Improved Medicare for All means something. Don’t dilute it!

August 13, 2018

Improved Medichttps://www.dailykos.com/stories/2018/8/6/1786278/-Improved-Medicare-for-All-means-something-Don-t-dilute-itare for All means something. Don’t dilute it!

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Dave Cox is front and center with Kentuckians for Single Payer Health Care at Humana’s marble headquarters in Louisville.

By Kay Tillow

On July 13, 2018, in an article1 on Vox, Tim Higginbotham and Chris Middleman of the Democratic Socialists of America’s (DSA) Medicare for All campaign condemned Paul Krugman, Adam Green, the Center for American Progress, and Andy Slavitt for their efforts to co-opt and water down the “Medicare for All” slogan into meaningless vague principles and inadequate programs.  They are absolutely right!

Higginbotham and Middleman’s analysis of those who seek to use and abuse the growing popularity of “Medicare for All” while abandoning the struggle for a real national single payer program is excellent.  The door-to-door grass roots proposal of the DSA is compelling with its plan to reach into the heart of every community.

But there is a problem embedded in Higginbotham and Middleman’s core principles that threatens to destroy all of their good work and do damage to the robust and growing single payer movement.  Their five core demands which they assert “dovetail with the Sanders and Ellison bills” are inadequate to give us a viable single payer system.  Why are Higginbotham and Middleman moving the goal posts?  Their core demands are good—but too sparse to support the reform they say they seek.  And the Sanders Senate bill S 18042 and the Ellison House bill, HR 6763 are worlds apart.

Do Higginbotham and Middleman really want to leave long term care out of Medicare for All?  Their principles do not include it.  That would abandon this vital care to the state Medicaid programs that require impoverishment prior to entering a nursing home.  Leaving long term care to state Medicaid programs assures wide variations from state to state as some states will provide the sparsest of care.   Medicaid has means-testing for eligibility, and that will worsen economic inequality as families must spend a lifetime of assets for final care.  This will worsen the wealth gap because nothing is left to be passed on to families.   Long term care isn’t included in Higginbotham and Middleman’s core demands even though it is a part of HR 676.  It is a necessity and should be included.  All necessary care for everyone means something.  Don’t dilute it.  The Senate bill S 1804 also excludes long term care.

Do Higginbotham and Middleman really want to allow the investor-owned, for-profit hospitals and nursing homes to continue to gouge patients with their higher costs and higher mortality rates?  In their article they call for the elimination of the profit motive, but their core principles are silent on this vital issue.  Does not removing the profiteers merit inclusion?  HR 676 transforms the investor-owned, for-profit hospitals, nursing homes, and other institutions.  S. 1804, the Senate bill, does not.  Shouldn’t ending the profits in health care be a core demand?

Check out the research.

“It has been shown that patients cared for at private for-profit hospitals have higher risk-adjusted mortality rates than those cared for at private not-for-profit hospitals4.”

And

Private for-profit hospitals result in higherpayments for care than private not-for-profit hospitals. Evidence strongly supports a policy of not-for-profit health care delivery at the hospital level5.”

Removing the for-profit hospitals and nursing homes must be a core demand.  As Dr. Andy Coates puts it,

“…it’s appalling that one person’s illness would be an opportunity for another to make money. The care of human beings should not be a commodity.6

The United States spends over twice as much on health care, per capita, as the average of other industrialized countries that provide universal health care.  So reaching our goal does not require spending more, but instead saving by removing the insurance companies and eliminating the waste caused by profits.  Improved Medicare for All, a national single payer system, requires administrative savings to free funds to improve care for all and expand it to everyone.  Yet Higginbotham and Middleman leave out of their core principles the vital global budgeting of hospitals and nursing homes and the separation of construction from operating costs.  These are essential to assure the savings to make single payer financially viable.  Is this not a core principle?

Without global budgets, the national system has little power to constrain long-term costgrowth7.”

In January of 1989 the Physicians’ Proposal for a National Health Program was published in the New England Journal of Medicine.  Through updates in 2003 in the Journal of the American Medical Association8 and in 2016 in the American Journal of Public Health9, the plan of Physicians for a National Health Program (PNHP) has continued as the evidence-based single payer proposal uniting a national single payer movement.

In 2003, with the assistance of the Physicians for a National Health Program, Congressman John Conyers, Jr. of Michigan put this plan into legislative form and introduced it into the House of Representatives.  Conyers introduced this bill, HR 676, into every Congress since that time, and it has been the sound legislation, Expanded and Improved Medicare for All, that now has 123 cosponsors.

