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

#541

Post by tekknik » Tue, May 10, 2022, 2:35 PM UTC

paulmd wrote: post #370

kmonsen wrote: post #239

Earlier quoted context omitted.

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.

> 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. adverse selection is the usual objection raised. If you can live in Montana while you're healthy, and move to New York when you're sick, then New York effectively becomes the dumping ground for the nation's sick and ends up picking up a hugely disproportionate amount of…

People don’t move for various reasons, and now sick people are going to move for healthcare?

It’s not financially possible. The tax rate will be so high healthy people will then leave and you’ll be left with a fat bill for your sick population.

You have it backwards, you won’t get more sick people you’ll have less healthy people covering the bills.

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

#542

Post by tekknik » Tue, May 10, 2022, 2:42 PM UTC

refurb wrote: post #445

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.

NYS has a bigger population than all of Canada which seems to do make universal healthcare work.

There’s comments above that explains it “working”. Here’s a site that explains it better. TLDR, taxes go up a lot, private spending for medical procedures slightly falls. Quality of care drops. Pretty well a losing proposition all the way around.

https://www.heritage.org/health-care-reform/report/how-socia...

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

#543

Post by tekknik » Tue, May 10, 2022, 2:46 PM UTC

maxerickson wrote: post #386

oneoff786 wrote: post #367

Earlier quoted context omitted.

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.

Having used VA healthcare, what data do you have to show that the gov provided medical services will be a “good benefit”?

I have some medical issues now due to those wonderful Drs decisions.

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

#544

Post by simulate-me » Tue, May 10, 2022, 3:43 PM UTC

wolverine876 wrote: post #522

simulate-me wrote: post #464

Earlier quoted context omitted.

Seattle and Austin are totally comparable, even preferable, to NYC and SF in many ways. So yes, all else equal, why not save an extra 10% of your income?

> Seattle and Austin are totally comparable, even preferable, to NYC and SF in many ways. I'm sure we can find ways, Seattle and Austin are wonderful places, and what makes NYC and SF special doesn't appeal to everyone. But really Seattle and Austin are not even close. There's a reason NYC and SF have been centers of culture and business for generations; there's a reason that demand is so high that housing costs are…

Sure NYC has certain desirable aspects. Seattle has a different set (e.g. way better nature). The point isn’t to compare the cities to find the absolute best. Rather, the question is whether or not the benefits of certain cities or worth the cost. For high earners, the cost of living in NYC is hundreds of thousands or even millions of dollars per year. For some percentage of people that cost is simply not worth it and they move. To claim people don’t move because of taxes is to deny basic economics.

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

#545

Post by nybble41 » Tue, May 10, 2022, 4:17 PM UTC

Krasnol wrote: post #524

nybble41 wrote: post #323

Earlier quoted context omitted.

> It kinda is voluntary. If you don't like it, you can leave the country which wants you to pay. Voluntary would be staying where you are and still not being forced to pay. When a mugger presents their victim with a choice like "your money or your life" they're not paying voluntarily just because there was another option. You don't have the right to evict people from their homes any more than you have the right to ta…

The funny thing here is that your obviously anti-social behaviour only works in a society where being anti-social has been normalized. You'd be dead in a social society because as a lone, greedy individual, you're weaker than a group where the strong care for the weak. But even you must be aware that your model is coming to an end. The anti-social aspects of it have become a topic. Something which hasn't been the cas…

You're either trolling or completely clueless. I suspect the former is more likely but I'll try to give you the benefit of the doubt.

> You'd be dead in a social society because as a lone, greedy individual …

You're obviously reading way more into my comment than I actually wrote, which says more about you than me. I am 100% in support of groups working together voluntarily and looking out for each other. The system you advocated for is not that, and opposing it does not make one "lone" or "greedy".

> … you're weaker than a group where the strong care for the weak.

Imposing a "choice" of compulsory payments or eviction is not the strong caring for the weak, but rather the strong preying upon the weak.

> … the parts you didn't answer to speak for themselves.

I didn't address the rest of your prior comment because it wasn't worth a response. But since you insist:

> Don't you pay for taxes or Government services too? This is how a civilized society works.

Civilized society persists despite taxes, not because of them. Theft is not civilized, and treating it as legitimate is corrosive to any civilized society.

> What do you expect people to do which can't afford to pay their health bills because they've been unlucky or something like that? Are they supposed to just die?

Obviously they aren't supposed to just die. That question was not asked in good faith. Taking other people's stuff isn't the answer either; the products of their labor are not for you to spend. People are expected work to provide for themselves and to plan ahead for the future, setting aside a portion of the surplus during good times to sustain them through the bad times. Working together with others makes this much easier but it is first and foremost an individual responsibility. For the truly unlucky cases there is plenty of honest, actually-voluntary charity to go around.

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

#546

Post by kbenson » Tue, May 10, 2022, 4:33 PM UTC

lettergram wrote: post #438

kbenson wrote: post #389

Earlier quoted context omitted.

