New York is Close to Having Universal Health Care
On May 4, House Republicans celebrated the narrow passage of a messy healthcare bill few of them apparently read, despite the promise that it will kill tens of thousands of their constituents in the unfortunate event that it makes it through the Senate. Here in New York, Governor Andrew Cuomo was quick to release a forceful 175-word statement condemning the American Health Care Act as a law passed by “ultraconservatives” that would “tear apart our healthcare system.”
Luckily for Cuomo and the nearly 20 million of us who live here, there’s a readily available solution that would rescue us from this hell: the New York Health Act, which would give every New Yorker access to state-funded coverage. And the best part? It’s as close as it’s ever been to becoming a law.
The bill was originally proposed by Assembly Member Richard Gottfried in 1992 and has passed in that chamber a total of three times, most recently in 2016. As the Voice reported in January, the plan would finance a universal health care expansion through progressive taxes on the wealthiest New Yorkers and save money on pharmaceuticals by buying them in bulk. Coverage would resemble that of Medicaid and Medicare and include services like eye care and dental.
Critics have protested that single-payer is not the health panacea its proponents make it out to be. Bill Hammond, the health policy director at Empire Center, an Albany-based think tank, warned that other countries with single-payer plans, like the United Kingdom and Canada, “have long waiting times to see specialists, pay their doctors and nurses significantly less, and, in some cases, ration access to expensive procedures and drugs.”
Yet there is no evidence to uphold the substance of these concerns and plenty that directly refutes them, said Gerald Friedman, the department chair of the University of Massachusetts at Amhert’s economics program, who in 2015 authored a 56-page analysis of the NYHA. As the Voice wrote previously, Friedman contends that the act would reduce total health care costs in the state by about 25 percent — more than $70 billion out of $287 billion for 2019. New York is currently home to at least 1.3 million uninsured residents who would gain coverage under the act, in addition to the 2.7 million whose insurance would likely be threatened by an ACA rollback.
As for the fear of rationed access, Friedman told the Voice that “the current system already involves rationing — New Yorkers are rationed by lack of health insurance.” He says 20 percent of New Yorkers are unable to visit the doctor because of high copays and deductibles. Under the NYHA, “all of those people would have equal access.”
Additionally, doctors currently squander much of their time filling out forms for the insurance industry — time that under a single-payer system would be spent seeing patients. Hundreds of thousands of dollars are spent each year on insurance-related expenses, Friedman said, adding that across the country, hospitals have more people employed for billing and insurance than they do beds. This stripping-away of cumbersome bureaucracy would likely drive more doctors to practice in New York, thus driving down wait times.
“All those resources that go to billing and insurance would go to patient practice,” Friedman said. “If it’s the same dollar, doctors would rather make that dollar dealing with patients than with insurance.”
Katie Robbins, the executive director of Physicians for a National Health Program’s New York metro chapter, agreed that not only will the conversion to a single-payer system actually save the state money, it will also benefit providers and patients greatly. She told the Voice that doctors in countries with single-payer systems often make more money than doctors here because bloated insurance costs aren’t eating into their margins. Plus, she said, polling shows that the majority of physicians would rather practice in a single-payer environment.
For patients on public insurance plans, wait times are already egregiously long, Robbins said. Universal coverage would allow doctors to accept everyone equally. “Right now if you’re on public health insurance, the reimbursement rates are lower, and it’s harder to find physicians,” she said. Under the NYHA, “we could organize that system to accommodate the patient population, and it wouldn’t be about tiered access to care.”
Assuming the NYHA passes the assembly for the fourth time — that vote is scheduled for today, May 16 [update: It passed] — it will be introduced in the Senate by Gustavo Rivera. “Every day we’re understanding a little bit better the fact that we’re going to have to do more at the state level to defend all sorts of populations that are vulnerable,” Rivera told the Voice. “We’re talking about people’s health care and the fact that the national administration is trying to take it away.”
Currently, the bill is only two votes shy of passing in the 63-seat state senate. It recently picked up the support of the influential Independent Democratic Conference, buoying its number of supporters to 30.
A special election on May 23 to fill an assembly seat vacated by now-councilmember Bill Perkins is all but guaranteed to go to real estate developer Brian Benjamin, who has vowed to support the bill, Rivera told the Voice. The only hurdles now include the conversion of just one more holdout — the most likely target is Senator Simcha Felder, a Democrat who caucuses with Republicans — plus a small pile of procedural battles. Felder, who told the Guardian in April that he had no position on the bill, did not respond to multiple phone calls and emails from the Voice.
When and if the 32 votes are confirmed, the bill would head to both the health committee and the fiscal committee, in what’s known as a dual reference. It would then have to age for three days, meaning it must undergo a first, second, and third reading. Only then may it go to a floor vote.
Rivera cautioned against excessive optimism that the initiative will be voted on in the short term. “Those are all very, very tall orders for the short time period that we have this year,” he said. “I’m of the mind that you have to take this one step at a time, and so that’s exactly what I’m doing.”
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