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N.H. rep proposes statewide single-payer health care



Monitor staff
Tuesday, October 24, 2017

A proposal to create a single-payer health care system in New Hampshire drew mixed reactions in the House on Monday, with some denouncing it as a wayward fantasy and others heralding an opportunity for a conversation on broader reform.

The legislative service request, sponsored by Rep. Peter Schmidt, D-Dover, is titled “establishing a New Hampshire single payor (sic) health care system.”

A single-payer system is a taxpayer-funded health care model through which a government provides health care to its citizens in lieu of private plans. In recent years, the idea of implementing it nationwide has gained sway among the progressive wing of the Democratic Party. New Hampshire Sen. Jeanne Shaheen, a Democrat, endorsed it in September, breaking from Sen. Maggie Hassan, her Democratic junior colleague.

But Schmidt said New Hampshire is ready to take action on its own.

“The health care situation is very much in flux, nationally and here in New Hampshire,” he said Monday. “And the bottom line is it’s just utterly irresponsible for the New Hampshire Legislature not to engage in this situation.”

It is unclear exactly how the proposed Granite State single-payer system would work; Schmidt was unable to immediately provide a copy of his draft legislation to the Monitor. But the mere mention of the idea drew a polarized political response.

In an unprompted statement, House Majority Leader Dick Hinch, R-Merrimack, blasted the LSR, pointing to another state’s attempt to do the same: Vermont.

In 2011, the Green Mountain State’s Legislature passed a bill authorizing the creation of a single-payer health care system, giving then-Gov. Peter Shumlin a mandate to devise a plan by 2013. But by 2014, Shumlin, a longtime champion of the effort, backed away over cost concerns.

Following through on the effort would have required a 9.5 percent increase in state income taxes and an 11.5 percent hike to the payroll tax; one analysis estimated a $4.3 billion annual price tag within an annual budget of $4.6 billion. The plan was never put into action.

Hinch said the example should be a sobering one for New Hampshire.

“New Hampshire Democrats just need to look next door to Vermont to realize that single-payer health care is not feasible,” he said. “The fact that we’re seeing legislation to even study the issue baffles me. Vermont studied it, and rejected it because it would have bankrupted their state.”

But Schmidt dismissed the critique.

“That’s like saying that your cousin broke his leg skiing because he doesn’t know what he’s doing so you shouldn’t try skiing, even though you’ve been on the college ski team and you’ve been skiing all your life,” he said. “You can’t go down that hill because he can’t.”

He argued that New Hampshire, with more than twice Vermont’s 624,000 population, is better situated to take on single-payer. And he pointed to a second LSR of his, which would create a commission to study a New England-wide single health care system to pool costs, an approach he called more viable.

Schmidt, 89, was previously involved in the creation of the N.H. Healthy Kids program in 1994, a health care service that eventually transitioned into the state’s Children’s Health Insurance Plan (CHIP) in 1997. A beneficiary of Medicare himself, Schmidt said the present model for both low-income children and seniors can be scaled up for all residents of the state.

“So maybe some of my fellow Democrats will say ‘Oh well, that’s too radical; we can’t do this, we can’t do that,’ ” he said. “And I say: Why not? Because it works just fine for people over 65, and it works just fine in the rest of the world.”

Others on the House Health, Human Services and Elderly Affairs Committee were more reserved. Many, including Chairman Frank Kotowski, R-Hooksett, declined to directly comment on Schmidt’s proposal without seeing the drafted bill first.

Committee member William Marsh, R-Wolfeboro said the same. But speaking on the idea generally, Marsh argued the idea would never work.

To start, he said, the volume of health care services the state of New Hampshire currently outsources to Boston is too vast for the state to pay for or substitute itself. And while Marsh conceded that teaming up with other New England states might be more workable overall, he said the costs would still be prohibitive for the Live Free or Die State.

Meanwhile, Walpole Democrat Lucy Weber, who sits on the committee, said that, while she can’t comment directly on the LSR, she supports the idea of single-payer as a way eliminate wasted money and inefficiencies in the present system.

However, Weber said she doesn’t see it as a feasible approach in the New Hampshire Legislature.

“I tend to look at what’s in the art of the possible,” she said. “With the current makeup of the House and the Senate, I think it’s highly unlikely that we are going anywhere near a single-payer (system).”

But to Schmidt, who said he’d make his draft available later this week, the long political odds are worth it for the discussion the bill would spark.

In that respect, he has one major supporter. House Democratic Leader Steve Shurtleff, D-Penacook, said he also can’t comment on a draft bill he hasn’t seen. But he added that whatever its prospects – or ultimate suitability – the attention the bill would draw to policy reform would justify its submission.

“It’s good to put it on the table because people are talking about it,” he said Monday. “When they’re talking about single-payer, they’re talking about health care.”

(Ethan DeWitt can be reached at edewitt@cmonitor.com, or on Twitter at
@edewittNH.)