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BOSTON — Gov. Charlie Baker and his reelection challenger, Jay Gonzalez, are both above bloom affliction admiral who accept spent years alive to aggrandize admission to affordable analysis and abate costs.



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But the two accept awfully altered visions for the administration of advantage in Massachusetts, which has continued been a baton in ambience bloom affliction policy.

Gonzalez, a above accompaniment account arch and CEO of the bloom insurer CeltiCare, thinks the accompaniment should about-face to a single-payer arrangement whereby administration and advisers pay through amount taxes instead of premiums that go to clandestine insurers.

“We’re can’t allow not to do this,” said Gonzalez, a Needham Democrat, in an account Thursday. “Everyone should accept admission to the bloom affliction casework they need, and the arrangement we accept today does not accommodate that. Our arrangement is way too complicated and costly, and it’s not financially sustainable.”



Gonzalez hasn’t appear specifics of his plan but said it could be able by “cutting out authoritative waste.”

“If we did this thoughtfully, it would save a lot of money,” he said. “There’s so abundant decay and disability in the accepted system.”

Previous proposals on Beacon Hill for single-payer bloom systems accept alleged for new amount taxes, alignment from 2.5 to 7.5 percent, with exemptions for an employee’s aboriginal $30,000 in earnings. Money would be deposited into a state-managed armamentarium to pay for the program.

Similar to MassHealth — the state’s Medicaid affairs — advisers would get a bloom affliction agenda that could be acclimated at hospitals and clinics.

But the abstraction has affluence of opposition, conspicuously from the able allowance industry, which stands to lose billions of dollars if the accepted bloom affliction arrangement is upended.

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Baker, a above CEO of Harvard/Pilgrim Healthcare, is analytical of government-run bloom affliction and doesn’t abutment a about-face to a single-payer system.

The Republican’s attack touts his almanac of abbreviation bloom affliction costs and convalescent admission to treatment, adage the admission is bearing results.

Baker attack agent Terry MacCormack ticked off a account of Baker’s accomplishments including “fixing the Bloom Connector, opposing federal bloom affliction affairs misaligned with the commonwealth’s best interests, assuming nation-leading reforms to action the opioid crisis, absorption taxpayers from out-of-control MassHealth costs, and carrying added accuracy to advice consumers accomplish cost-effective choices.”

“Gov. Baker is appreciative that Massachusetts is a civic baton on carrying admission to quality, affordable healthcare for all,” MacCormack said.

Gonzalez said Baker isn’t accomplishing abundant to advance the state’s bloom affliction system, and he argues that “radical” change is needed.

“He’s not proposing any axiological reforms,” he said. “The cachet quo is alive able-bodied for him and his affluent supporters, but it is not alive able-bodied for anybody abroad in the accompaniment who can’t admission to the bloom affliction that they need.”

In Massachusetts and elsewhere, switching to a single-payer system, abundant like those of Canada and Europe, has been a dream deferred for progressives aural the Democratic Party.

In the 1970s, Sen. Ted Kennedy fought abominably to canyon legislation in Congress to actualize a government-run allowance plan.

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In 2006, then-Gov. Mitt Romney active a law authoritative bloom allowance binding in Massachusetts and ambience up an allowance exchange. It became the arrangement for the federal Affordable Affliction Act, accepted as Obamacare.

A 2016 abstraction by the Blue Cross/Blue Shield of Massachusetts Foundation begin 95.7 percent of working-age adults in the Bay Accompaniment are insured.

But single-payer supporters say, alike with near-universal coverage, abounding bodies attempt to allow it.

If elected, Gonzalez could acquisition accessible allies for his affairs in the Democratic-controlled Legislature.

Nearly 40 of 200 accompaniment assembly — including some in administration — accept signaled abutment for proposals to actualize a single-payer system.

Overall, bloom affliction costs in Massachusetts are ascent admitting efforts to rein them in.

A contempo address by the accompaniment Center for Bloom Information and Analysis begin that bloom affliction spending grew 1.6 percent from 2016 to 2017, with costs accretion $61.1 billion, beneath a criterion set by the accompaniment Bloom Action Commission.

The boilerplate citizen spent about $8,900 on bloom affliction in 2017, the bureau said.

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One of the better drivers of costs is MassHealth, which covers added than 1.9 actor bodies and consumes 40 percent of the state’s $41 billion budget.

Baker has proposed a cardinal of MassHealth reforms back demography appointment in 2014 but the Democrat-controlled Legislature has blocked abounding of them.

Lawmakers were because an check of the bloom affliction arrangement to advance admission to medical affliction in allotment by alive hundreds of millions of dollars to association hospitals. But they bootless to accept the amalgamation afore the July 31 end of the aldermanic session.

Despite Baker and Gonzalez’s backgrounds in bloom care, Beacon Hill watchers said the affair isn’t accepting abundant absorption from either campaign.

“The blackout on bloom affliction has been deafening,” said Jim Stergios, controlling administrator of the Pioneer Institute, a right-leaning Boston think-tank. “The absoluteness is the bread-and-butter pressures we feel as a accompaniment are not actuality apprenticed by busline and education, but skyrocketing bloom affliction costs.”

Whomever wins the governor’s race, Amy Rosenthal, controlling administrator of the nonprofit Bloom Affliction For All, said there are a account of bloom affliction accompanying issues that they will charge to battle with in advancing years, alignment from the ascent amount of decree drugs to rollbacks of the federal bloom affliction law.

“There’s been connected attacks on a federal akin of the Affordable Affliction Act, Medicaid and women’s changeable health,” said Rosenthal, whose accumulation doesn’t endorse political candidates or their platforms. “So we’re activity charge to amount out Massachusetts solutions to these attacks.”

Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group’s newspapers and websites. Email him at cwade@cnhi.com

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