When Rep. John Conyers resigned, Rep. Keith Ellison took over the lead sponsorship of HR 676.  He, too, will be leaving the Congress to run for attorney general for the state of Minnesota.  Nothing is more important than that the new chief sponsor, whoever that may be, be willing to maintain HR 676 as the model plan, based on the PNHP proposal, that when enacted will bring us the universal care we need.

Some have suggested that the model single payer bill, HR 676, needs to be rewritten to conform to the flawed senate bill S. 1804.  That would be a disastrous setback for the single payer movement.  S. 1804 excludes long term care.  S. 1804 maintains private, for-profit hospitals and nursing homes.  S. 1804 includes some copayments for drugs.  S. 1804 has no global budgeting of hospitals.  S. 1804 adopts in Section 611 (b) a “value based payment” system that has been proven to discriminate10 against physicians who care for those with low incomes.  S. 1804 has a public option11 and a Medicare buy-in12 that will become barriers to achieving single payer.  S. 1804 needs to be improved to come up to the standards of HR 676.

As every trade unionist knows, a compromise placed on the bargaining table at the beginning of negotiations becomes a ceiling above which it is not possible to go.  If the ceiling is below viability of the new system, the plan fails before it gets off the ground.  It is vital to set the standards high.  A watered down, puny reform cannot inspire a nation to fight for it.  We need a bold and beautiful plan.

So applaud Higginbotham and Middleman’s grass roots campaign.  Join in the knocking on doors.

Build and energize across the country.  But don’t dilute the single payer principles.  Improved Medicare for All means something!

__________________________

1.  https://www.vox.com/the-big-idea/2018/7/13/17567952/medicare-for-all-centrists-copycat-plans-water-down-left-center-sanders

2.  https://www.congress.gov/bill/115th-congress/senate-bill/1804?q=%7B%22search%22%3A%5B%22s+1804%22%5D%7D&r=1

3.  https://www.congress.gov/bill/115th-congress/house-bill/676?q=%7B%22search%22%3A%5B%22hr+676%22%5D%7D&r=1

4.  http://www.cmaj.ca/content/170/12/1817.full

5.  http://www.cmaj.ca/content/170/12/1817.full

6.  http://www.pnhp.org/news/2018/march/the-end-of-insurance

7.  http://www.pnhp.org/MedicareForAll

8.  http://www.pnhp.org/publications/a-national-health-program-for-the-united-states

9.  http://www.pnhp.org/beyondaca

10.  http://www.pnhp.org/news/2017/november/value-based-payment-modifier-worsens-health-care-disparities

11.  http://www.pnhp.org/change/Public_Option_Myths_and_Facts.pdf

12.  http://www.pnhp.org/news/2016/may/is-hillary-clinton%E2%80%99s-medicare-buy-in-proposal-a-step-towards-single-payer

How Medicare Was Won

August 7, 2018

The history of the fight for single-payer health care for the elderly and poor should inform today’s movement to win for Medicare for All.

https://www.thenation.com/article/how-medicare-was-won/

NY Health Act Press Clips

June 19, 2018

NY Health Act Press Clips 

 

NY Assembly OKs universal health care; bill halted in Senate (Associated Press, below)

 

 

New York State Assembly Approves Universal Health Care Bill (USA Herald, below)

 

NY Assembly Passes Single-Payer Healthcare: POLL (New Rochelle Patch)

 

Jenne joins Assembly majority in voting for bill to give single-payer healthcare to St. Lawrence County, rest of NY (North Country Now, below)

 

Assembly passes universal health care bill (Rochester Business Journal) *Need subscription to access

 

NY Assembly OKs universal health care; bill halted in Senate

By Associated Press June 17, 2018

 

ALBANY, N.Y. (AP) — The New York state Assembly has again endorsed a single-payer universal health care system.

 

The Democrat-led chamber passed the measure last week for the fourth year in a row.

 

Passage of the legislation is largely symbolic, however. The Republican-led Senate is not expected to take up the measure before lawmakers adjourn for the year next year.

 

Assembly Speaker Carl Heastie says Democrats in his chamber believe all Americans deserve a health care system that guarantees coverage for all.

 

The proposal would allow all New Yorkers to enroll for health coverage that comes with no network restrictions, deductibles or co-pays. The system would use state and local funds that now go to Medicaid and other health care programs.

