NY Senate Bill S5474 proposing a universal single payer health plan for NYers • Hacker News Board

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

#271

Post by chrisseaton » Mon, May 09, 2022, 10:22 PM UTC

jeppesen-io wrote: post #84

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.…

> Coming from a country that has this, there should be caution It's big world - without knowing which country, this is of little help. I'd like to see a comparison of people forced into debt, bankruptcy or death due to the respective medical systems This hits home because I have a friend that got cancer with "good" U.S. insurance and if he did not fight the insurance company he'd be in debt for 1mm+

I'm from the UK, which is basically fully free-at-point-of-use healthcare (you pay a nominal fee for prescriptions, dentistry, optician) and is often championed as a great option.

Reality is it's pretty grim. Don't know if I'd recommend it to other countries to be honest.

Be careful what you wish for!

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

#272

Post by throw0101a » Mon, May 09, 2022, 10:22 PM UTC

version_five wrote: post #137

criddell wrote: post #91

Earlier quoted context omitted.

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 taxat…

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

Doctor's prioritize need. More sicker, more quicker 'service' / treatment.

> I agree with the idea of public healthcare, but not as a legislated monopoly.

There is no monopoly on health care in Canada: if you want to cut a cheque you can get private care. What is legislated is that if you take provincial funding you cannot also take private funds. It's either-or.

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

#273

Post by astura » Mon, May 09, 2022, 10:23 PM UTC

dwighttk wrote: post #168

joshstrange wrote: post #101

Earlier quoted context omitted.

Citation needed. Every population graph I can find show a small decline over the last few years but it's still above 2000 and they've had population dips before (1970-1980) that then recovered. This comment reads like my in-laws who always talk about how "people can't get out of CA fast enough", um the population numbers say otherwise.

NY had been holding steady at about 6.5% of the US population since around 2010, but recently dipped just below 6% https://united-states.reaproject.org/analysis/comparative-tr...

Doesn't sound like a "breakneck pace."

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

#274

Post by karpierz » Mon, May 09, 2022, 10:23 PM UTC

codefreeordie wrote: post #131

marricks wrote: post #65

Earlier quoted context omitted.

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 t…

> Actually, the median American has access to exceptional care.

Is there a source for this? I'd guess that there's a percentile where American health care has better outcomes than other countries, but 50th seems pretty low.

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

#275

Post by kmonsen » Mon, May 09, 2022, 10:24 PM UTC

codefreeordie wrote: post #250

monocasa wrote: post #195

Earlier quoted context omitted.

Why? Wouldn't a line skip be by definition something that the public system isn't offering?

I haven't read the full text of the bill, but presumably not. The intent will be to disallow private coverage for any service that the government would provide, specifically because they would want to make sure that people with money couldn't avoid the public system. That's how it ends up working in many places with government care

In Norway and UK there is public healthcare, but you can pay to skip the lines if you want to. I don't know why we would go full socialist in the US when living in a capitalist society. Should we only get cars allocated to us or something as well?

I am not hugely in favor or capitalism, but I can't see anything better or a way to replace it even though I am a social democrat. Let people with money spend them as long as we provide a decent floor for everyone.

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

#276

Post by lettergram » Mon, May 09, 2022, 10:24 PM UTC

kbenson wrote: post #199

vdnkh wrote: post #134

Earlier quoted context omitted.

> 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

I'm not even sure what they mean by ban "healthcare" (insurance, doctors, hospitals?), and I can't decide if that makes me agree with you more or less.

I meant health insurance, but gonna just leave it lol

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

#277

Post by jimmygrapes » Mon, May 09, 2022, 10:24 PM UTC

xyst wrote: post #210

If only we can get the other 48 states to have a single payer health plan initiative or adopt a nationalized single payer health care system. Health care should not be limited to just living in CA or NY or the rich. side note: this site for tracking bills at the state level is kind of nice. Wish other states had this. This is what I have to deal with in TX https://capitol.texas.gov/MnuLegislation.aspx

I wish all advocates for single payer systems could experience the Veterans Health Affairs (plus or minus the "Community Care" system) just to see what it they are in for. Give it a trial period of 2 years. Have fun.

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

#278

Post by yazaddaruvala » Mon, May 09, 2022, 10:24 PM UTC

nceqs3 wrote: post #102

marricks wrote: post #65

Earlier quoted context omitted.

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…

You ever been to a Canadian hospital?

I've been to multiple Canadian ERs (2 times total) and multiple US ERs (2 times total).

The only difference has been that 1 time the Canadian ER was busier and I waited my turn (based on an initial triage).

I feel, during my visit, I was appropriately handled in all 4 locations. After leaving the hospital in Canada I was done. However in the US, both times a few weeks later I got a bill for roughly $1000, and it actively makes me think twice about going to the ER (even though I can afford the $1000). In the US, I may have skipped the ER the second time if I hadn't felt strongly I was having an appendicitis. Truly scary to think I considered not going based on a bit of money.

If it wasn't clear, even being well off in the US, I prefer the overall experience in Canada.

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

#279

Post by mortehu » Mon, May 09, 2022, 10:24 PM UTC

ABCLAW wrote: post #236

hervature wrote: post #194

Earlier quoted context omitted.

I don't want to be rude, but if you paid 17%, that's basically the minimum income tax rate (10+4+3) for NYC. That's pretty far form the OP's "NYC high earners". Of course, if you got credits, that's orthogonal as normally those credits cost more than they are worth. For instance, the child credit is far from the cast of raising a child.

If you're a "high earner" there are a panoply of services that allow you to structure your income, wealth appreciation, or other forms of wealth generation in tax-optimized vehicles. The tax universes at 200k/yr and 500k/yr-2m/yr income look very different.

If we're talking wages here, what are the options exactly? Is there anything bigger than 401(k)?

This is ignoring charity, which I believe is available to anyone anyway.

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

#280

Post by ozmodiar » Mon, May 09, 2022, 10:24 PM UTC

nceqs3 wrote: post #102

marricks wrote: post #65

Earlier quoted context omitted.

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…

You ever been to a Canadian hospital?

I have, as have members of my family, and have received excellent care for some fairly serious conditions. I think the Canadian system is under funded, and I'm sure there are plenty of true horror stories, but they always get highlighted by people who want to tear down/prevent a public healcare system so I feel I have to bring up that my family have received good and timely care. When I really needed healthcare I was unemployed and it was stressful enough seeking care without having to worry about insurance. Now that I'm employed I'm happy to pay back into the system.

I value having public health care. I hope the US can come up with a good public system so that Canada can stop resting on "at least we're not like the US!"