NY’s Single Payer Health Law: Universal Access to Comprehensive Health Care

Greetings. I live in Long Lake and have been a member of the Campaign for NY Health for five years. The only goal of the campaign is the enactment of the NY Health Act.

For those of you who may not be familiar with the term, “single payer” health care in the United States is so called because the government, whether national or state, becomes the Unique payer to healthcare providers for the costs of all medical services, including dental, optical, pharmaceutical, long-term care and mental health, incurred by their subscribers. This is a role now played by the Center for Medicare and Medicaid Services (CMS) for people 65 and over who are on Medicare and for those who receive Social Security disability benefits. When and if the single-payer system is adopted, commercial or private for-profit health insurance companies, the major health care payers of their subscribers over the past fifty years, will be prohibited from selling insurance policies. private and will no longer play this role; which explains, in large part, the fierce opposition to the adoption of the law of the single payer. Billions of dollars are at stake.

If you’ve heard of the one-time payment through the mass media rather than the various organizations that actively support NY Health – the Campaign for NY Health; Doctors for a national health plan; NYS Nurses Association – you have probably been misinformed.

No, single-payer health care is not socialism – like Medicare, it is informed by social democracy, by the belief that health care is a right to which all residents of the United States and individual states are entitled.

No, the single payer does not take away your right to choose your doctor or health care provider. Your current insurance policy does this by limiting which providers you are allowed to see without incurring extra charges; often requiring prior approvals for now standard tests such as MRIs and CT scans; still requiring deductibles and sometimes high user fees. Without restricting access to healthcare, which is what these measures are aimed at, private insurance companies cannot make a profit for their shareholders.

NY Health does not enforce any restrictions. Rather, it has two objectives: to provide access to full health care at all people who live or work in NYS, including the two million New Yorkers who do not have health coverage; and provide it at a reasonable cost, much lower than that charged by insurance companies, even if your health benefits are provided by your employer.

Specifically …

Advantages, for all NYS residents or those who work in the state but live elsewhere, once you sign up for NYHealth:

  • Full: all medical, hospital and outpatient care, dental care, ears and eyes, prescription drugs, mental health, long-term care, without deductible or co-payment; an exclusion – cosmetic surgery, with the exception of repairs for injury or congenital impairment; no limits on suppliers in New York State and, shortly after enactment of the law, in most states of the United States.
  • Included: If you receive any federally granted or protected medical, disability or retirement benefits – Medicare, Medicaid, VA, ERISA – you continue to keep them, but you are eligible for all NYHealth benefits.

… In addition, all registrants can see the supplier (s) of their choice in NYS and, in most states of the United States; Since all reimbursement rates, if they are 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 an average of $ 6,100 per year;

… If you are receiving other federally protected retirement or disability benefits – eg ERISA, VA, etc.

  • Finally: Counties will no longer be forced to pay their $ 8 billion share of state Medicaid costs. These will be fully absorbed by NYHealth, allowing each county to reduce property taxes, now used to pay their Medicaid allowance.

In sum, the 2 million New Yorkers, 10% of the state’s population, who do not have access to health care will now have it; up to a third of New Yorkers who regularly postpone health care will now no longer be forced to do so; and no New Yorker will have to accumulate medical debt once enrolled with NYHealth.

Costs: A good number of costs, addressed via an elaborate financing mechanism, too complex for this article. I will give a brief overview of the data from the Rand Corporation An Assessment of the NY Health Act (2018) and Dr Leonard Rodberg Summary and assessment … from the Rand Study (2018), to be found on the Campaign for NY Health website, www.nyhcampaign.org.

Given current health spending patterns, NYS and its residents are expected to spend $ 311 billion in 2022; unlike the NY Health Act, with net savings of 3.6%…

graphic source of funding

The big changes when the NY Health Act becomes law – more private insurance underwriting by individuals, businesses and organizations and the end of deductibles and user fees for policyholders; replaced by an NYHealth tax; savings from reduced administrative billing costs and lower negotiated drug costs; resulting in a net saving of 3.6%. The estimated 11.4% savings will be used for additional health resources in anticipation of increased demand for services.

