While federal plans to repeal and replace the Affordable Care Act were dead on arrival at the U.S. House of Representatives last week, New York advocates for health care reform are working on a state law that could drastically change the way health care is paid for in our state.
The New York Health Act, now wending its way through the New York Senate and Assembly, would create a single-payer health care system, dubbed “Medicare for All” by advocates, which would remove private health insurance companies from the process of paying for health insurance for New Yorkers.
The system would be paid for through a progressive payroll tax that advocates say will make up a substantially smaller percentage of a family’s income than they currently spend on health care.
Advocates for the New York Health Act explained the nuances of the bill to a packed crowd at Southold’s First Presbyterian Church, organized by North Forkers for the Common Good, on March 23.
The discussion was led by Martha Livingston, Ph.D., Professor and Chair of the Public Health department at SUNY Old Westbury and Michael Zweig, Ph.D., professor emeritus and former director of the Center for Study of Working Class Life at Stony Brook University’s Economics Department.
Dr. Livingston, who serves on the Steering Committee of the Labor Campaign for Single Payer Health Care, said the Affordable Care Act “really built on the half of the health care system that is less efficient — the private health care industry.”
She pointed out statistics from the Congressional Budget Office on the millions of people who would lose care under the now defunct American Health Care Act, which was pulled by the White House just before a vote was scheduled in the U.S. House of Representatives March 24.
“This really is a matter of life or death,” she said. “And the idea of an a la carte menu of care, where you say, well, I don’t think I’m going to get cancer so I don’t need that. We can’t ever predict what kind of health care we’re going to need. Health care is not a commodity. It’s a public good.”
Dr. Livingston pointed out that Americans spend 17 percent of our gross domestic product on health care, double the amount spent in most modern economies, primarily due to the money spent on administrative wrangling with health insurance companies
“We’re spending half a trillion dollars a year on meaningless paperwork,” she said.
Dr. Livingston added that the New York Health Act would also improve on Medicare, which currently requires copays, deductibles and payments for prescriptions.
Dr. Zweig pointed out that people who wanted to expand Medicare at the federal level “were eliminated from the process” when former President Barack Obama’s Affordable Care Act was passed in 2009.
“They say that states are laboratories for democracy,” he said. “Let’s start from scratch and do it right. We have that opportunity.”
Dr. Zweig pointed out that government programs, including Medicare, Medicaid and the Veterans Administration, already insure more than half the people in America, and that, in practice, the idea that government administration is inefficient and incompetent hasn’t proven true.
He pointed out that administrative costs for for-profit insurance companies are about 28.6 percent of their budgets, while they are just 3.1 percent of the budget for Medicare.
“People who want to promote the private sector as the most efficient operator have to answer for this,” he said.
Dr. Zweig said versions of the New York Health Care Act have already passed the New York State Assembly four times, and the companion State Senate bill is a handful of votes short of being passed.
The proposal would be paid for through a graduated payroll tax, which would be paid for 80 percent by the employer and 20 percent by the employee. Non-wage income would also be taxed, but pensions and social security income would not.
People who make less than $25,000 per year would not be taxed, and people who make $25,000 per year would pay 10 percent of their income into the health care system, but they would not have to pay insurance premiums, deductibles or copays.
Attendees at the forum asked numerous pointed and critical questions.
Helen Finnigan said she imagined health insurance company lobbies would fight hard to stay in business.
“There’s going to be a whole lot of pushback from the health care industry,” agreed Dr. Livingston. “They will fight like crazy and we will have to fight back. They will have more money than we have, but we will have more people than they have. That’s how it works.”
Dr. Zweig said there has to be a plan in place to help transition the work force in the health care industry to other jobs.
Jim Gilvarry of Southold said he has to rely on two insurance companies, in addition to Medicare, in order to be covered for all his medical needs. He questioned whether doctors would be willing to participate in the state-sponsored system, and added that he heard there can be a two-year wait for a knee replacement in Canada.
Dr. Livingston said there are usually two arguments usually made in the U.S. against single payer health care systems — that they’re not politically possible and that “health care in other countries sucks.”
“We have to wait for non-urgent care here too,” she said. “But in a public system, if you see there’s a backlog, you can fix it because you’re in charge of the whole thing.”
Carol Edwards wanted to know if this is being done in any other state.
“Massachusetts has Obamacare, only they call it Romneycare,” said Dr. Livingston. “It was designed by the Heritage Foundation. It’s a conservative plan built by private industry. We’re hoping to beat California to a single-payer system. It passed their legislature twice but then-governor Schwarzenegger vetoed it twice.”
She added that she’s not sure whether Governor Andrew Cuomo would sign the bill.
“We’ll have to find that out and put his feet to the fire,” she said. “In the Senate, we’re five votes short. We can do this, this year or next. Is he going to want to run for president in four years and be the one to say he vetoed single payer health care in New York?
You can read more about the proposed New York Health Act on Campaign for New York Health’s website, http://www.nyhcampaign.org.
North Forkers for the Common Good is also planning to sponsor a bus to Albany for the April 4 “Health Care is a Human Right Day of Action.” The bus will depart the Mattituck Shopping Plaza at 5 a.m. Tickets range from $25 to $55 and are available on Eventbrite.com at “NY Medicare For All Lobby Day.”