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Some Cape Codders will vote on Health Care Tuesday

Health insurance question will come before Cape voters
Will be asked opinion on health care as human right

By James Kinsella

Voters in three state representative districts on Cape Cod and the Islands will get a chance Tuesday to give their opinion on an initiative that eventually could make a major difference for many of them: a single-payer health insurance system.

The question will come before voters in the 1st Barnstable District, which covers Brewster, Dennis and part of Yarmouth; the 4th Barnstable District, which covers the remaining Lower Cape towns; and the Cape and Islands District, which covers Nantucket, Martha's Vineyard, Gosnold and part of Falmouth.

The non-binding, advisory referendum would instruct the representatives in the districts to support establishing health care as a human right through establishing a publicly funded health insurance system for Massachusetts residents, and also to oppose any laws that penalize the uninsured for failure to obtain health insurance.

One of the referendum's supporters, Mary Zepernick of Yarmouth who blogs for capecodtoday, said the question will appear on the ballot in three Cape and seven off-Cape districts.

On the Cape and Islands, the question will come before voters in the 1st Barnstable District, which covers Brewster, Dennis and part of Yarmouth; the 4th Barnstable District, which covers the remaining Lower Cape towns; and the Cape and Islands District, which covers Nantucket, Martha's Vineyard, Gosnold and part of Falmouth.

While the referendum frames the question for all Massachusetts residents, the question also ties in with efforts under way for more than three years on Cape Cod to create a single-payer health insurance system for the Cape.

The proposed system, known as Cape Care, is backed by a mostly volunteer group known as the Cape Care Coalition. The coalition anticipates that a bill will be filed in the state legislature in January to establish the system for the Cape.

The coalition's mission, according to its Web site, is to create a "regional, community-owned health care system to provide all Barnstable County residents comprehensive and affordable health care, delivered through the current and expanded network of providers.

Under the plan, Zepernick said, Cape residents would pay higher taxes or fees in some form, but would not have to pay for health insurance. She said payments could involve higher property taxes or some form of payroll tax, but likely wouldn't come through a higher income tax.

She said residents' overall costs actually could go down under the proposed system. Zepernick anticipates that a locally administered health insurance system for Cape Cod would pose significantly lower costs than health insurance provided through private companies.

Zepernick also said Cape Care would leave current Cape health care providers intact, and likely attract more physicians and providers to the Cape by offering a less complex system with faster payments.

She further said Cape Care would offer broader insurance coverage, including dental insurance and long-term coverage, than many Cape residents now possess through their private plans.

She also said Cape Codders would be free to carry or obtain their own private insurance in addition to Cape Care.

Although the residents of Dukes and Nantucket counties will have a chance to vote on the referendum, Zepernick said Cape Care initially would be established just for Barnstable County. Plan supporters have judged that starting with a discrete political jurisdiction is the best way to proceed. She said the Cape's demographic pattern, with its large share of retirees, lends itself to creating a system.

Opponents of Cape Care include the incumbent state rep for the 5th Barnstable District, Jeffrey D. Perry.

About half the Cape, she said, already is in a single-payer pool through Medicare, a federally funded system that provides health care for people 65 years of age and older. Taking those patients under the system's wing would set the local plan well on its way to cover the remaining Cape residents.

Zepernick said the majority of the Cape legislative delegation supports Cape Care. Senate President Therese Murray of Plymouth, whose district includes the western part of the Cape, has yet to take a stand, Zepernick said, but is open to meeting with Cape Care advocates.

Opponents of Cape Care include the incumbent state representative for the 5th Barnstable District, Jeffrey D. Perry.

Perry opposes what he sees as more government involvement in and funding of health care. He said tort reform, which would limit awards in medical malpractice cases, would do far more to lower costs and attract more doctors to the Cape. His opponent, Glenn Pare, supports Cape Care as a way to provide improved health care to Cape residents.
Zepernick said people often don't consider health care in the same light as such basic government functions as public safety and public education, but should.
"We see this as a basic human right," she said.