State single payer moving right along

[eridani]

For Immediate Release:
Thursday, March 7, 2013

Contact:
Gottfried:
Mischa Sogut, [phone], [e-mail]
Perkins:
Tom Briggs, [phone], [e-mail]

Universal Health Care for New York Introduced

"New York Health" Single Payer Bill Provides
Comprehensive Coverage Regardless of Income

A plan to provide all New Yorkers with comprehensive health care coverage has been introduced in the State Legislature. “New York Health,” a universal health care bill, replaces insurance company coverage, premiums, co-pays, and limited choices of providers. Instead, it would provide publicly-sponsored coverage with a benefit package more comprehensive than most commercial health plans, with full choices of doctors and other providers. The bill, A.5389/S.2078, was introduced by Assembly Health Committee Chair Richard N. Gottfried and Senator Bill Perkins and is co-sponsored by 83 other legislators.

Gottfried and Perkins were joined at the Albany press conference today by Laurie Wen, Executive Director, Physicians for a National Health Program–NY Metro; Dr. Paul Sorum, former Chair of the Capital District chapter of Physicians for a National Health Program; Vito Grasso, Executive Vice President of the New York State Academy of Family Physicians; Lisa Blodgett, New York State Nurses Association; Doug Bullock, First Vice President of the Albany County Central Federation of Labor; Rev. Frances Rosenau, Associate Minister at the Westminster Presbyterian Church; and Mark Dunlea, co-founder of Single Payer New York and Executive Director of the Hunger Action Network of New York State.

New York would be the second state to pass groundbreaking legislation providing for a single-payer health plan. Vermont was the first, in 2011.

“President Obama said, ‘No American should ever spend their golden years at the mercy of insurance companies.’ But it shouldn’t be just our golden years,” said Assembly Member Gottfried.

"Healthcare should be about health, not profit. I applaud Assemblyman Gottfried for recognizing this as the lead sponsor of the single payer bills over the years along with my former colleague Tom Duane, who previously carried this important legislation and recommended that I continue to sponsor it. For some this may be a new issue, but this idea has been around for years and its time has more than come,” said Senator Perkins.

No one would have to give up their preferred doctors or other providers. Instead of individuals and employers paying high premiums, deductibles and co-pays, the coverage would be funded through a graduated tax on income, based on ability to pay. New Yorkers would be covered for all medically necessary services including primary, preventive, and specialist care; hospital; mental health; reproductive health; dental; vision; prescription drug; and medical supply costs.

“Health care should be a right, not a privilege. Coverage should be driven by the needs of patients, not insurance companies and stockholders,” Assembly Member Gottfried said. “You and your doctor work to keep you healthy. New York Health will pay the bill.”

“I have always advocated that your health is your wealth. Affordable health care demands broad bipartisan support. I’m proud to sponsor this important bill and look forward to working with my colleagues and the governor to see it become law,” Senator Perkins added.

For most people, New York Health will represent a net income savings compared to the current, regressive system of insurance premiums, deductibles, and co-pays.

Single payer models have dramatically lower administrative costs than private insurance. In 2009, the New York State Department of Health and Insurance Department found that a single-payer system would provide universal coverage at a lower total cost than plans relying on private, employer-based coverage.[1]

* * * * * * *

“With single payer, New York manufacturing would be more competitive with the western European countries and Canada that have had universal health care for decades. Single payer would be a big boost for unleashing creativity and entrepreneurship by permitting bright young students to start their own businesses without having to choose work in particular industries simply for health insurance.” --Wayne Bayer, Public Employees Federation Executive Board Member and Delegate to the Albany and Troy Labor Councils

“Right now, five New Yorkers die every day due to lack of health care, and many go bankrupt from medical bills. That is unacceptable and inhumane. A universal, publicly financed health care system would save lives AND money. It’s a win-win situation for patients, physicians, and our economy.” --Laurie Wen, Executive Director, Physicians for a National Health Program – NY Metro

“High health care bills are one of the main reasons that 3 million New Yorkers have to use emergency food programs annually. Unfortunately, the new Federal health insurance mandate will still leave many New Yorkers without access to affordable, quality care. We need a state single payer health care bill to make sure everyone is covered.” --Mark Dunlea, co-founder of Single Payer New York and Executive Director of the Hunger Action Network of New York State

