Governor Cuomo’s progressive agenda came to a screeching halt when he put the brakes on the single-payer “Medicare for all” plan that much of the new Democratic state Senate majority campaigned on. Prior to the November elections, Cuomo said single-payer sounded like a good idea; but afterwards he added “ ... at the Federal level.” Now he is proposing a commission comprised of “health policy and insurance experts” to study other options, including “strengthening New York’s commercial insurance market,” the primary culprit responsible for our present broken system.
The New York Health Act was first introduced in the New York Assembly in 1992 by Chelsea’s own Richard N. Gottfried. It’s been around ever since, gaining more strength and approval in recent years with the worsening of our health care system. As New Yorkers have learned, the Affordable Care Act and other reforms are helpful but insufficient, leaving us at the mercy of the insurance companies.
The state Assembly has passed the bill with strong majorities the last four years. New York Health, as the program is called, provides comprehensive health coverage for all New York residents, regardless of age, income, wealth, employment or immigration status, including those currently on Medicare and Medicaid. It provides inpatient and outpatient medical, primary, and preventive care. It covers prescription drugs, dental, vision, hearing, mental and behavioral health. And when the bill is reintroduced shortly, it will include long-term care. Under the program, a simple insurance card will be your access to the doctor and hospital of your choice, without networks to navigate and with no premiums, deductibles or co-pays.
Unlike some systems, including the British National Health Service, doctors would not be government employees. Under New York Health, public financing pays for care that is delivered in the private sector, very similar to the way Medicare works. Doctors could still be in private practice, but with a public funding source.
And who picks up the tab for all of this?
Today, premiums, deductibles, co-pays, and other health care costs have no relation to a person’s ability to pay. Americans pay twice as much as other industrialized nations for health care with no better, and increasingly worse, outcomes. In the U.S., over 31 percent of every health care dollar goes to paperwork, overhead, CEO salaries, profits, lobbying and such. Without a unified system, with thousands of different types of insurance, processing payments becomes duplicative, complex, and fragmented. In 2013, Duke University Medical Center had 400 more billing clerks (1300) than hospital beds (900). Medicare, with 44 million recipients, operates with just 3 percent overhead, a fraction of the overhead in the commercial insurance market.
Getting rid of for-profit middlemen and administrative waste; being able to negotiate drug prices for the entire population; and reducing the health care monies eaten by CEO pay will not take us the full way to guaranteeing all New Yorkers comprehensive cradle to grave coverage.
A new progressive income tax will be required. And I’m aware that whenever you say the word “tax” people’s antennae engage. So how would it fare if I said, “Would you like to trade in your premium payments, deductibles, coinsurance, out of pocket and out-of-network charges for a progressive tax under which 98 percent of New York households would pay less for health care than they pay now?”
Opponents will claim it’s unaffordable. But anyone judging this must compare it to what we are currently spending on health care. It’s the status quo that is unaffordable. Multiple studies at the state and national levels, including one by the right-wing Mercatus Center, show that single-payer can provide universal health care for the same or less than the cost of the current system.
Despite its recent success in the state Assembly, the New York Health Act has never gotten past the state Senate, which has been under Republican control for the past decade. But that’s over now. With a Democratic majority in both houses, the new progressive agenda must include the passage of the New York Health Act. It’s time for New York to lead. It’s time to ride the blue wave to a better health care system for all New Yorkers today, and all Americans tomorrow.