In his thoughtful op-ed essay “The Choice Facing Peake’s Successor” (Feb. 1, page A3), Stephen Kinzer reflected on the workings of the Massachusetts General Court and on Rep. Sarah Peake’s announced retirement. He posed the important question as to whether an elected official in that profoundly undemocratic body is most effective trying to reform its processes to make it more transparent and responsive to the needs of her or his constituents or working to “bring home the bacon” to their district. Both roles are important, but they appear to be incompatible. Troublemakers are not appreciated by leadership.
My own experience with the State House has mostly been through my efforts to bring a single-payer system of financing for health care, now known as Medicare for All, to the Commonwealth. Although surveys and referenda have uniformly reflected high levels of public support for such a reform, the enabling legislation has died in committee session after session for many years now.
These outcomes represent a surreptitious suffocation of the clearly expressed will of the people. After the public hearings of the Joint Committee on Health Care Finance, composed of state senators and representatives, there was no publicly recorded vote, nor was there a report issued. Months later, we learned that the legislation was “referred for study” — a euphemism for its quiet demise. But we know nothing of the why or the who that determined the outcome.
I testified in November at this current session’s hearing. Seventy-two other people from a great variety of backgrounds told their own very personal stories. Some were patients, or relatives of patients, who had been unable to access needed care or medications. Some were social workers and pharmacists, many were nurses, and quite a few were physicians. All but one were strongly supportive of the Medicare for All bills. The exception was an insurance broker.
We still don’t know what the joint committee’s decision will be; that news is expected to come in March. But history suggests it will once again be to shelve the proposals.
On Beacon Hill, the chairs of committees hold the reins very tightly, allowing nothing to pass that doesn’t have their approval. And they, in turn, serve at the whims of the Senate president and House speaker, who, in turn, do nothing to advance legislation that the governor doesn’t support.
All of this reflects the top-down control of our political process, which is worthy of a monarchy. During the years when this very blue state had a Republican governor, the word we received, in our many discussions with legislators, was that because the governor was opposed to single-payer health care there was no point in pushing that battle. But now, with a Democrat in the corner office — albeit one who has refused to commit to this popular effort to bring affordable health care to all — it seems that the issue is less partisan politics than the controlling role of the big-money players whose interests would be challenged by a Medicare for All system.
I am speaking of the insurance, pharmaceutical, and medical device industries and the big hospitals.
Health insurance reform would ensure access for all without financial barriers, more available primary and mental health care, much more affordable medications, and the safeguarding of our endangered small and rural hospitals. All this would come with tremendous savings because of the built-in reduction in bureaucratic paperwork and in profiteering in our health-care complex.
As our local legislative district faces the question of choosing a successor to Rep. Peake, the questions raised by Kinzer should be paramount. They reflect a fundamental divide in the way we view ourselves and our society. Does each individual strive to maximize her own welfare, or do we all do better when we work for the common good? Do our elected representatives work to maximize the money flowing to their districts, or do they do what would be right for all the residents of the Commonwealth?
These are questions that anyone wishing to succeed Rep. Peake in the next session should have to confront as they campaign for our support. It should be in the context of challenging the lack of transparency on Beacon Hill, for without reform of that current reality, our prospects for achieving universal health care appear to be slight.
Brian O’Malley, M.D., is Provincetown’s elected delegate to the Barnstable County Assembly.