“A single payer system is the only reform that will actually address the enormous cost of redundant administrative requirements by providing one uniform public plan offering the same level of quality care for all New Yorkers. It also includes a collective bargaining component to empower physicians to better advocate for patient safeguards and ensure that there is deference to clinical decision making by physicians.” --Vito Grasso, Executive Vice President of the New York State Academy of Family Physicians

“What physicians want, above all, is to provide all our patients regardless of their insurance with the health care we and they think they need. Please, New York State legislators, adopt this bill and allow us to take care of our patients rather than their insurance companies.” --Dr. Paul Sorum, former Chair of the Capital District chapter of Physicians for a National Health Program

[drm604]

1. How likely is this to pass?

I wish my state, PA, would do this.

[Victor_c3]

4. I'd imagine that something like this will take a lot of time to pass

It might make it in NY in the near future, but for the idea to spread to other states and then federally might take a lifetime.

[SoCalDem]

54. When it happens, companies will FLOOD in to "create jobs"..

Broadening the tax base, and thus lowering the cost to all for the coverage..

When companies no longer have to worry about the paperwork, cost and hassle of providing care, they can concentrate on commerce and perhaps giving people raises again.

People can also finally leave those dead-end jobs they hate and start up their own companies.. When you are young, eager and have a family, your dreams wither on the vine

[eridani]

6. Make it happen with Health Care for All--PA

http://healthcare4allpa.org/

They even have a retired Republican state legislator on their board.

[drm604]

23. It won't happen with our current state government.

Corbett won't even go along with Medicaid expansion.

[ReRe]

55. I think it's very likely to pass in NY State....

...have you noticed what they have been up to lately? As per Gun Control, "Fracking", etc? I think the state is on a roll to the left, determined to save itself from what's going down with the rest of the country. More power to 'em, is what I say...

[Victor_c3]

2. All I can say is "wow!"

I sure hope that this becomes a reality. Andrew Cuomo keeps saying how he wants to make New York States a progressive example for the rest of the country.

I'd probably stand to get my butt kicked with the new taxes required to pay for this (I bring home a pretty decent salary), but I'd be willing to pay a little bit more for a more fair system. Waitresses, janitors, and under-paid store clerks deserve the same ability to stay healthy as the rest of us. It isn't like they don't provide a valuable service to our society...

I'd hope that the taxes wouldn't be much more than the amount that I currently pay for my health insurance coverage, but we'll have to see. Also, if I'm not paying my 1/3 of the total cost for health insurance maybe my employer can sent the other portion they aren't paying to my paycheck.

[Squinch]

47. But at the same time, the NY legislature is defunding programs for the disabed, so I don't

really get this. It seems like they are working at cross purposes to themselves.

[RC]

3. How can we be the Greatest nation on earth, if we can't/won't even take care of our own citizens?

Every other industrialized nation has a form of Universal Health Care. None of those other countries want to go back to what they had before. And for sure, absolutely none of them want what we have now for health care in this country.
So why is it so hard to go with the most obvious, the most humane course of action, which is what every other industrialized nation on the planet has already done? Single Payer, Universal Health Care. The hard work has already been done by these countries. All we have to do is cherry pick what works. What is so hard about that?

Health care in other countries is a social service. Here in the United States, it's big business. Your money or your life. No money? Die and get out of the way for someone with money.

We have NO real health care system care in this country. What we do have is a for profit, patchwork of coverage for some people, if they can afford it that is, and literally nothing for many millions of others. If you are too sick to work regularly or to maintain a job that does provide health insurance, then you will have most likely not be able to afford health insurance. And you most likely will remain too sick to work. That is a terrible cycle and one that this country MUST eliminate.
Why do we stand for this shoddy treatment when other governments actually take care of their people? I do not understand. For starts, what we need to do is what other governments have done decades ago. And that was to prohibit the "Your Money or Your Life" health insurance companies from covering general health care. Why do we still allow this?

RC

[center][/center]

[Plucketeer]

25. Agreed

‘No American should ever spend their golden years at the mercy of insurance companies.’ But it shouldn’t be just our golden years,”

So I'm proposing we subsidize the health insurance industry to insure they're there to take your money.