New York State Assembly Approves Universal Health Care Bill

By Marivic Cabural Summers June 18, 2018

 

The New York State Assembly approved a legislation that authorizes the creation of a single-payer universal health care system.

 

In a recent statement, Assembly Speaker Carl Heastie and Health Committee Chairman Richard Gottfried announced the passage of the New York Health Act. This is the fourth consecutive year, the chamber, controlled by Democrats, passed a universal health care bill.

 

According to Speaker Heastie, “The Assembly Majority believes that decisions regarding medical care should not be based on cost.”

 

Additionally, he said that they believe that “New Yorkers and all Americans deserve a health care system that guarantees coverage for all.” That is their main reason for passing the New York Health Act “despite Washington’s efforts to undermine access to affordable care.”

 

Support for universal health care is growing

 

On the other hand, Health Committee Chair Gottfried emphasized that the “health care system is rigged against working people. The Congress and the Trump administration are working to restrict health care access even more.”

 

Gottfried believes that New York can do better with a single-payer health care system that covers every New Yorker and funded fairly. He noted that the public support for the legislation is growing even in the State Senate.

 

Under the New York Health Care Act, all New Yorkers will be eligible to enroll for health coverage regardless of age, income, employment or wealth. There will be no network restrictions, deductibles or co-pays.

 

New Yorkers will receive the following health benefits:

 

  • comprehensive outpatient and inpatient medical care
  • primary and preventative care
  • prescription drugs,
  • laboratory tests,
  • dental, hearing, vision, rehabilitative, and all benefits required by current state insurance law, by publicly funded medical programs or provided by the state public employee package.

 

“Assembly passage is an important step as we continue to build support for universal health care to benefit everyone,” said Gottfried.

 

Meanwhile, George Gresham, the president of 1199SEIU, said they’ve been fighting for universal health care coverage for decades. He praised the Assembly for approving the New York Health Care Act. He said, “We are hopeful that our state can reach our goal of affordable, quality healthcare for all.”

 

On the other hand, Judy Sheridan-Gonzalez, president of the New York State Nurses Association, commented, “Not one more death from lack of healthcare in the richest country in the world. Not one more. We will advocate until we have a healthcare system that delivers high quality care to every resident of New York.”

NY Assembly Passes Single-Payer Healthcare: POLL

By Michael Woyton June 16, 2018

 

Albany has taken the first step toward giving New Yorkers a single-payer healthcare system. On Thursday, the state Assembly passed bill A4738, The New York Health Act would establish a program that would create a system of access to health insurance for New York residents.

 

The bill, which was sponsored by Assemblyman Richard Gottfried, D-75th Assembly District, is now going to be considered by the Senate. The Senate version, sponsored by Sen. Gustavo Rivera, D-33rd Senate District, is currently being considered by the Senate Health Committee.

 

If it comes to the floor of the Senate, it’s a toss-up whether it could pass because, even though the Democrats have a one-seat majority in the 63-seat body, one Democrat — Brooklyn Sen. Simcha Felder — caucuses with the Republicans.

 

Under the bill, according to a press release from Assembly Speaker Carl Heastie and Gottfried, every New York resident would be eligible to enroll, regardless of age, income, wealth or employment, in the healthcare plan.

 

There would be no network restrictions, deductibles or co-pays.

 

Benefits would include comprehensive outpatient and inpatient medical care, primary and preventive care, prescription drugs, lab tests, rehab, dental, vision, hearing and all benefits required by current state insurance law, by publicly funded medical programs or provided by the state public employee package.

 

State funding would be combined with federal funds that are currently received for Medicare, Medicaid and Child Health Plus to create the New York Health Trust Fund.

 

Federal waivers would be sought by the state to completely fold those programs into New York Health.

 

Heastie said the local share of Medicaid funding would be ended, offering major property tax relief for New Yorkers.

 

There would be a payroll premium which would be progressively graduated so the percentage is higher on higher brackets of income.

 

People who are employed would pay 20 percent of the premium, with their employers paying 80 percent. Self-employed individuals would pay the full premium.

 

The bill is estimated to result in a $92 billion tax hike, according to healthleadersmedia.com.

 

A study of the bill by Gerald Friedman, professor and chairman of the Department of Economics at University of Massachusetts at Amherst, said the bill could save more than $70 billion in 2019, which is 25 percent of that year’s projected health care spending. He said the saving will increase over time.

 

Friedman said, while the largest savings would go to working households earning less than $75,000 a year, more than 98 percent of New York households would spend less on healthcare under the new legislation than they do now.

