Greetings. I live in Long Lake and have been a member of the Campaign for NY Health for the past five years. The Campaign’s sole objective is the enactment of the NY Health Act into law.
For those of you who may not be familiar with the term, “single-payer” healthcare in the U.S. is so called because the government, whether national or state, becomes the sole payer to treatment providers for the costs of all medical services, including dental, optical, pharmaceutical, long-term care and mental health, incurred by their subscribers. It’s a role now played by the Center for Medicare and Medicaid Services (CMS) for persons 65 and older who are recipients of Medicare and for those who are recipients of Social Security Disability Benefits. When and if single-payer is enacted, commercial or private for-profit health insurance companies, the primary healthcare payers for their subscribers for the past fifty years, will be proscribed from selling private insurance policies and no longer play that role; which explains, in large part, the fierce opposition to single payer’s passage into law. Billions of dollars are at stake.
If you’ve heard about single-payer through the mass media rather than the several organizations that actively support NY Health – the Campaign for NY Health; Physicians for a National Health PLAN; NYS Nurses Association – you’ve probably been misinformed.
No, single-payer healthcare is not socialism – like Medicare, it’s informed by social democracy, by the belief that health care is a right to which all residents of the US and the individual states are entitled.
No, single payer does not take away your right to choose your physician or healthcare provider. Your current insurance policy does that, limiting the providers you’re permitted to see without incurring a surcharge; often requiring prior approvals for now-standard tests like MRI’s and CAT scans; always requiring sometimes hefty deductibles and co-payments. Without restricting access to healthcare, which these measures are designed to do, private insurance companies cannot make a profit for their shareholders.
NY Health employs no restrictions. Rather, It has two objectives: provide access to comprehensive healthcare to all persons who live or work in NYS, including the two million New Yorkers who have no medical coverage; and provide it at reasonable cost, much lower than that charged by insurance companies, even if your health benefits are provided by your employer.
Benefits, for all NYS residents or those who work in the State but live elsewhere, once you enroll in NYHealth:
- Comprehensive: All medical care, inpatient and outpatient, dental, ear & eye care, prescription drugs, mental health, long-term care, with no deductibles or co-payments; one exclusion – cosmetic surgery, save for repairs for injury or congenital impairment; no limits on providers in NY State and, within a short time after enactment of the law, most states in US.
- Inclusive: If you receive any Federally-granted or protected medical, disability or retirement benefits – Medicare, Medicaid, VA, ERISA — you continue to retain them but are eligible for all NYHealth benefits.
… Further, all enrollees can see the provider(s) of their own choosing in NYS and, within most states in US; since all reimbursement rates, if low, will be increased to match Medicare rates, there will be additional providers to choose from;
… If you receive Medicare — NYHealth will pay the cost of your Medicare Part B and save subscribers $6100 on average annually ;
…If you receive any other Federally-protected retirement or disability benefits – for example, ERISA, VA, etc. — NYHealth will pay for all care not covered by those benefits, including any required deductibles or co-pays;
- Finally: Counties will no longer be obliged to pay their $8 B share of the State’s Medicaid costs. Those will be fully absorbed by NYHealth, enabling each county to reduce property taxes, now used to pay their Medicaid allotment.
In sum, the 2 million New Yorkers, 10% of the State’s population, who have no access to healthcare will now have it; as many as the one-third of New Yorkers who regularly put off healthcare will now no longer be obliged to do so; and no New Yorker will have to accumulate medical debt, once enrolled in NYHealth.
Costs: A good many costs, addressed via an elaborate funding mechanism, too complex for this article. I will provide a brief overview with data from the Rand Corporation’s An Assessment of the NY Health Act (2018) and from Dr. Leonard Rodberg’s Summary and Evaluation … of the Rand Study (2018), to be found on the website of the Campaign for NY Health, www.nyhcampaign.org.
Given current modes of healthcare spending, NYS and its residents are projected to spend $311B in 2022; in contrast to the NY Health Act, with net savings of 3.6% …
The big changes when the NY Health Act becomes law – no more purchases of private insurance by individuals, businesses and organizations and the end of deductibles and co-payments for insured individuals; replaced by a NYHealth Tax; savings realized by the reduction of administrative billing costs and lower negotiated drug costs; resulting in net savings of 3.6%. The estimated 11.4 % in savings will be utilized for additional healthcare resources in anticipation of increased demand for services.
The Rand Corporation’s ten-year estimate of net cumulative savings, expenditures v. income, will amount to 2% per annum for the period 2022 to 2031, with annual costs lowered by 3% or $10B by 2031.
The big bone of contention is the dramatic rise in graduated income taxes, approximately 20% to be paid by wage earners, the remaining 80% by their employers, with total amounts for each lower than those currently paid for private insurance premiums. As per Dr. Rodberg, NYHealth will initially require $159.6 B annually in payroll and non-payroll taxes to cover all costs …
Note that the tax schedule rates, while hypothetical, are based on realistic assessments of New Yorkers’ financial circumstances; they can’t be finalized until the NY Health Act is passed into law. It should also be noted that the first $25K of an individual’s income will not be taxed. Ultimately, the health tax rates are graduated to ensure the inclusion of the 80% of New Yorkers who earn less than $100K annually. The rates are also established per individual not per household so all members’ incomes are counted to determine cost per household or family. At present, a private healthcare policy for a family of four amounts to $27K annually (Kaiser Health News, 2021), plus more than $3K in deductibles and co-payments, up from $21K in 2017. Just take another look at the figures.
Conclusions & Prospect for Enactment: When and if enacted, the NY Health Act will provide a full range of benefits for ordinary New Yorkers that the great majority of us would never have been able to afford. It will not only provide us with unexpected income but with great peace of mind, welcome relief from constant fear and anxiety about our and our families’ well-being. Accordingly, the prospects for passage are uncertain. Ever since the NYHA came close to approval in the Legislature in 2019, the forces of opposition have been gathering, galvanized by this prospect, particularly the corporate entities with the most to lose financially, whose lobbyists will flood Albany and Washington with anti-single payer messaging.
Prospects for passage of the bill can best be measured by the support we receive from the New Yorkers who stand to benefit from its enactment, folks like many of the persons reading this.
If you’d like additional information or want to get involved, start by logging on to the website of the Campaign for NY Health, www.nyhcampaign.org. If you scroll across the top of the title page, click on any of the links, beginning with “Learn” and scrolling down to “FAQs”, to find out more about NY Health and the Campaign. If you’d like to get involved, contact either of the Campaign’s co-Directors, YuLing Koh Hsu, email@example.com, or Ursula Rozum, firstname.lastname@example.org.
You can also contact me at Jacarney4214@gmail.com or log onto my FB page, North Country Access to Health Care Committee.