[xtraxritical]

50. You're not serious about that "greates nation on earth" nonsense are you?

[RC]

53. Well, we could rightfully claim that at one time

Some still try to.

[xtraxritical]

59. What time was that, before the Europeans got here?

[RC]

61. Sounds about right.

[RC]

62. That's all you got from my post?

"greates nation on earth" nonsense?

You missed all the rest?

[ananda]

5. Wow.

I wish I lived in a state like that.

[eridani]

7. Check out state chapters of Physicians for a National Health Program

http://www.pnhp.org/

[Left Coast2020]

56. Well that state used to be my state of Calif.

It was numero uno in education before ronnie ray-gun, or that other repug Dukmejiun. I wish this state could have been the innovator as it was in the past. Oregon too was working at being creative. At least it passed and started vote by mail which increased turnout.

California should have been doing this first. Glad we don't say "kali-fornya" any more. Arnold's gone.

[Jim Lane]

8. Wouldn't single payer in one state lead to reverse cherry-picking?

The private, for-profit insurers engage in cherry-picking by insuring only the people least likely to need expensive care. If New York were to establish single payer, then uninsured people from around the country who were diagnosed with cancer or who needed a transplant or whatever would have an incentive to move to New York to get the treatment that they otherwise couldn't afford. The result would be to skew New York's cost curve. Single payer would show high costs, and would look inefficient compared to the private market, but it would be because an artificially high percentage of the population was using the most expensive services.

Does anyone know how the New York bill would deal with this problem?

[eridani]

9. Most state single payer bills have residency requirements n/t

[dkf]

11. And how difficult is that?

[thesquanderer]

46. If you had to be a resident for two years to qualify...

...that would eliminate being able to go to New York for the life saving treatment you can't get where you are.

It's terrible that it would come to that.

But to not permit the single payer benefits to ANYONE because they are not yet available to EVERYONE would be a mistake. It has to start somewhere. Better that some people have it than nobody have it. Then, when people (and other states) see that it works, it will spread. Transition periods always have their issues, but you can't get from here to there without them.

[eridani]

51. Not to mention which, single payer doesn't give people jobs or housing n/t

[dkf]

10. That's what I am wondering.

[Capt. Obvious]

28. Of course you were

What's going to happen is thousands of people will be driving up the New York state border and dropping their dying relatives off at the first rest stop.

That's what's happening in Vermont right now.

[dkf]

30. Even if they say you need to be a resident are they then going to leave these people on the side

Of the road?

[Capt. Obvious]

36. That's exactly what's happening in Vermont right now

Orphaned elderly people left to wander the rest stops until the state takes them in and takes care of their exorbitant health costs.

New York - think about what you're doing.

[dkf]

39. If they want to take that on more power to them.

Well that's one way of making the financial industry pay more taxes.

[happyslug]

44. But such elderly people are 100% covered by Medicare and Medicaid.

What Medicare will not pay, Medicaid will pay. The only downside is the State has to pay 50% of the costs of Medicaid. Which also means 50% of the costs are carried by the Federal Government.

Now, Obamacare will change this, increasing the percentage paid by the Federal Government.

Thus "Orphaned" elderly are NOT a problem, for they are treated the same no matter what state they are in.

Single payer insurance is aimed at those people below age 65, this is the group with the most money and the least amount of actual medical costs (Most medical cost are in your last five years of life). That this group had seen a drop in income, leading to them NOT having private health insurance is the problem Obamacare was designed to cure (That people below age 65 NOT having Health Insurance NOT the drop in income for people below age 65).

Single payer would increase the rate of insurance among people below 65 at lower costs then Obamacare by the simple fact Government, when it comes to a universal service, since it is a SINGLE entity, when Government provides the service it can do so at much lower costs then private companies who MUST spend money to make sure they are NOT spending money on other private insurance company's insured.

Sorry, your story of people leaving their elderly in another states, does NOT make sense, it violates HOW the Federal and State Government share the cost of taking care of such people. The states pay some of the costs, up to 50%, but the Federal Government provides the rest, and at times up to 80% of the costs.

[Jim Lane]

49. Vermont has not yet implemented single-payer.

I know you were just being sarcastic, but the serious point is that there is, as yet, no Vermont experience to inform other states (or the federal government).

