Taking Action on Single-Payer Health Care

By: Khin Oo, MAFP Advocacy Coordinator

“Lack of quality, comprehensive health insurance is a major barrier to health care for patients, especially in our underserved communities. As primary care physicians, we see the toll this takes on our patients on a daily basis, and it takes a toll on us, as well. Working within this broken health care system adds to moral injury and burnout. As a specialty that strongly values health equity and justice, we must recognize that we will not be able to provide equitable care until there is equitable access to health care for all.”

-From the resolution, “Taking Action on Universal Single-Payer Health Care,” adopted at the 2021 House of Delegates

In recent years, Minnesota Academy of Family Physician (MAFP) members have put through several (adopted) resolutions/policies addressing single-payer health care and the need to ensure all Minnesotans have equitable access to health care.

MAFP member Mark Brakke, MD, chairs Health Care for All Minnesota, a nonprofit organization dedicated to promoting affordable, high quality health care for every Minnesotan through advocacy, education and community organizing. Brakke is a retired family physician with experience in health systems management. He also serves on our Legislative Committee.

We asked Brakke to share about single payer health care and his work with Health Care for All Minnesota.   

Tell us about Health Care for All Minnesota. 

Brakke: Health Care for All Minnesota is about education and communication [to support the movement for single-payer health care in Minnesota]. How do you get people who haven’t been paying attention to something to pay attention to it? How do we really reach out and impact a community? We can put out all kinds of fact-based information and all kinds of analysis. If it isn’t getting to the voter, to the people who are uninformed, the work isn’t of any value. That’s the big challenge. 

Just because people have not heard of single-payer before or have not had a crisis in their own family, we would like them to be educated so they don’t have to face any crises as a result of health care finance problems. A lot of people don’t realize that the biggest cause of personal bankruptcy in the U.S. is medical bills. The biggest pitch for funds on GoFundMe is to cover medical expenses. We’ve let much of our health care system evolve so businesses and corporations have been allowed to figure out how they can extract the maximum amount of money from people who are sick. 

What’s the most effective tool for educating people about single-payer health care? 

Brakke: It requires a multimedia approach and having educational material available to people on a consistent basis. One needs to communicate through print media, like newspapers and magazines, and have a presence on social media. Television should be engaged in an active way. We should also be encouraging our politicians to use their influence to educate the public on these topics. 

What activities of Health Care for All Minnesota are you most excited about? 

Brakke: We participated in public events this last year in order to reach new people, including booths at the Minnesota State Fair, Pride Festival and Farmfest. Rural Minnesota is even more in need of health care finance reform than metropolitan areas. I’m in the process of writing monthly columns for an agricultural newspaper, called The Land, to discuss different aspects of US health care and how we can improve it.

Our goal is to get the organizations in Minnesota that are interested in this issue to work together in a coordinated way so when there is legislation at the Capitol which needs to be voted on, we can all chime in and nudge legislators to make good decisions. If there is not good legislation, we need to find legislators to craft it. We’ve got about 20 organizations now involved with what we call Health Justice Allies. Our goal is to keep building that group and get them to educate their members. If legislators aren’t hearing from the people who vote for them, they don’t pay very much attention to issues. 

If one wants to influence the political process, the best way to do that is to get to know your elected officials. Establishing a personal connection is very valuable. I currently have a relationship with both my Minnesota senator and representative, where I can send them an email and often get a personal response the same day. I used to think about elected officials as living in another world. I was at the foot of the mountain, and they were up somewhere on the mountain. I think that’s not the way we should look at it. We should try to have them see us as valued constituents and people whose voices they want to listen to. If they don’t want to listen to us, then we’ve got a problem and that’s what elections are for. 

What is something you wish people knew about single-payer health care? 

Brakke: If we simply clean things up by having a single-payer system instead of multiple insurance companies with multiple coding and billing systems, we can save 10-15%, maybe more, of the money which is already being collected for health care and direct it to actually taking care of patients. The data suggests that more than 25-30% of the US health care dollar is going to administrative costs. If you look at other modern countries with more rational systems, you see that they’re getting by with administrative costs in the 12% range. When people wonder how we can do universal health care, the issue is not that we need to spend more money, the issue is we need to simply do what you would do if you were a manufacturer trying to design a new vehicle. You just design it, so it’ll work well. 

Those 65 and older have been getting an ad a week from UCare, Humana, UnitedHealthcare, etc. for a couple months because the industry insuring the Medicare age population is so profitable that these companies are spending significant amounts of money trying to get a bigger chunk of that marketplace. It just shows how dysfunctional health care insurance is. One of the notions currently baked into insurance and the Affordable Care Act is this idea of various levels of insurance, so you can buy less expensive plans that cover less. The problem with that philosophy is people who buy the less expensive plans are people who don’t have much money and are the ones who need insurance the most. When they buy a plan which doesn’t have comprehensive coverage and have the bad luck of getting sick, they’re the ones who end up in personal bankruptcy. Everybody should have the same good coverage, and we can get rid of all this foolish marketing. 

How can others get involved with Health Care for all Minnesota? 

Go to HCA-MN.org and get on our contact list to keep up to date with what we’re doing and what’s happening at the legislature. 

Additional Resources

MAFP resolutions: 

AAFP resources: 

Minnesota organizations working on single-payer health care: 

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