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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

#131

Post by codefreeordie »

marricks wrote: post #65
goatcode wrote: post #46

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.…

Who gets "good" care here? Senators and millionaires definitely do. But, most people don't get good care, many people are missing essential care (dental), and everyone has to wait. Often months. We in the US pay more per capita for worse care than most other developed nations (Canada/UK/Nordic countries). Name your country where the care is worse than the US please and let us know how much they pay for it per capita…

Actually, the median American has access to exceptional care.

What is actually the case is that care available to the bottom quartile of Americans is below the care received on average in a top-tier universal care nation, and the US spends an absolute fortune delivering this quartile with substandard care.

We also spend a bit more than average providing exceptional care to everyone else, except that we also spend a truly ludicrous amount (compared with every place on earth except possibly Japan, which is still less than us but not quite as much less) on care for roughly everybody above the median during the last year of life, because we have baked some very expensive decisions in as the default (basically, if you don't specifically ask otherwise, you will get absolute treatment maximalism basically until 30 days from death)

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

#132

Post by exhilaration »

mywittyname wrote: post #82
irrational wrote: post #22

Earlier quoted context omitted.

You really think people are going to flee NYC and the large cities in CA over this?

OP sounds to be arguing the opposite. One lives in a low tax state while earning money / paying taxes, then retires to a rural part of NY / CA to receive tax-payer-backed benefits without paying for them.

Having a bunch of (medicare-covered) retirees (with no school-age kids) spending their (taxable) social security income in NY / CA sounds pretty great. Much better than losing them to Florida or Arizona. Bonus if the states get to tax their estates in the end.

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

#133

Post by lr4444lr »

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.

There is nothing stopping NY employers now from just giving people enough cash to buy a plan on the ACA marketplace. You're assuming this upcoming plan will have offerings employees will want, and charges employers whether or not this is the case.

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

#134

Post by vdnkh »

lettergram wrote: post #33
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.

Why would you want it nation wide? Even if you “support it”, I’d much rather watch the implications from the various experiments across states. Then we can select the best option. Personally, I’d like to see some states ban healthcare outright. Others have full coverage and everything in between. Then wait 10 years and we can see the results. I strongly suspect there would be states willing to do this.

> Personally, I’d like to see some states ban healthcare outright. Others have full coverage and everything in between. Then wait 10 years and we can see the results. I strongly suspect there would be states willing to do this.

This is the most HN comment I've ever seen

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

#135

Post by codefreeordie »

KoftaBob wrote: post #90
version_five wrote: post #74

Earlier quoted context omitted.

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?

This bill doesn't ban private insurance, it does however have this rule: "Private insurance that duplicates benefits offered under New York Health could not be offered to New York residents." So in other words, private insurances can only be offered if they provide benefits that surpass whatever the public option has. I imagine that private insurances will logically offer more benefits regardless, otherwise why would…

that will mean, though, that it will be impossible to get insurance to actually cover the things that the public system "covers" if you wait 35,600 years for your turn

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

#136

Post by johnsanders »

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…

One of America's best ideas. Laboratories of democracy. Maybe it works.. maybe not. But the rest of us learn from whatever happens.

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

#137

Post by version_five »

criddell wrote: post #91
version_five wrote: post #74

Earlier quoted context omitted.

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.

But it's also crazy that your access to healthcare is based on how the government prioritizes your need of it.

I agree with the idea of public healthcare, but not as a legislated monopoly. And that's true for government services generally. Monopolies don't benefit anyone except the monopolist, and competition makes everyone stronger. If the government wants to use it's buying and borrowing power (and maybe even taxation to the extent voters tolerate it) to provide a universal healthcare option, that's a big win. But if they want to push out other market participants in the name of some kind of fairness - well instead of having two-tier healthcare, everyone is on the bottom tier

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

#139

Post by TuringNYC »

It would be great if they could handling things already successfully resolved in other places, like Balance Billing https://en.wikipedia.org/wiki/Balance_billing#United_States

When I was with a Virginia employer, it was WYSIWYG on billing. In NY, you never know since there is the co-pay, and then there is the surprise 2nd bill that comes in the mail. It is a solved problem, not sure why such obvious solved problems cannot be implemented in NY.

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

#140

Post by ipaddr »

mupuff1234 wrote: post #119
lotsofpulp wrote: post #93

Earlier quoted context omitted.

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 won't have much of an option. I don't see them closing up shop and leaving NY if the talent is there.

I do, the talent exists elsewhere cheaper
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