has to actually be shown to work.”
Greg Schwartz, a primary-care physician and the 12th Middlesex Massachusetts State Representative, who attended the discussion, explained his view of the challenges of implementing single-payer or Medicare for All, including limitations of state regulation due to federal laws such as the Employee Retirement Income Security Act (ERISA) and the role of private commercial insurance. “It’s a very complex system, and as simple as it seems – Oh, you just get the insurance companies out of there – there’s no real perfect solution, because there’s still going to be a need for managing demand,” he said.
He outlined what he described as realistic changes to improve healthcare outcomes and reduce costs, focusing on preventive care, “I think we can make some incremental and significant changes in how our system reimburses primary care,” said Schwartz.
In January 2025, Governor Maura Healey established the Primary Care Access, Delivery, and Payment Task Force co-chaired by the Executive Office of Health and Human Services and the Massachusetts Health Policy Commission, to address the crisis in primary care crisis in Massachusetts and increase primary care reimbursements.
“There’s already been some work done in the last [state legislative] session to create a primary-care task force,” said Schwartz. “I think we can build on that and really try to make some both realistic and pretty impactful change.”
