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Democrat Matt Brown vows to provide 'Medicare for All' if elected governor

Providence Journal - 7/27/2018

July 27--PROVIDENCE, R.I. -- Should he win his bid to become Rhode Island's next governor, Democratic primary contender Matt Brown promises to renew the fight for universal health-care under the banner: "Medicare-for-All."

His pledge: "On our first day in office, we will create an expert commission of health care and economic advisers ... to create a plan to move Rhode Island to a universal health care system that covers everyone while lowering average costs for people and businesses in the state."

He also pledges to restore cuts championed by his primary opponent -- Gov. Gina Raimondo -- in the growth of Rhode Island's$2 billion-plus Medicaid program, but has not yet specified where he would get the money to pay for the resulting state spending increase.

Brown -- the former Rhode Island secretary of state (2003-07) who is challenging Raimondo in the September primary -- has not identified a clear funding stream, or embraced the new 10 percent payroll tax proposed by the state lawmaker leading the charge during the last legislative session: Rep. Aaron Regunberg, who is now running for lieutenant governor. (The bill did not pass.)

Brown relied on his belief that savings from unnecessarily high administrative costs, sky high executive salaries -- and lack of bargaining power -- will help pay the tab.

Beyond that, he said: "The commission we will put together will explore ways to fund it."

Who would run it? "The state Medicare for All system will pay for health care and negotiate rates, just as Medicare does now on the federal level. That's one of the main ways Rhode Islanders will save -- by using the bargaining power of 1 million Rhode Island residents to fight monopoly prices in the health care system."

The problem, as Brown sees it: "Everyday in our state, hardworking Rhode Islanders struggle to afford the care they need. Even those with insurance avoid doctor's visits, because it costs too much to go. If people lose a job, they lose their health care. Small businesses pay so much to insure their employees, it stops them from hiring, even when they need the extra help. For 40,000 Rhode Islanders, there is no affordable insurance plan, so they have none; they use emergency rooms and urgent care clinics, and the bills pile up."

"Health care costs for Rhode Islanders have nearly tripled since 1991. Seniors spend 75% more on average for prescription drugs now than they did in 2006; meanwhile, the average annual cost of just one prescription drug is nearly $13,000 -- most of a typical Social Security check."

"That's not who we are and not who we want to be," said Brown, who has been openly wooing the "Bernie Sanders" wing of the state Democratic Party that gave the Vermont Senator a Rhode Island win over presumed front-runner Hillary Clinton in the 2016 presidential primary.

His pledges: restore unspecified Medicaid "cuts" in the state budget and somehow do at the state-level what Congress has not chosen to do, and that is to reduce "prescription drug costs and expensive middleman fees while providing high-quality health care to everyone in our state." (Prescription drug costs were also a key issue for Brown during his short-lived campaign for the U.S. Senate in 2006.)

His working theory: "Monopolist drug makers and medical device companies can essentially charge whatever they want, in part because few insurers have the bargaining power to negotiate truly lower prices -- and those that do pocket the profits instead of passing savings on to small businesses and patients."

"A Medicare for All system would save money by eliminating administrative costs, middleman fees and other expenses in the current system, and by using the bargaining power of a combined insurance pool of the one million people in Rhode Island to push down monopolist drug and medical device costs ... With only one buyer for health care, doctors and hospitals would save an estimated $1 billion in billing costs alone."

On the Medicaid front, he said: "The Governor has proposed more than $191 million in cuts over the past three years, and enacted cuts have led to lower reimbursement rates to hospitals and other health providers; several have closed in part because of the cuts."

It is not yet clear which cuts in the growth of Medicaid he seeks to reverse -- and how he proposes to pay for the resulting increases in spending, but he noted: "Rising medical costs -- particularly the cost of prescription drugs ... [make] Medicaid an increasingly expensive option for Rhode Island to cover a third of the state's population."

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(c)2018 The Providence Journal (Providence, R.I.)

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