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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

#91

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.…

Would healthcare overall in e.g New York be equivalent though? In Canada, we have "free" healthcare but literally have no other option so it's the Soviet style mess you'd expect a government monopoly to be. But would this bar paid healthcare? Couldn't people still have health insurance and get private care? Is there something preventing that?

I’m a Canadian living and working in the US and I’d take the Canadian system any day of the week.

I think it’s crazy that your access to healthcare is dependent on your employment.

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

#92

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.…

I come from a country with universal healthcare too, and my experience is the opposite.

Yes, to this day, it doesn’t cover dental or vision, which is BS if you ask me, and there is some co-pay for certain prescriptions; regardless, it is a fantastic system, and I miss it so much every time I need to go to the doctor here in the US. The main reason is uncertainty: in the US, I can never know how much something is going to be, even if it starts as a mere visit to a family doctor, because there are uncountable variables that may factor in the final cost.

As a result of this, I try to avoid going to the doctor as much as I can, and it makes me think about all the people who really cannot afford healthcare, and don’t qualify for Medicare either.

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

#93
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.

Big employers like having health insurance tied to employment. It makes changing jobs a riskier maneuver for employees as they do not know the quality of the other jobs' insurance coverage, and it creates higher overhead costs for smaller employers so it provides a competitive advantage there too.

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

#94

it appears that this bill does not actually deal with the funding mechanisms for single payer, which will undoubtedly be contentious. From the Campaign for New York Health: > this legislation can be passed outside of the budget as a standalone bill - the #NYHealthAct is intentionally written to first pass on human rights principles - that care should be equitable and available to all. Then we pass the funding mechani…

[deleted]

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

#95

Earlier quoted context omitted.

maybe I'm misunderstanding but I see at least 4-5 cosponsors that are members of the health committee? not saying I think this will come to pass necessarily but there's like 30 cosponsors listed and the NY State Senate is 63 members.

That is a lot of cosponsors, I was reading the page wrong (Govtrack’s site and Congress houses have a slightly different format for showing sponsors and cosponsors together)

understandable, I didn't realize it had this many cosponsors and I live in NY.

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

#96
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…

That's 60% marginal rates.

Last year I paid 17% of my total income in taxes.

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

#97

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.

There are UK employers who have offer health insurance as a benefit on top of the healthcare available from the NHS. There's not much point to it, but it is available.

I have such an arrangement and it's extremely useful.

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

#98

Earlier quoted context omitted.

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.

Big employers like having health insurance tied to employment. It makes changing jobs a riskier maneuver for employees as they do not know the quality of the other jobs' insurance coverage, and it creates higher overhead costs for smaller employers so it provides a competitive advantage there too.

> they do not know the quality of the other jobs' insurance coverage

And the fact that you can't actually take time off of work to pursue a career change or look for a new job, because you need your job in order to be able to afford basic healthcare. Which makes it a lot harder to pursue a career change or look for a new job, because you are stuck/busy at your current one + whatever other life responsibilities you have (not to mention the really high commute times in NYC).

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

#99
post #76

Earlier quoted context omitted.

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.

Are health insurance companies allowed to discriminate customers by their health status, that includes age? With a good deal of populace morbidly obese and not even bothering to exercise, it's expected that healthy 25 yo are going to pay crazy insurance payments. Corps, on the other hand, absolutely do discriminate by all sorts of characteristics and insurers know what they are signing up for. Offer health insurance…

No. Per the Affordable Care Act, since 2010 health insurance companies can only price insurance based on age, smoking status, and location. And they must offer insurance to all.

https://www.healthcare.gov/how-plans-set-your-premiums/

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

#100
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.

> a payroll tax that is basically equal (in aggregate) to the insurance

Whereupon there is no reduction in cost to any employer.

Theoretically there could be a reduction because the state would be a larger pool of cross-subsidization than any particular employer. In reality the costs are worse since the state will use the taxes to subsidize non-employed persons.

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