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NY Senate Bill S5474 proposing a universal single payer health plan for NYers

nysenate.gov

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Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#41

Post by lettergram »

rootusrootus wrote: post #17
ldayley wrote: post #4

With California and New York both exploring statewide single payer healthcare it looks like the Overton window is moving closer to legitimate discussion of a nationwide single payer plan in the US. It’ll be interesting to watch, since this is such a hot-button topic here on many levels.

Something is going to have to change. As it stands, there isn't a plan on the national insurance exchange that I can buy that's even remotely as cheap as my company's plan (actual premium, not just the fraction paid for by employee).

Probably because your company can negotiate and control the population characteristics (unlike the exchange). Or is self-insured, meaning they aren’t profit motivated.

Insurance on average is always more expensive than not having insurance on average. The question is given that risk, how much of a premium can / will insurance companies take. Turns out they like high profits and low risk.

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#42

Post by jjoonathan »

VWWHFSfQ wrote: post #16

If this is anything like the ACA then the vast majority of New Yorkers will end up paying twice for insurance. Once in taxes to subsidize the single-payer marketplace, and then again for their own employer-based insurance. Have to start somewhere though, I guess.

Nooo! Public option is not a half measure, it's a ~zero measure.

Single payer >>> public option. Public option is really easy to kill, just kneecap it any of a hundred ways, call it a failure, and then sell killing it as a tax break. It has the staying power of a cobweb on a car wheel. Failure is inevitable and it won't just be dead, it'll be held up for decades as proof that our government is uniquely incapable of doing insurance.

Contrast to single payer, which is hard to kill because people are yes paying a tax but also seeing a benefit and seeing a benefit that they didn't have before (healthcare doesn't go away if they lose employment). It doesn't suffer from adverse selection, it isn't an easy target for kneecapping, and it has a chance in hell of actually working.

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#43

Post by outside1234 »

aserdf wrote: post #30

it will be interesting to watch NY (and/or CA) put something like this in place and observe from afar. i strongly feel that states should be much more aggressive running policy experiments if their constituents desire them, and at the national level we all get some benefit of seeing how things turn out in real time. all that said, assuming there is some tangible tax increase, NYC high earners are going to be knocking…

Remember that this expense is also reducing the cost of employers.

One of the best ways to finance this would be a payroll tax that is basically equal (in aggregate) to the insurance the company is (usually) already paying.

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#44

Post by newaccount2021 »

ceejayoz wrote: post #5
endisneigh wrote: post #3

Earlier quoted context omitted.

It would be shocking if it didn’t

No, it wouldn't. The European single-payer systems pay half what we do per-capita, factoring in private and public spending in both systems. The US system is wildly cost inefficient. See the chart at https://data.oecd.org/healthres/health-spending.htm

No post body was provided.

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#45

Post by endisneigh »

ceejayoz wrote: post #39
endisneigh wrote: post #25

Earlier quoted context omitted.

Not really, there are people who get great health care for free from their employer, and others who get a greatly discounted rate. Their employers will not necessarily savings with their employees. The result for these employees could be more taxes for the same or worse care they’re already receiving. In aggregate I believe it’s the right move but let’s not act like everyone wins here.

> Not really, there are people who get great health care for free from their employer, and others are a greatly discounted rate, who will not necessarily share savings with their employees. Then require that savings be shared. Make it a legal requirement that any company that has employer-provided healthcare must rebate employees the premium costs if they opt-out.

That makes no sense, salaries would simply be adjusted to compensate. The kind of bureaucracy you’re proposing is why things are already so complicated to begin with.

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#46

Post by goatcode »

Coming from a country that has this, there should be caution: it gets more affordable, but you get what you pay for. In my country of origin, you get a partially-paid-for ride to the emergency room, where you pay for things like casts, non-ward rooms, dental care out of pocket. There is no prescription coverage. There is no optometry coverage. I would wait significant chunks of a year for procedures and diagnostics. To cover the things that aren't covered, most have private insurance through work or also out of pocket.