 

The plan would also be expected to create more than 200,000 new jobs, which would more than replace those lost in insurance and in billing.

 

Katie Robbins, director of the Campaign for New York Health, is in favor of the legislation.

 

“This proposal will guarantee healthcare to all New Yorkers, making healthcare a right and a public good,” she said. “There is evidence from around the world that similar systems provide quality care, control costs and are enormously popular with the public. We have the opportunity to transform the social contract and vastly improve health outcomes and quality of life for all residents of New York.”

 

The bill does have its detractors, though.

 

The Business Council of New York State did a poll on the single-payer healthcare system and found that it’s not that popular.

 

The survey, done in May, found that 54 percent of New Yorkers were opposed to a single-payer healthcare system.

 

Bill Hammond, health policy director at the Empire Center for Public Policy, gives the single-payer system a thumbs down.

 

He said the state would become a magnet for people from other states and countries in need of medical care and would more than double the tax burden of a state that is already heavily taxed.

 

So, what do you think about New York adopting a single-payer healthcare system? Vote in our highly unscientific poll and tell us what you think in the comments below.

Jenne joins Assembly majority in voting for bill to give single-payer healthcare to St. Lawrence County, rest of NY

By North County Now June 14, 2018

 

A bill to extend single-payer health coverage to all residents of St. Lawrence County and the rest of New York state today passed the Assembly, with support from Assemblywoman Addie Jenne, D-Theresa.

 

Her office says the bill would give all state residents “quality health care coverage without any co-pays or premiums.”

 

Assemblywoman Jenne has continually been a vocal supporter of the legislation.

“The New York Health Act could mean the difference between life and death for many of our neighbors, loved ones and friends,” Assemblywoman Jenne said in an announcement.

 

“People shouldn’t have to choose between having food in the fridge and picking up a prescription. They shouldn’t be forced to forgo critical treatment to keep the lights on at home. We need a single-payer system to protect New Yorkers from skyrocketing premiums and insufficient coverage while ensuring everyone gets the care they need.”

 

The New York Health Act would establish a universal health care system within the state, known as New York Health, that would cover all residents, regardless of wealth, income, age or pre-existing condition, according to Jenne’s office.

 

Every enrollee would have access to a full range of doctors and services, including inpatient and outpatient care, maternity care, prescription drug costs and dental, vision and hearing care. Out-of-state health care would also be covered, her office said.

 

Care providers and coordinators would be fully paid by New York Health, with no copays, deductibles or other charges to patients, her office said.

 

The system would be publicly funded based on a shared 80-20 employer-employee payroll contribution that would be progressive and based on the amount the employee is paid, Jenne’s office said, which she says would “relieve employers of the burdensome administration of health plans.”

 

The local share of Medicaid would also end, providing New Yorkers with much-needed property tax relief, Jenne’s office said.

 

“This is a major concern for local government leaders in St. Lawrence and Jefferson counties and eliminating the local share of the Medicaid costs would translate into major reductions in the county’s portion of local tax bills,” Jenne said in a statement.

 

“Research by the University of Massachusetts at Amherst shows New York could save an estimated $45 billion in the first year alone by implementing a single-payer system and that system would also lower annual health insurance costs for 98 percent of households in the state,” according to Jenne’s office.

 

The bill will now head to the Senate.

 

 

NY Assembly Passes Single-Payer Healthcare: POLL Should New York implement a single-payer healthcare system? Take our poll.

June 18, 2018

https://patch.com/new-york/whiteplains/s/gg43z/ny-assembly-passes-single-payer-healthcare-poll?utm_source=alert-breakingnews&utm_medium=email&utm_term=weather&utm_campaign=alert




NY Assembly Passes Single-Payer Healthcare: POLL

Albany has taken the first step toward giving New Yorkers a single-payer healthcare system. On Thursday, the state Assembly passed bill A4738, The New York Health Act would establish a program that would create a system of access to health insurance for New York residents.

The bill, which was sponsored by Assemblyman Richard Gottfried, D-75th Assembly District, is now going to be considered by the Senate. The Senate version, sponsored by Sen. Gustavo Rivera, D-33rd Senate District, is currently being considered by the Senate Health Committee.

If it comes to the floor of the Senate, it’s a toss up whether it could pass because, even though the Democrats have a one-seat majority in the 63-seat body, one Democrat — Brooklyn Sen. Simcha Felder — caucuses with the Republicans.

