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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

#401

Post by Spooky23 »

mortehu wrote: post #279
ABCLAW wrote: post #236

Earlier quoted context omitted.

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.

401k, HSA, 529s for state taxes. You can give children gifts up to $28k, which is taxed at the kids rate. There are games you can play with home equity loans.

If you own a business there is a thousand ways to do it. One thing I’ve seen is people’s businesses “donate” to private schools and then get “merit” scholarships for their kids. You can accelerate depreciation of up to $500k of assets, etc.

If you’re smart, you’ll sometimes pay less tax in high tax states. Usually the low tax states have higher property and sales tax rates.

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

#402

Post by coding123 »

RHSeeger wrote: post #306
AnIdiotOnTheNet wrote: post #220

Earlier quoted context omitted.

Maybe if people didn't buy property they don't live in as an investment then things like the stupid housing bubble might not happen in the first place. Personally I think owning a residence you don't actually live in should just straight up be illegal, but I'm admittedly pretty radical about parts of the system that seem to exist solely to make the rich richer.

So, if I am going to live in an area for a year... I should be required to purchase a house, including all the money, time, and effort that involves? I would hate to live in a world where that was the case. I have both owned and rented at different points in my life. There have been times where renting was a better choice for me, for a variety of reasons. I am glad that renting is an option.

In a world where there was no rentals there would probably be new things we can't imagine such as community ownerships. The specific thing that shouldn't exist - in parent commentors and myself is that the renter is paying money so that the actual owner pays off the property for their benefit, not the renter.

If some kind of community property system exists (not for ALL properties but a large number of them) then any rent you pay in say New York is also paying down a virtual mortgage you have the the "community" that spans the country. Like a virtual HOA.

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

#403

Post by theptip »

RHSeeger wrote: post #344
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.

If you follow this specific thread, the discussion looks like this >>>> Person complaining about how his previous state-run health care system was awful >>> Person replying that your current plan will still be there, no one will force you to take the state run plan >> Person commenting on how funding for the bill will kill it > Response that funding will come from the money that companies were paying on health plans.…

It was later edited, but I think the bit where the thread diverges from your summary is

> - Companies will continue to offer the health plan they currently offer

I think the GP (GGP?) reading was that the current health plans would have to change; they can't duplicate the state mandatory coverage. (But they can build on top of it).

So theoretically a $1k/mo plan paid by the employer might turn into a $400/mo plan for extra coverage, and the baseline would cost $600/mo and that part would be taken over by the state. Best-case they can streamline that portion and decrease the cost through economy of scale; worst-case you have 2x the operating costs for two different insurance plans and the quality goes down because of the duplication and billing uncertainty for providers. (I'd hope that the bit covered by the state would be good enough for many people to have as their only coverage though).

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

#404

Post by tootie »

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…

There's guaranteed to be risks and downsides but the status quo is utterly unconscionable so I will take absolutely any step in the right direction.

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

#405

Post by colinmhayes »

chrisseaton wrote: post #271
jeppesen-io wrote: post #84

Earlier quoted context omitted.

> 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!

UK does not have single payer, their system is nationalized. Big difference, especially with capitated plans that medicare is championing. Competition is what makes capitalism great, single payer is the best way to accomplish it among medical providers.

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

#406

Post by colinmhayes »

mattmcknight wrote: post #361
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.

It's not though. We have have ACA plans you get independent of employment and Medicaid for the unemployed.

Costs $20k for a family.

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

#407

Post by tootie »

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.

Not to sounds hyperbolic, but we're moving farther and farther towards partitioning the country than we are towards M4A. The SC has just crossed the biggest line between liberals and conservatives for the last 50 years and signalled they're not done. The composition of the Senate and electoral college could put us a good 30+ years from being able to restore those rights. Best case scenario is both sides of the aisle double down on states' rights so liberals can have free choice and socialized medicine while the others can wait for maternal mortality rates to force their hands in a generation or two.

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

#408

Post by thenightcrawler »

kmonsen wrote: post #239
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…

This came up in the VOX in the weeds on healthcare policy some time ago. Their conclusion from the people that had looked into it is that it is sort of impossible for states to do this. Can't really remember the reasons. There was another state that was trying something like this, I believe it was Vermont.

The inability to run deficits is the killer here.

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

#409

Post by et2o »

throwaway743 wrote: post #381
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…

Nice. Yeah maybe this will be a win. I’m overall more for it than against it. Just think there are some downsides. Glad to hear you have had a good time on the NY State insurance. Is it Medicaid? Langone actually has the best (most private) payor mix of any of the hospitals in NYC, I believe primarily from geographic reasons. Did you get to compare to Bellevue at all? Curious on your perspective there. Hope you’re doing okay.

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

#410

Post by IX-103 »

rabuse wrote: post #265
AnIdiotOnTheNet wrote: post #220

Earlier quoted context omitted.

Maybe if people didn't buy property they don't live in as an investment then things like the stupid housing bubble might not happen in the first place. Personally I think owning a residence you don't actually live in should just straight up be illegal, but I'm admittedly pretty radical about parts of the system that seem to exist solely to make the rich richer.

If government reduced their hold on zoning restrictions and allowed for more properties to be built, we wouldn't be in this mess. Supply and demand.

I'm not sure of your logic.

There's no guarantee that builders will use the loosened restrictions to build the most efficient housing. In fact they will most likely build the most profitable housing instead.

The most profitable is on the high end - so marble countertops, stainless steel appliances, etc. All the builders will race to build as much of that as they can, as fast as they can. Then, when the market is glutted, they'll be unable to sell off their investments. Builders will end up with their capital all sunk in cheap land and expensive housing. no one can afford to buy. The builders can't sell the cheap land since they leveraged it to pay for developing the expensive housing. They can't sell the expensive housing because the market has temporarily dried up. The builders will just wait until the glut resolves and continue business as usual.

Meanwhile, there is not really that much more actual housing for the low end market. Some builders made a bunch of money and some craftsmen got extra work building houses they can never afford.

Capitalism at it's most typical.

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