Single Payer New York recommends a "no" vote on the proposed health care reform bill (HR3962) in the US Congress.

The bill falls far short of making health care a right. Tens of millions of Americans will still be denied adequate access to essential health care services.

The legislation fails as real reform in 5 crucial ways: cost, access, choice, disparities and quality.

1. Cost - The bill fails to control the unsustainable cost of our health care system. Instead, health care spending for millions of Americans, especially the middle class and state and local governments, will increase. Instead of eliminating or even curtailing the extremely negative role played by private and for-profit health insurance, the bill does the opposite. Federal taxpayer funds will subsidize insurance companies, not care. The bill also guarantees pharmaceutical industry super-profits.

2. Access - not only will the reform leave millions uninsured, but health insurance will remain tied to your job. When you lose your job you will still lose your health insurance.

3. Choice - Choice of doctor and hospital will remain in the hands of the insurance companies for those who get their insurance through an employer. In addition, the “public option” would, by 2019, enroll only 2% of the population, the poorest and sickest members of society, and according to the CBO "would cost more than private plans."

4. Disparities - the shameful disparities in care in the US, between rich and poor, between rural and urban, between whites and peoples of color, would largely remain intact. More people on Medicaid will not lessen disparities.

5. Quality - the plans to study quality in health care included in the bill do not include the power to implement changes, for example in coverage or in payments. Quality initiatives need resources, not further study.

The first rule of medical care is do no harm. This bill fails this test on many levels. While we understand the desire of some reformers to embrace this proposal since the need to improve our health care system is so great, it would be better for Congress to start over rather than enact changes that will impede real reform for years.

The real beneficiaries of the bill are the private insurance companies who will be getting 50 million new consumers, subsidized by U.S. taxpayers. The government will coerce individuals to purchase a defective product: private health insurance. While millions of Americans will decide to pay a penalty instead of buying insurance, those that do obtain subsidized insurance will still often be unable to obtain the medical services they need due to high deductibles, limited coverage and denials by insurance companies.

Certainly the proposed expansion of eligibility for Medicaid services is important (though it will have less impact in NY.). However, we know from bitter experience that just because a patient has Medicaid, it does not follow that the person will find a caregiver, due to the low level of payments to providers. Major Medicaid expansion will prove unsustainable, for it pushes costs back onto states (and in New York, counties) that now suffer severe budget crises.

While we do not believe that a robust public option would accomplish the above goals, the present public option is so puny and restrictive that it will provide little to no benefit while undercutting the prospects for future reforms.

America needs a health care system that covers everyone (i.e., no one left out); controls costs, starting with eliminating the $400 billion associated with our wasteful system of for-profit insurance; and improves quality, starting with creating a health care system that focuses on preventive health care (i.e., keeping people healthy). We urge Congress today to adopt the Weiner amendment to establish a single payer system, though we are dismayed at the process bringing this critical to a vote. We also support the Kucinich amendment to empower states to individually adopt a single payer system.