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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

#381

Post by throwaway743 »

et2o wrote: post #285

I’m an MD who trained in NYC. I have also had emergency surgery in the NHS at one of their most prestigious hospitals in London and so I feel like I’ve seen the system a little bit from the inside. It was far cheaper for me than it would have been as a Brit in the USA, but the standard of care was lower. They didn’t have some technical and staffing resources late in the afternoon that would be a baseline in any of th…

I'm on NY State insurance rn while unemployed and it fucking owns. All the doctor's appts and procedures I've had the last year or so have been amazing, mostly through Langone, and the doctor's have been super thorough and attentive.

It's the highest number of (much needed) appts Ive had in the last 10 years combined and at 0 copay. Yes, taxes, but idgaf seeing as the private employer based insurance I had took a big chunk out of my checks, had to pay co-pays, and I had to pay out the ass for my prescriptions.

This is a huge win if passed for anyone in the state, regardless of income, seeing as it would be a huge safety net. The rug could pulled on anyone of any background tomorrow, yet they'd have their covered in the best way possible.

Fuck, I hope this goes through!

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

#382

Post by kmonsen »

erosenbe0 wrote: post #343
kmonsen wrote: post #282

Earlier quoted context omitted.

Same in Norway, max marginal rate caps out at almost 50%: https://www.skatteetaten.no/en/rates/maximum-effective-margi...

In a high-tax US state like California the top marginal income tax is about 47%. This covers no health care unless you are over 65, disabled, or are below the medicaid threshold, which is low. There is also a lower rate om capital gains such as stock or real estate, sales (like a VAT), gas tax, vehicle tax, utility tax, phone tax, cable internet tax, etc. Plus, of course, employers are paying some extra payroll taxes…

I lived in the UK, Norway, Switzerland and US (NYC and Bay Area). Except Switzerland I did not really notice a big tax change for any of the others.

Sure in UK and Norway healthcare and University is free, but healthcare is provided by my employer in the states. So for me it is a wash.

But hey in the US I get to pay for the largest army on the planet.

What I would say is that in the US my taxes feel the most "unfair" since my tax rate is sort of the max. Richer people have ways of avoiding taxes and poorer people pay less tax.

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

#383

Post by nradov »

gnopgnip wrote: post #290
johnsanders wrote: post #136

Earlier quoted context omitted.

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

NY currently greatly restricts how health insurers can discriminate on price based on age to the point that age basically isn't a factor. But most states allow for a ~3x price difference based on age. The other state with a similar rule, Vermont, has a form of single payer insurance as well

It's the federal Affordable Care Act (Obamacare) that limits price discrimination based on age to 3×. A few states do compress that even further.

https://www.valuepenguin.com/how-age-affects-health-insuranc...

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

#384

Post by chrisseaton »

fzeroracer wrote: post #379
chrisseaton wrote: post #271

Earlier quoted context omitted.

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!

I'm from the US born and raised, so I could talk at lengths about how the healthcare system here bankrupted my parents and nearly forced me into generational poverty. Or how poor the care is despite being under decent corporate healthcare. Or how misaligned the incentives are resulting in doctors suggesting nonsensical treatments like holistic care rather than actual treatment. Most people don't encounter this stuff…

> doctors suggesting nonsensical treatments like holistic care

Did you know that until 2017 the NHS literally funded homeopathy?

I'm not even joking.

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

#385

Post by mattmcknight »

rootusrootus wrote: post #23
ceejayoz wrote: post #14

Earlier quoted context omitted.

If I pay $10 in tax to save me $20 in costs, I'm not inclined to see that as a tax hike.

That assumes you get the cost saving. If my company stopped paying for my insurance benefit and instead gave that money to me directly, and then I bought the cheapest plan I could find on the insurance exchange ... I'd be paying more, not less. By a fair amount.

Is this because your employer is paying part of the cost for the plan?

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

#386

Post by maxerickson »

oneoff786 wrote: post #367
buescher wrote: post #267

Earlier quoted context omitted.

Somehow they have private insurance in Europe too. Germany has universal health care and you are well advised to get private insurance if you make enough that the state will allow you to buy it. The threshold is a salary of about $68K/year in US dollars.

That’s not what I’m saying. The norm is that a fairly substantial part of your comp in the US is healthcare provided by your employer. If this suddenly becomes worthless (or rather much less valuable because there’s a single payer system in parallel) but your salary stays the same while your taxes go up, you will lose out big time. It could work just fine if everyone did it. But seems very hard to do just Ny.

The notional value of insurance isn't impossibly high and it would likely loosen up the job market if switching was not complicated by continuing coverage and the risk of not replacing a good benefit.

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

#387

Post by bombcar »

ceeplusplus wrote: post #238
yazaddaruvala wrote: post #232

Earlier quoted context omitted.

Companies currently provide health insurance and pay per employee. Per employee costs go up due to health care payroll taxes. Per employee costs come down due to not paying for health insurance. Overall, net-neutral cost to companies and simplifies health care payments for hospitals, clinics, etc so fewer employees to explain and collect payments so cost of care comes down. Seems like a win - win - win.

Health insurance is a constant cost per employee, effectively decreasing in percentage of income as income goes up. Payroll taxes scale up as your income goes up. So no, it's not net-neutral as it's highly redistributive. If single payer were implemented as a flat tax, then it would be net-neutral.

Having it scale is fine imo as it fights against the overtime/overwork issue where since the health costs are constant it’s better to overpay and overwork one employee than to hire two.

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

#388

Post by nradov »

kevin_thibedeau wrote: post #173
hersko wrote: post #146

Earlier quoted context omitted.

I live in NY and pay >$18k a year in property tax for a small house. Real estate taxes are high enough.

They are offensively low for multi-million dollar buildings in NYC. Cut some slack for owner occupiers who had the assessed value skyrocket on them. Tax everybody else fairly.

"Fair" is highly subjective and no one can agree on what that means. Most of us think the fair option is to raise other people's taxes.

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

#389

Post by kbenson »

lettergram wrote: post #276
kbenson wrote: post #199

Earlier quoted context omitted.

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

I figured, but with the "Most HN comment" meme and Poe's law providing context, it can be hard to be sure someone isn't suggesting something a bit more... extreme. :)

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

#390

Post by dahfizz »

beebmam wrote: post #96
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…

That's 60% marginal rates. Last year I paid 17% of my total income in taxes.

How do you manage that? I get 31% taken straight from my paycheck (state + federal income, socsec, medicare, etc, and this is after 401k deduction) and then have sales tax and property tax on top.
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