The ten-year estimate of the Rand Corporation’s cumulative net savings, expenses vs revenues, will be 2% per year for the period 2022 to 2031, with annual costs reduced by 3% or $ 10 billion by 2031.

The big bone of contention is the dramatic increase in progressive income taxes, about 20% payable by employees, the remaining 80% by their employers, with total amounts for each lower than those currently paid for employee bonuses. private insurance. According to Dr. Rodberg, NYHealth will initially need $ 159.6 billion per year in payroll taxes and non-wages to cover all costs …

pay for ny health chart

Note that the schedule’s tax rates, while hypothetical, are based on realistic assessments of the financial condition of New Yorkers; they cannot be finalized until the NY Health Act is enacted. It should also be noted that the first $ 25,000 of an individual’s income will not be taxed. Ultimately, healthcare tax rates are graduated to ensure the inclusion of the 80% of New Yorkers who earn less than $ 100,000 a year. The rates are also set per individual and not per household, so the incomes of all members are counted to determine the cost per household or family. Currently, a private health insurance policy for a family of four is $ 27,000 annually (Kaiser Santé news, 2021), over $ 3,000 in deductibles and co-payments, up from $ 21,000 in 2017. Take another look at the numbers.

Conclusions and prospects for adoption: When and if enacted, the NY Health Act will offer a full range of benefits to ordinary New Yorkers that the vast majority of us could never have afforded. This will not only provide us with unexpected income, but also great peace of mind, welcome relief from the constant fear and anxiety regarding our well-being and that of our families. As a result, the passage prospects are uncertain. Since the NYHA bordered on Legislative Assembly approval in 2019, opposition forces have rallied, galvanized by the prospect, especially those corporations with the most to lose financially, whose lobbyists will flood Albany and Washington’s unique anti-payer. Messaging.

The prospects for passage of the bill can be best measured by the support we receive from New Yorkers who will benefit from its enactment, people like many reading this.

If you want additional information or want to get involved, start by logging into the Campaign for NY Health website, www.nyhcampaign.org. If you scroll to the top of the title page, click any of the links, starting with “Learn” and scrolling down to “FAQ”, to learn more about NY Health and the campaign. If you would like to get involved, contact one of the campaign co-directors, YuLing Koh Hsu, [email protected], or Ursula Rozum, [email protected].

You can also contact me at [email protected] or log onto my FB page, North Country Access to Health Care Committee.

Jack Carney

Jack Carney

Jack Carney is a clinical social worker who retired after fifty years of practice, nearly forty of which in the public mental health system. He received his MSW from UCLA in 1969 and his DSW from CUNY in 1991. He is also a trained family therapist, trained in dialectical behavior therapy, and has devoted much of his professional life to teaching and counseling. training mental health professionals, developing and implementing innovative treatment approaches and programs, and conducting research in clinical practice. He retired in 2010 from a large New York welfare agency. He now lives with his wife and their two cats in the Adirondack Mountains of upstate New York, where he spends much of his time writing provocative leaflets and working as a community and care advocate. health care, heavily involved in the campaign for NY health and the enactment of single payer health care statewide – the New York health law – and national – Medicare for All – on a based. He is the author of a book of essays – Nation of Killers: Guns, Violence, White Supremacy – The American Dream Become Delusion, published in 2015 and available through Amazon. He has also published over 40 blog posts on Mad In America and Op-Ed News, all concerned with the political deterioration of the U.S. state and its institutions and the steps ordinary Americans can take to oppose a oppressive corporate ruling class that crushes the life and dynamism outside of us. A nearly complete list of all of his writings – a work in progress – can be found on his website, www.paddling upstream.org.

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