State representative says it can be paid for by a 10 percent payroll tax
PROVIDENCE, R.I. — With U.S. Sen. Bernie Sanders of Vermont drawing national headlines for his renewed talk this week of “Medicare for all,” Rhode Island advocates gathered at the State House on Wednesday to draw attention to their own renewed effort to provide universal health-care, financed — at least initially — by a new 10-percent payroll tax.
The advocates pose this question: Is health care a fundamental human right, or a privilege for those who can afford it?
The answer from state Rep. Aaron Regunberg, one of the left-leaning Democrats leading the Rhode Island drive: “Health care should be a fundamental human right for all Rhode Islanders.”
Wednesday’s press conference centered on the latest, reworked Rhode Island versions of the “Medicare for all” legislation that Sanders — the liberal favorite in the 2016 presidential contest — is still promoting from his national platform. Sanders’ online “town hall” drew more than 1 million live viewers Tuesday night, according to the Washington Post.
“Sanders’s audience alternated between rapt attention and grateful applause as experts explained how higher tax rates could replace America’s health-care system with universal Medicare,” the news story said.
The big question: how to finance a new publicly run health-care system in Rhode Island?
Regunberg’s answer: “The program would be funded with a 10-percent payroll tax.” (Sen. Jeanine Calkin, D-Warwick, is introducing a Senate version.)
“It’s really important to remember … that this would replace the full cost for individuals and businesses of health insurance, premiums, co-pays — everything we currently pay for health care.” Regunberg said. “Our economic analysis finds that this results in a net savings of $4,000 per resident per year after full implementation. So it’s a big program, but it completely replaces a much bigger cost to our families, businesses and economy, while providing more comprehensive and universal coverage.”
The backers ask and answer “frequently asked question(s)” on their website: rihealthcare.org/faq. Among them: What is “Single Payer?”
The answer: “It is a system in which a single public agency handles health financing (instead of multiple health insurance companies) and delivery of care remains largely private. … All Americans would be covered for all medically necessary services, including doctor visits, hospital stays … long-term care, mental health care, reproductive health care, dental and vision care, prescription drug and medical supply costs.”
Next question: “How would we pay for the program?”
Regunberg suggested one payment approach: a payroll tax and with it, a tax on unearned income. Here is another approach, according to the online description posted by the group leading the fight: those at “higher brackets of income” would pay “specified taxes … at a higher marginal rate than lower brackets,” Small businesses and low wage earners would get tax credits or exemptions to offset the cost.
Leading the push in Rhode Island is the state chapter of Physicians for a National Health Program, chaired by internist J. Mark Ryan, and a new affiliate: the Rhode Island Healthcare Access and Affordability Partnership.
At Wednesday’s press conference, Ryan stated the problem he sees daily: “Patients who cannot afford the medicines I prescribe and the test I order for them. I am constantly seeing the care my patients receive delayed and limited by the financial interests of the insurance and pharmaceutical industries … I waste countless hours dealing with [their] endless bureaucracy.”
Regunberg said, “The reality is that Rhode Islanders already pay enough money to have comprehensive and universal health insurance. Yet despite our spending, we still have tens of thousands who are uninsured. We still have folks putting off medical care because of huge deductibles; families experiencing financial disaster because they get a serious illness, small businesses struggling with health-care obligations.”
Last year’s House hearing was dominated by proponents including representatives of the Southern R.I. Progressive Alliance, Indivisible, SEIU Local 1199, and Physicians for a National Health Program. Opposing arguments came from the R.I. Public Expenditure Council, the R.I. Business Coalition and New England convenience stores.
The arguments for the legislation were intertwined with the push by many of the same groups for a guaranteed right to an abortion, regardless of what a reconstituted U.S. Supreme Court might do to the landmark Roe v. Wade decision in the Trump era.
Katherine Gregg is a reporter for The Providence (R.I.) Journal.