Cyr a leader of single-payer push

Nov. 16--BOSTON -- Cape and Islands District state Sen. Julian Cyr, D-Truro, had a significant impact on the extensive health care reform and cost-containment bill approved by the Senate late last week.

Five amendments sponsored by the freshman lawmaker were included in the bill, most notably a proposal to measure the impact a single-payer -- or publicly financed -- system would have on the cost and delivery of health care in Massachusetts.

"This is huge," Cyr said Tuesday. "We are the first Legislature in the nation to move forward on this. If this (bill) gets enacted through the House, it will be a nation-leading effort."

Massachusetts spends $59 million per year on health care, the highest per capita in the country, but unless residents are income-eligible or old enough to receive benefits, they are neglected, according to Cyr.

"This is for the middle class," he said. "If businesses were freed up from how much they spend on health insurance costs, it would change the conversation about offering higher wages and other benefits for employees."

Cyr's "Health Care as a Right" amendment calls for the state's Health Policy Commission to develop a single-payer benchmark, or the projected cost of providing health care to all state residents, and compare it with actual state spending on health care for a three-year period.

If the single-payer plan is determined to be more cost-effective, the commission would be required to submit a "Single-Payer Healthcare Implementation Plan" to be enacted by the Legislature.

"My colleagues really want us to view health care as a right and move toward that," Cyr said.

A similar bill filed five years ago was defeated in the Senate, but this measure passed, 35-3, including a "yea" vote from state Sen. Bruce Tarr, R-Gloucester, the minority leader of the Massachusetts Senate.

"Even if you're skeptical of single-payer, you'd want the state to do this study," Cyr said.

State Sen. Viriato "Vinny" deMacedo, R-Plymouth, whose district includes Bourne, Falmouth and Sandwich, was one of three senators who voted against the Cyr amendment.

"I'm not opposed to a study, but I believe they will come up with the same conclusion as Vermont -- that it's too expensive to implement," deMacedo said.

Vermont scrapped its plans for a single-payer system in 2014 because of the tax increase needed to carry out the plan.

Massachusetts has a form of universal care now, with its mix of private-pay and public coverage that allows care for everyone, deMacedo contends.

"If you don't have the resources, we subsidize it," he said, noting that 97 percent of residents have insurance, and the other 3 percent don't access coverage.

DeMacedo also took exception to an implementation plan being "triggered" in any of the three study years if the benchmark outperformed the actual amount spent by the state. He said he favored competition in health care and thought a single-payer system would sacrifice the quality of care in the Bay State.

Another Cyr-sponsored amendment incorporated into the bill advocates for funding and reinstatement of the state's Prevention and Wellness Trust Fund.

The program, from which community health organizations in Barnstable County received $4.2 million from 2014 to 2017, was cut from the state's fiscal 2018 budget. Among activities funded by the trust were blood-pressure monitoring programs, diabetes education and home safety assessment visits to prevent the elderly from falling.

The entire health care reform bill now moves to the House of Representatives for consideration and debate, which Cyr expects will occur during the winter or spring.

-- Follow Geoff Spillane on Twitter: @GSpillaneCCT.

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