Here's the information from the State of Vermont's website:

In May of 2011 Vermont passed Act 48, putting the state on the path to implementing a universal and unified health care system that covers all Vermonters. The path to publicly financed, universally available, high quality health care coverage is complex. Like any complex journey, this one will be accomplished in several steps.

The Vermont Health Benefit Exchange will go into effect January 2014. Today, the state is working to implement the Exchange as mandated by federal and state law. At the same time, we are planning ahead in accordance with Act 48 to implement Vermont's single-payer health care system. The single-payer system will not go into effect until a number of milestones are achieved, including obtaining a waiver from the federal government and approval by the Vermont legislature of a financing plan that meets the requirements of Act 48. (from "Health Care Reform Timeline")

[Tom Rinaldo]

13. Just speculating here, but I don't think that it would be unmanagable

Most people have accute tunnel vision when it comes to major life choices. Moving from one state to another for services requires thinking outside of the box, not to mention significant life disruption associated with relocation; loss of employment of self or spouse, seperation from family and friends, real estate sales and purchases and the like. I'm not saying that there would not be people who would pull up their roots in order to qualify for affordable health insurance should a major illness hit, but I think the overall costs associated with some doing so would not be so large as to sink the program or obsure its inherent cost saving advantages.

[Lydia Leftcoast]

18. Countries that actually have single-payer generally provide true emergency care only to foreigners

For example, if you break your arm in Canada or the UK, they will put it in a cast and give you some pain pills, but they won't provide any follow-up care. If you have a heart attack, they will stabilize you and urge you to go back to your own country for further treatment. Nor will they treat you for minor ailments.

This is one thing the right-wingers didn't understand about the sad case of actress Natasha Richardson, who suffered a head injury while skiing in Canada. The Canadian system stabilized her, but then, since she wasn't a Canadian citizen or legal resident, they sent her back to New York, where she was living at the time. The right-wingers interpreted this as meaning that Canadian hospitals weren't competent to treat head injuries. They are, but Richardson didn't qualify for extended treatment, since she was only visiting Canada.

[Tom Rinaldo]

20. Exactly. Though many might be tempted to visit a "Single Payer" State for treatment...

...far fewer would actually move to and become a legal resident of one for that reason

[dkf]

31. Or you could be desperate.

[Tom Rinaldo]

34. Yes. It might make sense for many but human nature being what it is...

...many of those for whom it would make sense wouldn't do it. Some obviously would, as well they should if that were the only way to get life sustaining treatment. But it is hard enough to get some people to just go to the doctor even when the need is fairly obvious. It takes breaking through a lot of inertia to pack up and actually move

[The Blue Flower]

17. You'd have to qualify to be a resident

That means you'd have to pay the same tax to cover the cost as everyone else.

[jeff47]

24. Presumably, there could be a residency requirement. But you also have to think of the size

New York has a lot of people. The number of people who move to New York in order to get cheaper healthcare should be a fairly small percentage of the overall NY population.

And keep in mind the entire point of the ACA is that there would not be "expensive" diseases - at least for the patient. The exchanges and the rest of the strum and drang should greatly reduce the incentive to move.

I'd be far more concerned about people moving to Vermont, since they have relatively small population.

[eggplant]

42. Yes, that would be tragic. (Not.)

Think how terrible it would be for those people who otherwise would have to just DIE since their states suck would come here for treatment.

This seems remarkably like asking what the north will do with all those slaves that move here and become free.

[Jim Lane]

48. There's no call to make your analogy to slavery.

My concern is not that some people might get health care. (As a cancer survivor who's too young for Medicare, I might end up being a medical refugee myself.) As my post made clear, my concern was for how a bad experience might set back the cause of single payer nationwide: "Single payer would show high costs, and would look inefficient compared to the private market...." This would be a bad argument, but the right-wing noise machine would trumpet it ceaselessly.

Most DUers know that a proper nationwide single-payer system would be much more efficient than the private market. Unfortunately, we have a ways to go to convince enough people of that to have a realistic chance of getting it through Congress.

[mother earth]

12. Single payer is going to happen. Our current system has been a mess, providing miniscule coverage

at maximum cost. It is simply unsustainable, & the sooner we understand that, the sooner we smarten up & go single payer. If all men are created equal, than all should have access to a real health care system that provides quality of life not just to the privileged few.

K & R, eridani, thank you for all you do at DU.

