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

#491

Post by listless » Tue, May 10, 2022, 1:26 AM UTC

thebigman433 wrote: post #254

listless wrote: post #164

Earlier quoted context omitted.

I’m a landlord and yes it is. My taxes doubled last year because of the stupid housing bubble and so we had to raise rent as well. Gotta make a profit here for this investment to be worthwhile.

> My taxes doubled last year because of the stupid housing bubble and so we had to raise rent as well. Gotta make a profit here for this investment to be worthwhile Surely you see stuff like this is part of what is driving this very bubble?

Yeah - that’s not lost on me. I didn’t even pass the full cost on. I’m still down. Just trying to hedge my losses at an acceptable rate.

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

#492

Post by listless » Tue, May 10, 2022, 1:30 AM UTC

AnIdiotOnTheNet wrote: post #220

listless wrote: post #164

Earlier quoted context omitted.

I’m a landlord and yes it is. My taxes doubled last year because of the stupid housing bubble and so we had to raise rent as well. Gotta make a profit here for this investment to be worthwhile.

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.

I respect the honest response. In my case, I'm not rich. I’m just trying to build up enough passive income to retire someday. There’s no pension for me. I can’t depend solely on my 401K. I’m just trying to be moderately responsible about my own future.

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

#493

Post by timtom39 » Tue, May 10, 2022, 1:33 AM UTC

UnpossibleJim wrote: post #205

timtom39 wrote: post #148

Earlier quoted context omitted.

CA is losing population: https://www.sfchronicle.com/bayarea/article/Bay-Area-countie... It isn't crazy fast but it is happening. We will see if the trend holds...

How much of this do you think comes from the Bay Area and Los Angeles housing costs and the ability to remote work in the last couple of years (which seems to be coming to an end... possibly) and how much do you think is because of policy and city deterioration which has been publicized? I can't speak for CA but I see parallels in Seattle, though there's only movement to other cities within other WA cities (mainly th…

I lived in SF for ~8 years and left during COVID and bought a house. I have worked remote for 5 years (long before covid). My quality of life is just better not living in SF. I should have left earlier. It is all of the reasons you listed and more.

Also, I am a startup junkie and avoiding CA's 13% capital gains has more than offset any pay cut I might take by working remote (which hasn't happened).

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

#494

Post by OrvalWintermute » Tue, May 10, 2022, 1:35 AM UTC

jorblumesea wrote: post #478

q1w2 wrote: post #449

Earlier quoted context omitted.

Why is it ok to force the 60% to pay higher taxes and accept WORSE healthcare so that the 40% get better healtcare for nothing? We already pay to cover our own family members on our plans. Why are we being forced to now cover everyone else's family? I'm more likely to move to the adjacent state than pay 15% higher tax rate and literally get LOWER quality care.

1) It's not clear it will be worse, many countries with single insurer/single payer have just as high quality care (Canada) 2) Leaving these people uninsured is not cheaper, you're paying for it already with significant healthcare costs. The same people complaining about the cost of healthcare turn around and deny preventative coverage to people who end up in the ER and you pay for it regardless. 3) It's the right th…

My wife, a practicing surgeon, refuses to work as a wage slave.

She already performs a significant amount of her practice as "charity care" where she gets no reimbursement whatsoever.

Given that for a fellowship-trained (3) board-certified (2) surgeon the train-up period is measured in ~2+ decades, not 4 years for regular professions.

> What an incredibly ignorant take, no wonder we don't have any healthcare solutions

Please don't assign false morality to the compensation people expect when their working career is effectively halved due to their extensive training requirements, and their educational bills dwarf by comparison every other profession.

The US already subsidizes medical research and bigpharma profits for the entire planet. We're not the freeloaders you're making us out to be.

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

#495

Post by gen220 » Tue, May 10, 2022, 1:41 AM UTC

q1w2 wrote: post #439

gruez wrote: post #428

Earlier quoted context omitted.

You can't move a house (or the land it sits on) out of state.

I can't tell if you're being serious - but when people start moving out because of excessive taxation, prices drop and tax revenues go down with them (because real estate taxes are based on home values). Capital flight lowers real estate tax revenues. This should be obvious, so maybe your comment was a joke?

FWIW, in NY generally the tax assessed value of properties is far below the market price (20-30%, sometimes more).

NY could afford for the "market price" to fall quite considerably before it would significantly affect tax revenues.

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

#496

Post by OrvalWintermute » Tue, May 10, 2022, 1:45 AM UTC

standardUser wrote: post #113

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.…

"you get what you pay for" No country pays more for healthcare per capita than the US. If we could capture some of the huge chunk that goes to private insurance companies (each company has its own redundant staff and technology systems, their own execs all getting their own bonuses, etc), we could provide healthcare even better than we already provide in the US to those who can afford it or qualify for public program…

> their own execs all getting their own bonuses, etc

While we love to critique big insurance, and some of it may be earned, that industry is not known for the skyhigh profits OR margins like IT is.