Under the bill, according to a press release from Assembly Speaker Carl Heastie and Gottfried, every New York resident would be eligible to enroll, regardless of age, income, wealth or employment, in the healthcare plan.

Are you in favor of New York having a single payer healthcare system?

There would be no network restrictions, deductibles or co-pays.

SubscribeBenefits would include comprehensive outpatient and inpatient medical care, primary and preventive care, prescription drugs, lab tests, rehab, dental, vision, hearing and all benefits required by current state insurance law, by publicly funded medical programs or provided by the state public employee package.

State funding would be combined with federal funds that are currently received for Medicare, Medicaid and Child Health Plus to create the New York Health Trust Fund.

Federal waivers would be sought by the state to completely fold those programs into New York Health.

Heastie said the local share of Medicaid funding would be ended, offering major property tax relief for New Yorkers.

There would be a payroll premium which would be progressively graduated so the percentage is higher on higher brackets of income.

People who are employed would pay 20 percent of the premium, with their employers paying 80 percent. Self-employed individuals would pay the full premium.

The bill is estimated to result in a $92 billion tax hike, according to healthleadersmedia.com.

A study of the bill by Gerald Friedman, professor and chairman of the Department of Economics at University of Massachusetts at Amherst, said the bill could save more than $70 billion in 2019, which is 25 percent of that year’s projected health care spending. He said the saving will increase over time.

Friedman said, while the largest savings would go to working households earning less than $75,000 a year, more than 98 percent of New York households would spend less on healthcare under the new legislation than they do now.

The plan would also be expected to create more than 200,000 new jobs, which would more than replace those lost in insurance and in billing.

Katie Robbins, director of the Campaign for New York Health, is in favor of the legislation.

“This proposal will guarantee healthcare to all New Yorkers, making healthcare a right and a public good,” she said. “There is evidence from around the world that similar systems provide quality care, control costs and are enormously popular with the public. We have the opportunity to transform the social contract and vastly improve health outcomes and quality of life for all residents of New York.”

The bill does have its detractors, though.

The Business Council of New York State did a poll on the single-payer healthcare system and found that it’s not that popular.

The survey, done in May, found that 54 percent of New Yorkers were opposed to a single-payer healthcare system.

Bill Hammond, health policy director at the Empire Center for Public Policy, gives the single-payer system a thumbs down.

He said the state would become a magnet for people from other states and countries in need of medical care, and would more than double the tax burden of a state that is already heavily taxed.

So what do you think about New York adopting a single-payer healthcare system? Vote in our highly unscientific poll and tell us what you think in the comments below.

Image via Shutterstock.

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June 3, 2018

https://www.chronogram.com/hudsonvalley/can-new-york-pull-off-single-payer-healthcare/Content?oid=5042601&showFullText=true

 

Can New York Pull Off Single-Payer Healthcare?

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

click to enlargeThe mess that is our current healthcare system. - INFOGRAPHIC BY DANIEL NEGHASSI, MD.

  • Infographic by Daniel Neghassi, MD.
  • The mess that is our current healthcare system.

The New York Health Act proposes single-payer healthcare which would do away with the private insurance companies.

About 10 years ago, when she was 44, Eve Madalengoitia had a hunch that something was wrong. She was experiencing concerning symptoms of the lady sort, and her doctor said it’s probably nothing, but let’s get you an MRI to be sure. At the time, she was working as a consultant from her home base in Poughkeepsie, writing grants and fundraising for nonprofits; her husband was a self-employed artist. They didn’t have health insurance. The expense of an MRI (ballpark $2,600) was so daunting that Madalengoitia convinced herself that her symptoms were nothing to worry about. She was young and healthy, wasn’t she?

A few months later she got insurance through a new job, so she went ahead and scheduled the exploratory test. Soon after, she received some news that no one expected. “I had aggressive, high-grade uterine cancer, which was not common in women my age,” she says. “I needed immediate surgery, chemo, and radiation.” Thankfully, her insurance paid for it, and now she is NED (no evidence of disease). But she is keenly aware of the what-ifs. “Without health insurance, I probably wouldn’t have gotten the test and the cancer would have spread,” Madalengoitia says. “I wouldn’t be here to tell my story.”

Madalengoitia’s experience is pre-Obamacare, but even people who have health insurance often forgo medical tests and treatment because of high deductibles, coinsurance, copays, or all of the above. Even for those with employee-provided insurance, out-of-pocket healthcare spending has increased by more than 50 percent since 2010, according to human resources consultant Aon Hewitt. Medical debt is the number one reason why Americans file for bankruptcy, according to financial services company The Motley Fool.