[dotymed]

14. Watching Dan Rather this morning, he was speaking of all of the

unemployed phD scientists and mathematicians. Some have decided to go to medical school. If most did this we could easily employee many bright people. They could earn a nice salary (like in Europe) and provide universal health care for a very deserving society. Corporations should not be able to profit from people's suffering. All other industrialized nations recognized this long ago.

This would be a win/win proposition for America. The greedy health insurance CEO's might not profit from this but they have kept us slaves way too long.

[Lydia Leftcoast]

19. Even faster, if all the army medics were trained to become nurse practitioners or physician's

assistants, we could set up clinics for routine, non-emergency care (check-ups, minor injuries, immunizations, minor illnesses) all over the country.

I wonder how many nurses and PA's, hell, even MD's, could have been trained tuition-free for the cost of the Iraq War. At $250 million a day, quite a few.

An acquaintance of mine who has lived in Israel said that they train as many doctors as possible tuition free, so that there's no shortage and so the new MD's don't graduate with a huge debt burden. They are therefore willing to accept lower fees than U.S. doctors. Furthermore, everyone is covered by a basic medical policy but is urged to buy insurance for extras such as elective surgery, a private room, etc.

[dkf]

32. Do we have a nurse shortage?

[Lydia Leftcoast]

43. I'm talking about nurse-practitioners and PA's, who can perform routine checkups and treat minor

illnesses and injuries. With clinics set up around the country, we could take the pressure off hospital emergency rooms for non-emergency ailments.

No, we don't have a shortage of nurses, but my understanding is that we would if hospitals staffed to their actual needs instead of trying to make one nurse do the work of two. I don't know if you've visited a hospital lately, but the nurses RUN between patients.

[riverbendviewgal]

15. hooray

I am rooting for NY.

[bluedigger]

16. Gun control, fracking, single payer...

What the hell is going on in the NY State Assembly?

[theKed]

33. Very good things

An example for other states.

[bluedigger]

35. Do they have a supermajority?

I haven't heard of this much progressivism since the New Deal.

[theKed]

37. I'm not sure

I know California does - I would love to see them run at this, too. Two of the populous states doing this would be monumental. That would be one in 6 americans covered with single payer.

Interesting note - the coverage laid out is even more comprehensive than in next-door Ontario (they don't cover optical or dental)

[AllyCat]

21. And our dumb state (WI) is gutting our once great public health insurance program

so we can prove we don't take kindly to government largess.

I wanna move!!!

[KittyWampus]

22. Paying my health insurance is crushing our family business. The premiums are INSANE.

And they just keep going up. They can never be too expensive.

We were talking about letting it go and just getting catastophic/hospital… but I'm getting a bit older now.

[Fantastic Anarchist]

26. This is fucking awesome!

K&R

[BrotherIvan]

27. ++++++++!

I'm praying for California too! Two big states leading the way and showing the fools that single payer healthcare is the best way to go. This will be a tremendous boon for business as well. I've never understood why all those businesses are willing to pay up so much money in employer-chained healthcare so another company could make obscene profits. It just boggles the mind.

[Fantastic Anarchist]

41. I've never understood that, either.

You think capitalists of all the other industries would be all for it, right? Nope.

I have heard that it does keep salaries down in terms of the leverage corporations have with offering benefits, but I just don't see how that could outweigh the increase in revenue/profits, not mentioning having a healthy workforce is having a productive workforce.

But, that's just another internal conflict with capitalism.

[mountain grammy]

29. way to go NY. Here in Co. our new Democratic majority is moving gun regulation

And marriage equality. Guess single payer will have to wait but maybe next year.
Democrats take back your state governments!

[Wounded Bear]

38. I was hopeful of this....

ObamaCare was none too good, though a slight improvement. What I was hoping for was that after that, true single payer in some form would start emerging at the state level.

Kudos to New Yourk for leading the charge. California actually passed a bill that got vetoed by Gov Schwarzeneggar. Hawaii actually has it. Wash had a pretty good healthcare plan for the poor called Basic Health that has been laargely gutted in the recent budget wars. I'm hoping they revitalize and expand that.

Sure, there are kinks to work out, but the real question is political will. It's starting to build nation-wide, and if we destroy the insurance industry, I won't cry much.