Since moving to the US, it is more expensive (than next to nothing), but I actually get good care. Several conditions that were ignored or misdiagnosed for me are now cured. My life might be significantly shorter had I not come here.

If NY does this, the near zero chance of my moving there ever would go to absolute 0. It is a terrible system for any place that does not have infinitesimal state or national government expenses and more-than-60% kind of taxes (e.g., Scandinavian countries).

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#48

Post by lotsofpulp »

toomuchtodo wrote: post #27
lotsofpulp wrote: post #12

Earlier quoted context omitted.

It is dead in the water. The Republicans show no sign of supporting broad non means tested or non age gated taxpayer funded healthcare, and they hold the cards in the US Senate. On the state level, any broad based benefit that does not discriminate is also futile because benefit recipients can move into the state and payers for the benefits can move out of the state. See Vermont for the previous trial of this: https:…

California is the fifth largest economy in the world. New York State's GDP is roughly $1.5 trillion, 8 percent of the U.S. total. They are resourced at levels of entire OECD countries that offer universal healthcare. If Congress can't get its shit together, states that can should. https://www.politifact.com/factchecks/2015/sep/01/dan-gecker... https://web.archive.org/web/20160107120644/https://www.who.i...

30% of the US federal budget is healthcare spending.

https://www.usaspending.gov/explorer/budget_function

And that is only because a ton of people do not actually get healthcare, either because deductibles dissuade them or they do not pass the means testing to get enough subsidies to buy Medicaid or healthcare.gov insurance.

And that is because Medicaid severely underpays doctors to the point that if you visit a US city subreddit, one of the frequently asked topics is "where can I find a doctor that will accept Medicaid".

I think this issue can be too big for even NY or CA. It seems like it is for the US federal even, such that the political will only exists to provide healthcare via extreme price segmentation/discrimination. But most importantly, you can surely have your high risk pregnancies and hemophiliacs and cancer or whatever other high cost patient population move to the state, and the price tags on those patients is nothing to sneeze at.

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#49

Post by endisneigh »

outside1234 wrote: post #43
aserdf wrote: post #30

it will be interesting to watch NY (and/or CA) put something like this in place and observe from afar. i strongly feel that states should be much more aggressive running policy experiments if their constituents desire them, and at the national level we all get some benefit of seeing how things turn out in real time. all that said, assuming there is some tangible tax increase, NYC high earners are going to be knocking…

Remember that this expense is also reducing the cost of employers. One of the best ways to finance this would be a payroll tax that is basically equal (in aggregate) to the insurance the company is (usually) already paying.

If you think employers will share the savings with their employees, think again.

Re: NY Senate Bill S5474 proposing a universal single payer health plan for NYers

#50

Post by mullingitover »

toomuchtodo wrote: post #27
lotsofpulp wrote: post #12

Earlier quoted context omitted.

It is dead in the water. The Republicans show no sign of supporting broad non means tested or non age gated taxpayer funded healthcare, and they hold the cards in the US Senate. On the state level, any broad based benefit that does not discriminate is also futile because benefit recipients can move into the state and payers for the benefits can move out of the state. See Vermont for the previous trial of this: https:…

California is the fifth largest economy in the world. New York State's GDP is roughly $1.5 trillion, 8 percent of the U.S. total. They are resourced at levels of entire OECD countries that offer universal healthcare. If Congress can't get its shit together, states that can should. https://www.politifact.com/factchecks/2015/sep/01/dan-gecker... https://web.archive.org/web/20160107120644/https://www.who.i...

There was a bill in California pretty recently, it was killed without a vote in the full chamber [1].

The window-breaking-and-repairing industry is too powerful for us to stop it, unfortunately.

[1] https://www.npr.org/2022/01/31/1077155345/california-univers...

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