We may pride ourselves on our high-quality medical care, but Americans spend almost twice as much money on it, as a percentage of our economy, than other advanced industrialized nations ($3.3 trillion, or 17.9 percent of our GDP in 2016). And we’re no better for it: Our health outcomes are poorer and we die younger than citizens of other wealthy countries. It’s not the amount of healthcare we consume that is the problem: It’s the cost of healthcare. As long as big pharma, big insurance, and big hospital networks are calling the shots, we’re unlikely to see these costs go down. And as long as we skimp on social services for our underserved populations, many experts say, we’re unlikely to see our life expectancy go up.

A Little-Known Bill Is Gaining Momentum

When it comes to troubling scenarios like these, our lack of universal healthcare is the elephant in the room: It’s a huge marker for our poor health outcomes and financial dire straits. We’re the only major industrialized nation in the world that does not have universal healthcare. After Hillarycare was famously shot down during Bill Clinton’s presidency, the idea receded from the public discussion. It didn’t get major play again until Bernie Sanders made his Medicare for All proposal a cornerstone of his rousing campaign in the 2016 Democratic presidential primaries. President Trump’s potshots to the Affordable Care Act are not helping to keep Americans insured—but they may be pushing states to devise their own solutions. Several states, including Sanders’ home state of Vermont, have made or continue to make efforts to design single-payer programs. What many New Yorkers don’t realize is that the Empire State, too, has a single-payer bill floating around in Albany.
It’s called the New York Health Act, and it is not new: First proposed in 1991, it’s been through many incarnations. In its current form, the bill has p-assed in the State Assembly by a wide margin for the past three consecutive years. Yet a Republican majority in the State Senate means the bill has not made it out of the health committee and onto the agenda for a vote. That could change quickly, as the bill has 31 co-sponsors in the 63-seat State Senate, and only one more co-sponsor is needed to tip the balance.

“The healthcare system is rigged against working people, and the Trump administration is working to make healthcare access even worse,” says Assembly Health Committee Chair and bill sponsor Richard N. Gottfried, who originally authored the 1991 bill. “New York can do better with an ‘improved Medicare for all’ single-payer system that covers all of us and is funded fairly. Support is growing with the public and in the State Senate. I expect the Assembly will pass the bill again this session, an important step as we continue to build support for universal healthcare in the face of the Trump agenda.”

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.”
On a single-payer plan, the insurance companies don’t decide what’s covered, and neither does the government. “You and your doctor decide on the treatment you need to have,” says Rivera. “Your doctor doesn’t need to check and see what’s covered. If you’re in the system, it’s covered.” The proposed plan would also cover dental, vision, mental health, and long-term care. This is a game-changer for the average working person. “We’re not talking about people who are living off subsidies,” says Robie. “We’re talking about people who are employed, people who are busting their butts and not making enough money for health insurance. When you have to choose between putting food on your table and paying medical bills, that’s not a choice you should have to make.”

While the fight for single-payer healthcare is gaining momentum, Rivera says it could take a long time to jump through every hoop required to set a plan in motion. “It could be years away, but the battle is worth waging.” Before Canada implemented single-payer healthcare nationwide in 1968, it started in one province, Saskatchewan, and spread to the rest of the country over a 10-year period. In the US, the path is likely to begin in one state. New York could lead the way.

It’s going to take a concerted effort to stand up to big insurance and big pharma. Madalengoitia and Robie both volunteer for the Campaign for New York Health to help spread awareness about the New York Health Act. Madalengoitia wants to make sure that others don’t put off going to the doctor because of cost and play roulette with their health the way she did. “I wouldn’t have thought that would happen to me,” she says of her cancer ordeal. “People think, ‘Why should I pay for somebody else’s insurance when that’s not going to happen to me?’ The reality is that we all pay for it anyway.”

Robbins encourages supporters to get involved: Call your state senator and assembly member, and go to Lobby Day in Albany on June 5 to rally for the New York Health Act. (The Campaign for New York Health has buses available.) Tell your story, have conversations with neighbors, and speak up for universal healthcare as a human right—and the right course of action for a first-world country.

RESOURCE

Campaign for New York Health This story is a collaboration between Chronogram and The River, a digital news site on the Civil platform publishing regional news of national importance. The River, the latest project of Luminary Media, will be launching later this month. Find out more and sign up for The River newsletter.

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