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 . :)

Lol first time my thoughts on banning health insurance is the less extreme option haha... For reference, the idea is to optimize for public good. Banning insurance would drop fees dramatically because people would get less unnecessary work done. At the same time, hospitals and others would be willing to offer loans provided you could pay it off. This would drive down costs to the point even the poor can get some dece…

> At the same time, hospitals and others would be willing to offer loans provided you could pay it off.

I'm not sure we want to encourage people to go through loan terms while possibly fearing for their life, especially when the people advising them on their health options are associated with those offering the loan.

"We need to operate as soon as possible, you're at risk until we resolve this. Oh, here's the loan information if you choose to get a loan through the hospital. The terms aren't as favorable as some others might offer, so feel free to take your time and shop around. Oh, but don't forget that your time is limited. Let me know when you've secured funding and we'll schedule the operation."

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

#547

Post by revnode » Tue, May 10, 2022, 4:45 PM UTC

Aunche wrote: post #487

revnode wrote: post #476

Earlier quoted context omitted.

Bobby gave Lisa $10. Lisa then gave $3 to Uncle Sam. What percentage of Bobby's money went to Uncle Sam? 30%. It's that simple. Bobby gave Uncle Sam 30% of his money.

If you use that logic, 100% of Bobby's money goes to Uncle Sam after a long enough chain of transactions.

We can stop at 3rd parties. That's reasonable enough.

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

#548

Post by notch656a » Tue, May 10, 2022, 4:48 PM UTC

boeingUH60 wrote: post #531

notch656a wrote: post #178

Earlier quoted context omitted.

I think funding the elderly is a lofty goal, but I don't see a good intellectual argument for FORCING our children to pay for our healthcare. You shouldn't view your child (nor your neighbor's child) as your own personal piggy-bank to extract from when you get ill. IMO our goal should be to hand down resources from parent to child, not the opposite direction. If I made this story a bit more personal and wrote ("I am…

> I am too ill to work anymore, so I drove to my son's house and took $200 off his counter to buy my medication Maybe it is because we come from different cultures, but I see absolutely nothing wrong with this. In fact, I recently paid for my parent's hospital bills and did it happily. My country doesn't have universal healthcare, but I'll be happy if we did. At the end of the day, we live in a society, and one of th…

>In fact, I recently paid for my parent's hospital bills and did it happily.

Yes and I recently paid thousands of dollars for my wife's hospital bill, would you like a cookie? That's how it's supposed to work: you voluntarily decide to help your loved ones and the payment is made.

How it isn't supposed to work is that the elderly make a moral judgement that the youth are less deserving of investment than themselves, and involuntarily they extract that money from the youth without their consent. I have no problem with a society where you voluntarily pay your parent's hospital bill, in fact you can do that in most any country already. Congratulations, your goal is already achieved.

>we end up paying for things we don't like regardless of our opinions

In this case you seem to mean we are made to pay for others without our consent.

>I think healthcare should be a priority..

Maybe I think hookers should be a priority; sex is correlated with good health. You wouldn't mind if I took a couple hundred from you for my health would you?

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

#549

Post by jmckib » Tue, May 10, 2022, 4:59 PM UTC

refurb wrote: post #463

jmckib wrote: post #396

Earlier quoted context omitted.

Looks like the official NHS policy is that you get a checkup every five years if aged 40 to 74. https://www.nhs.uk/conditions/nhs-health-check/nhs-health-ch... I'm not a doctor but that doesn't seem often enough for an older person. I'm an American in my 30's and I just had a checkup, and my doctor told me to come back every two years. Of course the American system is pretty awful in its own ways, especially for thos…

Preventative care is $0 as a part of the ACA and reputable physicians are included. Similar to the UK, my in laws in Canada can’t get annual physicians scheduled either - there needs to be something wrong before a doctor will take an appointment.

I'm glad ACA coverage is available but it can be pretty expensive. I paid somewhere in the range of $300-350 per month as a healthy young person. Some of my friends went without insurance for years because they simply couldn't afford it.

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

#550

Post by OrvalWintermute » Tue, May 10, 2022, 5:32 PM UTC

danaris wrote: post #535

OrvalWintermute wrote: post #520

Earlier quoted context omitted.

> Same as in the US. Three months is the minimum. big nope. Wife is booking emergent same day, and depending on the case length and type, 1-2 weeks for most cancer cases, up to a month for a complex deep inferior epigastric perforators flap breast reconstruction surgery which is a long surgery if bilateral; getting that much OR time is a challenge. They'll book for saturdays if they need. Cases that can be done in a…

Way to deny people's lived experience. I can corroborate the GP's experience of having to book several months in advance for non-emergency care—the fastest medical booking I've had in the past several years is surgery for my cat , which was about three weeks.

It sounds like we have different experiences due to the local/regional availability of physicians.

Certain areas of the US, particularly many big cities have a plethora of physicians and active competition between them.