Can New York Pull Off Single-Payer Healthcare? | Health | Hudson Valley | Chronogram Magazine
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Can New York Pull Off Single-Payer Healthcare? 

The US Healthcare System is Broken. New York Could Lead the Way to Fixing It.

Last Updated: 06/20/2018 10:39 am

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Meanwhile, State Senator Gustavo Rivera says he and his colleagues are working to get the bill's 32nd co-sponsor. If the Democrats can reach a majority, Rivera will be the ranking member of the Senate Health Committee, and his next step will be to get the bill on the agenda and eventually onto the governor's desk. The bill would cover all New Yorkers regardless of income, preexisting conditions, or immigration status. "We don't believe that your wealth should determine your health," says Rivera.

Individual costs for New York's proposed single-payer plan would come from a progressive taxation scheme: The amount that you pay is based on your income and tax bracket. A 2014 study of the New York Health Act by the University of Massachusetts at Amherst estimated that people making under $25,000 a year would pay nothing; those making $50,000 would pay $2,250 a year; and those making $75,000 would pay $5,000 a year. Of those amounts, the employer would pay 80 percent and the individual would pay 20 percent. For wealthier individuals, the estimated amount increases incrementally according to tax bracket, but doesn't rise to infinity. Over 98 percent of households would spend less on healthcare than they do now. Because the funding mechanism is through taxes, there is no "opting out" of the single-payer plan. Additionally, funding from the federal government, which the states already receive for Medicaid and Medicare, would be essential to keeping the program affordable. "You pool everyone's risk together, and therefore you lower the cost for everybody," says Rivera.

Private Insurance–Induced Stress Disorder, a Modern Malady

A single-payer plan would do away with the private insurance companies—removing the middlemen along with their CEO salaries and bonuses, as well as the enormous associated administrative costs. But these behemoths are not likely to go down easy. The most formidable hurdles to making single-payer a reality are moneyed interests like big insurance and big pharma, which sets our country's sky-high drug prices. If the New York Health Act does pass in the state legislature, we can expect these big guns to fight back with a disinformation campaign that plays into people's fears.

That's why educating people is essential. "There's a century of propaganda and a history of making people afraid of universal healthcare," says Katie Robbins, director of the Campaign for New York Health, a grassroots coalition with the goal of winning single-payer healthcare for New York State. "The public is wising up to this, and most people across party lines now believe that healthcare is a right. Premium costs are rising faster than inflation, yet we're getting skimpier plans every year. People are so frustrated."

While Americans no longer seem to fear "socialized medicine" (a misnomer), many do fear big tax bills. While it's true that tax bills would go up under a single-payer plan, the cost of private health insurance would be eliminated, resulting in a net savings for most people. A single-payer plan would also do away with copays, deductibles, and other cost-sharing, because the revenue from taxes and federal support would entirely replace the payments charged by today's health plans. To some extent, New York would have to set up a bureaucracy to handle a single-payer system, but it has one already for Medicaid and Medicare, and we'd see an administrative savings due to the reduced billing complexity of having fewer plans.

"A person who is uninsured can't afford primary care, so when they have a problem they go to the emergency room, which is the most expensive kind of care," says Rivera. "And guess who pays for that? Taxpayers do. So we're paying for it already." A single-payer plan would open the door to primary care for all, and from a cost perspective, it's leaner. "Research studies have calculated the cost to be about $45 billion less than we now spend," says Rivera.

A View from Inside the Healthcare Mess

Support is growing for single-payer healthcare among doctors and other providers, who get to see the dysfunction of our current system on a daily basis. "When you have a heart attack or stroke, your whole life falls apart," says Jess Robie, a registered nurse who works at HealthAlliance Hospital Broadway Campus in Kingston. "This is not the time to argue with your insurance company about what is and is not covered. Why does someone who is not a doctor and has never seen or talked to you get to make that choice? It's insane to me. Families fall apart over this stuff."

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