LTE: Supporting single payer in Rhode Island

The following is a letter sent to the RI House Finance Committee by Portsmouth physician Mark Ryan, who submitted it for publication here.

Dear Members of the RI House Finance Committee:

We are writing to ask you to support H 7381, legislation proposing a single payer program that could ensure all Rhode Islanders have affordable, comprehensive heath care coverage. This legislation has been introduced by Representatives Regunberg, Amore, Tanzi, Handy and Almeida and will have a hearing before the Finance Committee. See

The bill is based on a 2015 Rhode Island-focused study by Professor Gerald Friedman, Chair of the UMass Amherst Economics Department. See the attached report, addendum memo and letter in support of the 2015 version of this proposed legislation. The problems Professor Friedman' identifies include the following:

  • Between 1991 and 2014, health care spending in RI per person rose by over 250% – rising much faster than income – greatly reducing disposable income.
  • Health care is “rationed” under our current multi-payer system, despite the fact that Rhode Islanders already pay enough money to have comprehensive and universal health insurance under a single-payer system.
  • The federal Affordable Care Act (ACA) cannot control rising premiums, co-pays, deductibles and medical costs, nor prevent private insurance companies from continuing to limit available providers and coverage.
  • Fully implemented, the ACA will still leave 4% of Rhode Islanders without insurance – resulting in as many as 116 Rhode Islanders dying unnecessarily from lack of insurance each year.
  • In the United States, 62% of personal bankruptcies were medical cost related and of these, 78% had health insurance at the time of their bankruptcy.

H. 7381 addresses these problems because it will:

  • Save approximately $4000 per resident per year by 2024 and put more money into the Rhode Island economy.
  • Significantly reduce administrative costs (almost $1 billion in the first year) and shift these dollars to actual provision of health care.
  • Decrease provider administrative burdens and allow them to spend more time providing health care.
  • Establish a funding system that is public and progressive.
  • Eliminate health insurance costs and administrative obligations on Rhode Island businesses and make them more competitive and profitable (e.g., in the first year, payroll contributions to a single payer plan would be over $1.2 billion less than current private health insurance premiums).
  • Contain health care costs (reduce administration and control over monopolistic pricing) and save 23% of current expenditures in the first year with larger savings in subsequent years.
  • Create a significant economic stimulus for the state by attracting businesses to and keeping businesses in Rhode Island because of reduced health insurance costs.

The high and increasing costs of health insurance puts an enormous burden on Rhode Island working families and businesses. In every other industrialized nation in the world, a universal comprehensive single payer health insurance solution exists. Although it would be preferable to have a national program and there is significant public support (e.g., HR 676), gridlock in Washington, DC, dictates that action at the state level must also be taken. You should note that the Canadian national single payer system began as a regional program in Saskatchewan.

Given your concern for the financial and health care needs of Rhode Islanders, we urge you to support this bill.

Please let us know by replying to this email ( if you have any questions, comments or criticisms. We welcome the opportunity to discuss your concerns prior to the hearing. We would also be happy to meet with individuals or groups interested in learning more about single payer. For more information, including significant peer-reviewed research, go to:

Thank you for your time and attention to H 7381.

Yours truly,

J. Mark Ryan, MD, FACP
Chair, Rhode Island Chapter - Physicians for a National Health Program

Howard Rotblat-Walker, PhD
Chair, Rhode Island Chapter - HealthCare-Now

RI Healthcare reform
Effect of RI State Funded Health Plan on Disposable Income
Friedman Testimony, May 26 2015