Monday, June 12, 2017

STATE ACTION: Phone Storm for Single-Payer Healthcare

This week, June 12-16, we will be calling about Single Payer healthcare (Medicare for all) via the New York Healthcare Act. We are asking for broad support for the concept of Single payer Healthcare and we are specifically asking for support of S4840. This bill was passed the Assembly and Governor Cuomo will sign this into law if delivered to him.
Some key links:
Follow past the break for good talking points, possible counter-arguments, and a detailed Q&A with Prof. Leonard Rodberg of Queens College/CUNY. For more information contact State Committee chair Danielle King at


Here are some talking points in favor of single payer healthcare:

  • It is still unclear where the Federal health policy will go, but it seems likely that many New Yorkers will find themselves with no affordable options for obtaining health insurance. It would be against our values to say that they deserve to be without healthcare because they are not wealthy enough.
  • Relying on emergency rooms to provide healthcare to the uninsured is shortsighted and wrongheaded. Emergency Rooms do not have the funding needed to build out new capacity to handle the radically increasing numbers of uninsured. Also, emergency room treatment of a crisis condition that would have been preventable at much lower cost is a big wast of taxpayer money and provides clearly inferior care to New Yorkers.
  • You can't have a healthy community when the people who mow your lawn and deliver your pizza and drive your school buses don't have healthcare
  • United States has very expensive healthcare but only mediocre outcomes. Single Payer will eliminate a lot of administrative overhead yielding a more efficient system.
  • This is not socialized medicine because healthcare providers will not be government employees. It is just another form of insurance.

Here are some arguments against single-payer that Sen. Murphy may cite:

  • All of the projected costs are fake because there has not been any CBO-style deep analysis of costs and offsets.
  • All of the money you are paying in premiums, copays and deductibles will be paid to the government to cover the cost of this program. This will be a new tax, probably 20% of your income, or more. Middle class New Yorkers will leave.
  • Government employees will be deciding what doctors can charge. Today, if a single carrier sets its reimbursements too low the provider can just not participate with that carrier. Under single payer there is no competition, when the bureaucrat decides the rate there is no recourse. Doctors will leave.
  • If simplified procedures result in cost savings, it is because some of the people employed in administrative jobs will lose their jobs. Massive savings would come from massive layoffs. This surge in unemployment will have direct and indirect costs to the state.
  • Existing Medicare at the Federal level is supplemented by Medicare Alternatives, Medicare Supplements, Pharmaceutical Plans, etc. How many years will it take for private insurance companies to develop and offer supplements like this for NY single payer healthcare?

Q & A prepared by Leonard Rodberg, PhD - Professor Emeritus of Urban Studies/Queens College/CUNY


Q: Is the NYHA modeled after any programs that might already have been enacted somewhere, for example California, Canada, the United Kingdom?
A: The New York Health Act would operate similarly to the Canadian system in that it is a publicly funded, privately delivered system. Traditional Medicare is a similar system as well.
Q: Are the projected costs reliable?
There has not been any CBO-style deep analysis of costs and offsets.
The analysis performed by Prof. Friedman uses the same methodology that CBO or its state equivalent would use. That is, it used the best current data from the Federal and State government, along with the results of more than twenty-five years of research on single payer Medicare-for-All systems, starting with CBO and GPO studies in the early 1990s. So I believe that these results are as solid as studies that will eventually be done by some government analysis office. [note from Dwight, if you would like to look at the 56 page economic analysis you can find it here: http://www.infoshare.org/main/Economic_Analysis_New_York_Health_Act_-_GFriedman_-_April_2015.pdf ]
Q: All of the money you are paying in premiums, copays and deductibles will be paid to the government to cover the cost of this program. Opponents have suggested that there will be a new tax, probably 20% of your income, or more. Middle class New Yorkers will leave.
A: First, the money to support the system will be less than we are now spending to support the private insurance system. Second, the New York Health Act provides the 80% of the payroll assessment will be paid by employers, just as they now pay most of the cost of private insurance premiums. So, overall, most individuals and families will be paying less than they are now spending. In fact, New York will be a more popular place to live because of its superior health care system.
Q: Government employees will be deciding what doctors can charge. Today, if a single carrier sets its reimbursements too low the provider can just not participate with that carrier. Under single payer there is no competition, when the bureaucrat decides the rate there is no recourse. What will keep doctors from just leaving New York?
A: The legislation provides that, as in the current Medicare program, representatives of physicians will negotiate with the Department of Health to assure that reimbursements are adequate to make sure that physicians are fairly paid. However, the representation will be even more broad-based and intensive than with Medicare, because all providers of medical care will be represented and the representation will be guaranteed by the legislation.
Q: If simplified procedures result in cost savings, it is because some of the people employed in administrative jobs will lose their jobs. Massive savings would come from massive layoffs. This surge in unemployment will have direct and indirect costs to the state.
A: Ultimately, about 150,000 workers will be affected. This is just 1.5% of the work force in New York State. The legislation provides funds to help them transition to new jobs. These might include some of the many new jobs that will be created as the number of people accessing health care grows as a result of the new program.
Q: Existing Medicare at the Federal level is supplemented by Medicare Alternatives, Medicare Supplements, Pharmaceutical Plans, etc. How many years will it take for private insurance companies to develop and offer supplements like this for NY single payer healthcare?
A: These supplements won't be needed under the NY Health Program. They are needed now because Medicare has large gaps, including substantial deductibles and 20% copays. NY Health covers the full cost of care, so these supplements are unnecessary, though insurance companies might eventually develop programs to provide amenities, like private hospital rooms, that the program might not cover.