2019 -- S 0296

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LC000657

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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S E N A T E   R E S O L U T I O N

CREATING A SPECIAL LEGISLATIVE COMMISSION TO STUDY AND ASSESS THE

IMPLEMENTATION OF MEDICARE-FOR-ALL SINGLE PAYER PROGRAM IN RHODE

ISLAND

     Introduced By: Senators Bell, Nesselbush, Quezada, Miller, and Seveney

     Date Introduced: February 13, 2019

     Referred To: Senate Health & Human Services

     WHEREAS, Rising health care costs are a major economic threat to Rhode Islanders:

Between 1991 and 2014, health care spending in Rhode Island per person rose by over 250% –

rising much faster than income and greatly reducing disposable income; and

     WHEREAS, It is estimated that by 2025, the cost of health insurance for an average

family of four will equal about 1/2 of their annual income; and

     WHEREAS, In the U.S., about two-thirds of personal bankruptcies have been medical

cost-related and of these, about three-fourths of those bankrupted had health insurance; and

     WHEREAS, Rhode Island private businesses bear most of the costs of employee health

insurance coverage and spend significant time and money choosing from a confusing array of

increasingly expensive plans which do not provide comprehensive coverage; and

     WHEREAS, Rhode Island employees and retirees are losing significant wages and

pensions as they are forced to pay higher amounts of health insurance and health care costs; and

     WHEREAS, The state and its municipalities face enormous Other Post-Employment

Benefits (OPEB) unfunded liabilities mostly due to health insurance costs; and

     WHEREAS, Although Rhode Island significantly expanded health care coverage for its

citizens under the federal Affordable Care Act (ACA), it is not enough. Currently, about 47,000

Rhode Islanders remain uninsured, and even fully implemented, the ACA would leave 42,000

Rhode Islanders (4 percent) uninsured and many more underinsured - resulting in many excess

deaths; and

     WHEREAS, Efforts at the federal level to repeal or defund the ACA, severely threaten

the health and welfare of Rhode Island citizens; and

     WHEREAS, The U.S. has hundreds of health insurance providers (i.e., multiple

“payers”) who make our health care system unjustifiably expensive and ineffective; and

     WHEREAS, Every industrialized nation in the world, except the United States, offers

universal health care to its citizens under a "single payer" program and enjoys better health

outcomes for about one-half the cost; and

     WHEREAS, About one-third of every health care dollar spent in the U.S. goes towards

administrative costs (e.g., paperwork, overhead, CEO salaries, and profits) rather than on actual

health care; and

     WHEREAS, Health care is rationed under our current multi-payer system, despite the

fact that Rhode Islanders already pay enough money to have comprehensive and universal health

insurance under a single-payer system; and

     WHEREAS, The solution is for Rhode Island to institute an improved Medicare-for-all

type single payer program; and

     WHEREAS, Single payer health care would establish a true “free market” system where

doctors compete for patients rather than health insurance companies dictating which patients are

able to see which doctors and setting reimbursement rates; and

     WHEREAS, The high costs of medical care could be lowered significantly if the state

could negotiate on behalf of all its residents for bulk purchasing, as well as gain access to usage

and price information currently kept confidential by private health insurers as “proprietary

information”; and

     WHEREAS, In 1962, Canada’s successful single payer program began in the province of

Saskatchewan (with approximately the same population as Rhode Island) and became a national

program within ten years; and

     WHEREAS, Single payer would provide comprehensive coverage that would include

vision, hearing and dental care, mental health and substance abuse services, as well as

prescription medications, medical equipment, supplies, diagnostics and treatments; and

     WHEREAS, Health care providers would spend significantly less time with

administrative work caused by multiple health insurance company requirements and barriers to

care delivery and would spend significantly less for overhead costs because of streamlined

billing; and

     WHEREAS, Rhode Island must act because there are currently no effective state or

federal laws that can adequately control rising premiums, co-pays, deductibles and medical costs,

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or prevent private insurance companies from continuing to limit available providers and

coverage; and

     WHEREAS, "Public option," "Medicare buy-in," and "state Medicaid buy-in" proposals

all keep intact our administratively inefficient, expensive, fragmented, dysfunctional health care

financing system while merely adding administratively complex options; and

     WHEREAS, In 2018, Rhode Island House Bill 7285, based on an analysis by Professor

Gerald Friedman of the University of Massachusetts, Amherst, proposed a single payer program

for the state, including a funding mechanism, and this bill has been "held for further study"; and

     WHEREAS, In 2019, similar legislation will be introduced again in the General

Assembly and will likely again be "held for further study"; now, therefore be it

     RESOLVED, That a special legislative commission be and the same is hereby created

consisting of eleven (11) members, all of whom shall be appointed by a majority vote of the

Senate Health and Human Services Committee and shall all be familiar with health insurance

finance issues as follows: two (2) of whom shall be members of the Rhode Island Senate; three

(3) of whom shall be health care providers, including two (2) primary care physicians; two (2) of

whom shall represent employers who provide health insurance to employees; two (2) of whom

shall be union representatives; and two (2) of whom shall be university professors of economics.

      The appointing authority may appoint a member of the general public to serve in lieu of

a legislator.

     The purpose of said commission shall be to make a comprehensive study to determine the

pros and cons of implementing a single payer program in Rhode Island.

     Vacancies in said commission shall be filled in like manner as the original appointment.

     The membership of said commission shall receive no compensation for their services.

     All departments and agencies of the state shall furnish such advice and information,

documentary and otherwise, to said commission and its agents as is deemed necessary or

desirable by the commission to facilitate the purposes of this resolution.

     The Joint Committee on Legislative Services is hereby authorized and directed to provide

suitable quarters for said commission; and be it further

     RESOLVED, That the commission shall report its findings and recommendations to the

Senate no later than one year from the date of passage, and said commission shall expire two

years from the date of passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

S E N A T E   R E S O L U T I O N

CREATING A SPECIAL LEGISLATIVE COMMISSION TO STUDY AND ASSESS THE

IMPLEMENTATION OF MEDICARE-FOR-ALL SINGLE PAYER PROGRAM IN RHODE

ISLAND

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     This resolution would create an eleven (11) member special legislative commission

whose purpose it would be to study and assess the implementation of Medicare-for-all single

payer program in Rhode Island, and who would report back to the Senate one year from the date

of passage, and whose life would expire two years from the date of passage.

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