[pnwmom]

40. How does this work with different doctors charging different rates?

Will all doctors in a specialty be paid the same thing or how will it work?

Will people really be able to keep their own doctors or will doctors be allowed to opt out of participation?

[eridani]

52. Under global budgeting, health care providers would negotiate yearly with the

--health board to set the prices of covered procedures. Capital and operating budgets would be separate.

[pnwmom]

57. And will some doctors be able to opt out altogether, like they can with Medicaid? n/t

[eridani]

58. Only if they don't want any patients except for those wealthy enough to opt out n/t

[happyslug]

45. The Federal Court has ruled you can become a resident of a state within 30 days

If a state sets a longer residency requirements, the Federal Courts have been hostile to any longer residency period.

On the other hand, if you are earning less then 133% of the poverty level ($14,856), under Obamacare your medical coverage will be paid 100% by the Federal Government over the next two years and then slowly be reduced to 80% paid by the Federal Government.

Thus if you are earning less then $14,856 the Federal Government will pay 80% of said costs (100% for the first two years of the program).

http://obamacarefacts.com/obamacares-medicaid-expansion.php

If you are over 65, you have Medicare, if low income Medicaid will pay any co-payments. If you are earning less then $14,856, over the next three years, if the state agrees to participate, the Federal Government will pay 100% (Then slowly drop it down to 80%).

Thus we are looking at people less then 65 years of age and whose income is over $14,865, These tend NOT to have serious medical problems (if they did, they income drops below $14,865 and thus medical care is 100% Federally paid for).

Thus with the passage of Obamacare, Single payer at the state level can save money. As to people moving to a single paying state, if they do and they have no income, then medical care is 100% Federally paid for the next two years, and then 80% paid for afterward.

Thus the various statements that this will encourage people to move to a single payer state, would be right, except the people most likely to do so would be covered by Federal payments for the Medical care no matter what state they are in and thus have no real incentive to do so.

[Politicub]

60. Kick for progressive change

Universal HC may happen state-by-state initially, and then snowball like gay marriage public opinion.

I haven't given up hope on Medicare Part E (for everyone).

[Quantess]

63. Kick

[eridani]

64. Assembly Health Chair: 2013 ‘A Superb Year’ To Pass Single-Payer Insurance

http://statepolitics.lohudblogs.com/2013/03/07/assembly-health-chair-2013-a-superb-year-to-pass-single-payer-insurance/

Assembly Health Committee Chairman Richard Gottfried, D-Manhattan, has carried a single-payer health care bill in New York for more than two decades. But Thursday, he said this is the year it will pass.

The bill, dubbed New York Health, replaces insurance company coverage with publicly sponsored universal health insurance. Patients contribute to the program based on their “ability to pay,” so higher-wage earners pay a higher percentage and low-income workers pay less.

A similar bill passed in Vermont in 2011. In New York, the bill has passed the Assembly only once—in 1992.
“Getting a bill like this to the floor and passed takes a lot of work from advocacy groups. And over the years, advocacy groups from year-to-year have been more focused on what were seen as more urgent, pressing issues, including fighting for better health care reform at the federal level,” Gottfried said Thursday at a noon news conference. “I think this year is really a superb year to refocus that effort on this issue, and I expect that to happen.”
He said he is “optimistic” about the bill’s chances in the Assembly, where it has 74 sponsors. Sen. Bill Perkins, also a Manhattan Democrat, used the word “optimistic” as well to describe his feelings about the bill’s outcome in the Senate, where there are 11 sponsors.

Gottfried dismissed the argument that New York should wait to see the full implementation of the federal Affordable Care Act before changing to a universal health-care system.

He said he knows how the Affordable Care Act will work.

“We know what things it tries to change and what things it doesn’t try to change,” he said. “It doesn’t prevent insurance companies from skyrocketing premiums. It doesn’t give us premiums based on ability to pay. We already see the insurance industry moving to jack up premiums in anticipation of the ACA. We already see a growing number of employers planning on dropping health coverage. We see more and more insurance plans having high deductibles, which to most people, means you’re paying premiums, and you’re getting nothing in exchange. And the core of the ACA is to leave the vast majority of us in the hands of insurance companies.

“So there’s really nothing that we need to wait to see how it works, because it’s all out on the table, we can do a lot better,” he finished.