Here is an HMO for ya

> OAKLAND, Calif. — Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals, and their respective subsidiaries (KFHP/H) reported 2021 annual financial results. Total operating revenues for 2021 were $93.1 billion compared to $88.7 billion in 2020. Total operating expenses were $92.5 billion compared to $86.5 billion in the prior year. Operating income was $611 million, or 0.7% of operating revenues, compared to $2.2 billion in 2020. Increased care delivery expenses due to COVID-19 surges contributed to the decline in operating income.

> “After almost 2 years, the COVID-19 pandemic continues to impact Kaiser Permanente just as it does our daily lives,” said chair and chief executive officer Greg A. Adams. “We rapidly rolled out vaccines, and now boosters, and administered more than 9 million COVID-19 tests while managing new and unpredictable variants like delta and omicron as they surfaced. Throughout this crisis, gratitude goes to our dedicated employees and physicians who have remained focused on providing care and strong support for members and communities.”

> Like other organizations, Kaiser Permanente benefited from strong investment performance due to robust financial markets during the year, resulting in total other income and expense of $7.5 billion compared to $4.1 billion in 2020. This sharp increase in investment performance more than offset the $1.6 billion decrease in operating income, resulting in 2021 net income of $8.1 billion compared to net income of $6.4 billion in 2020.

> Capital spending totaled $3.5 billion compared to $4.0 billion the year prior. During 2021 Kaiser Permanente opened 11 medical offices. Kaiser Permanente now includes 734 medical offices, 39 owned and operated hospitals, and 58 retail and worksite clinics.

and regular insurance

> United Healthgroup Profit as % of Revenues 6%, Profits as % of Assets 7.8%, Profits as % of Stockholder Equity 23.5% for CY2021

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

#497

Post by unclenoriega » Tue, May 10, 2022, 1:59 AM UTC

q1w2 wrote: post #434

bawolff wrote: post #327

Earlier quoted context omitted.

This is how it worked in canada. Saskatchewan decided they wanted single payer health care so they did it. About a decade later the federal gov made it national.

...and why combined tax rates for the middle class are around 50%. As someone who's lived in the Canadian health care system and the US system - it is absolutely lower quality than what average private employer healthcare plan provides in the US. Even before covid, Quebec's healthcare system was in crisis with packed ERs having dozens of neglected patients on beds in the hallways for weeks... GP access is impossible…

The US already spends more than double what Canada spends per capita. If we had the cost efficiency of Canada's health care system, we could by double the health care without spending more than we already do.

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

#498

Post by 1270018080 » Tue, May 10, 2022, 1:59 AM UTC

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…

Yeah. If a European country who is poorer than NY with a population of 20 million can fund universal healthcare, NY should be able to also.

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

#499

Post by jorblumesea » Tue, May 10, 2022, 2:00 AM UTC

OrvalWintermute wrote: post #490

jorblumesea wrote: post #481

Earlier quoted context omitted.

Most Americans have never experienced a system like that, and will fight tooth and nail against things they don't understand or have experienced. They are told by billionaires who run the media empires that universal healthcare is expensive, will ruin the country, will remove their ability to get appointments scheduled. Of course coming from any other country, this is ridiculous. But it goes to show you how out of to…

>Most Americans have never experienced a system like that, and will fight tooth and nail against things they don't understand or have experienced. They are told by billionaires who run the media empires that universal healthcare is expensive, will ruin the country, will remove their ability to get appointments scheduled. My wife, a practicing physician, did fellowships in multiple countries like this. I asked her for…

The US also has terrible waiting periods for elective care as well. I've talked to many physicians in the US (wife is MD) and you're booking way out anyways. So...universal healthcare has wait times of 7 months instead of 5 months.

It's just weird how people argue for the US system as if it's superior but it really has the same problems as other countries with even more downsides. If we're supposed to be "good" at elective surgeries we're giving up a lot to be pretty mediocre.

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

#500

Post by unclenoriega » Tue, May 10, 2022, 2:06 AM UTC

nradov wrote: post #392

7speter wrote: post #300

Earlier quoted context omitted.

I'm guessing the economy of scale for such a buy in isn't enough, and that states would have to take out as much debt as their yearly budgets or even more. Even a Elizabeth Warren's proposed solution was something like 17x the federal budget.

States wouldn't be able to borrow on anything like that scale to fund a healthcare program. Any major increases in healthcare spending would have to be funded by huge tax increases.

> increases in healthcare spending

FWIW, New York's current Medicaid budget alone puts it between San Marino and Israel for per capita healthcare spending. Widening the net a bit, that's between Italy and the UK.