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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

#561

Post by notch656a »

Krasnol wrote: post #558
notch656a wrote: post #556

Earlier quoted context omitted.

>Who the hell do you think you are? Some random financial crisis would throw you onto the street. And here the true colors emerge. You pretend to care about supporting others, but you take the first opportunity to denigrate someone for your perception that they are not rich enough to weather a storm. No one here has shit-talked you because of your finances. No one here has lambasted you because of your occupation or…

> And here the true colors emerge. You pretend to care about supporting others, but you take the first opportunity to denigrate someone for your perception that they are not rich enough to weather a storm. No, that's what you want to read because what I actually wrote would hurt your world view too much. That's why I repeat it again: THE SYSTEM AND IDEOLOGY YOU LOVE WOULD CRUSH YOU. > No one here has shit-talked you…

>you're hurt so much that you not only drop the whole topic but roll on the floor crying?

>Look how weak you are.

>Your personal crisis in your own world didn't even start and you're broken already. Look how easy it was.

>his evil and anti-social society you cherish so much

>a broken and weak person like you

Lol and I'm supposed to be the "anti-social" one, after you've written this drivel?

I've survived in a number of nations and varying societies, from US to Syria to Paraguay. I've survived homelessness, war, unemployment, and other challenges without turning to involuntarily funded social security. I've voluntarily spent tens of thousands to support loved ones. I'm trying to live the voluntary life I preach, or at least move closer to it; of course both you and I are flawed.

I'm not sure what the full range of systems are under which I would survive, or at least not be 'CRUSH'ed under. But I do know I will survive just fine without reading further your anti-social ramblings. Good day.

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

#562

Post by heavyset_go »

lettergram wrote: post #269
heavyset_go wrote: post #153

Earlier quoted context omitted.

> isnt that the main reason the salaries are so high? It's because the NIH limits the amounts of medical residencies in the country, and to become a doctor with a license to practice, you must have completed residency somewhere. The amount of doctors in the US are kept at low numbers because of this.

I thought it was the AMA, but yeah I know about this and agree. This is the real problem

AMA lobbies but doesn't decide how residencies are funded.

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

#563

Post by astura »

OrvalWintermute wrote: post #520
astura wrote: post #503

Earlier quoted context omitted.

>"horrible waiting periods for elective care, and non-emergent surgeries" Same as in the US. Three months is the minimum. Hell, I couldn't even schedule a tooth cleaning with a new dentist less than six months out - I called close to 10 dentist offices.

> 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…

Why are you telling me that my experience is somehow invalid?

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

#564

Post by simulate-me »

wolverine876 wrote: post #559
simulate-me wrote: post #544

Earlier quoted context omitted.

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 an…

> To claim people don’t move because of taxes is to deny basic economics. No, it's just not framing the entire economic question around taxes. There are many, many other factors. You can live in places with no taxes at all, but people don't choose to. > 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…

Maybe we're discussing different things. I was responding to the claim that higher taxes doesn't cause people to move. Just because high earners live in NYC doesn't mean that there weren't some high earners that left due to taxes.

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

#565

Post by polski-g »

1270018080 wrote: post #498
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.

European countries ration care. America does not. Until we're willing to, health care costs will remain astronomical.

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

#566

Post by OrvalWintermute »

astura wrote: post #563
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…

Why are you telling me that my experience is somehow invalid?

Your experience sounds anecdotal.

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

#567

Post by Krasnol »

notch656a wrote: post #561
Krasnol wrote: post #558

Earlier quoted context omitted.

> And here the true colors emerge. You pretend to care about supporting others, but you take the first opportunity to denigrate someone for your perception that they are not rich enough to weather a storm. No, that's what you want to read because what I actually wrote would hurt your world view too much. That's why I repeat it again: THE SYSTEM AND IDEOLOGY YOU LOVE WOULD CRUSH YOU. > No one here has shit-talked you…

>you're hurt so much that you not only drop the whole topic but roll on the floor crying? >Look how weak you are. >Your personal crisis in your own world didn't even start and you're broken already. Look how easy it was. >his evil and anti-social society you cherish so much >a broken and weak person like you Lol and I'm supposed to be the "anti-social" one, after you've written this drivel? I've survived in a number…

It's quite funny that you are seriously unaware how much information there is about you on the internet. Freely available.

But I guess you need to lie to yourself to be able to spread that kind of Ayn Rand LARP cringe material.

Bye.

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

#568

Post by inferiorhuman »

et2o wrote: post #365
inferiorhuman wrote: post #354

Earlier quoted context omitted.

As a not doctor I don't understand this: > It will likely strain these systems even further, as reimbursements from Medicaid/Medicaid are insufficient to run large health systems which depend on higher rates from private insurers Time ran an article a few years ago about hospital billing and whatnot. One of the things that they pointed out was that Medicare reimbursement rates were based on the actual cost to provide…

1. It’s just a fact that if all reimbursement was currently Medicare-level, the existing hospital systems in NYC would run a massive deficit and couldn’t provide the services they do now. They wouldn’t be in business barring massive reductions in staffing, hours, services, salaries, etc. I don’t know what you read in the NYT but this is well-known in healthcare. Hospitals lose money on Medicaid/Medicare patients in g…

> I don’t know what you read in the NYT but this is well-known in healthcare.

Time Magazine, not the New York Times. I don't know what you think but it's commonly known that the chargemaster is indeed bloated to cover things like indigent, uninsured patients. Here's the thing, people without money use the emergency department for primary care because they cannot be turned away. That's expensive. Getting those folks covered and away from the ER absolutely reduces costs.

https://time.com/198/bitter-pill-why-medical-bills-are-killi...

> By law, Medicare’s payments approximate a hospital’s cost of providing a service, including overhead, equipment and salaries.

So I'm not sure what you're talking about. Obviously Medicare doesn't exist to guarantee a profit. Whatever fee schedule is negotiated with private insurance companies does not actually reflect the cost of providing a service – the negotiated rates include things like profit and taking care of patients who can't pay.

> I’m not exactly sure what happened at UCSF with your ultrasound. Not familiar with SF really. But you can look up mean wait time for most elective procedures in the USA vs. Canada or USA vs. the UK. Or access to new therapies.

Dunno what to tell you. My experience was back in the mid-00s, and I doubt anything's improved since then. It didn't then (and doesn't now) take much effort to find people struggling just to find a doctor that takes insurance. I couldn't tell you why UCSF was so short of ultrasound techs, but yeah I potentially could've found an outside (but still in-network) provider on shorter notice. But then I would've been on the hook to deal with insurance billing hell. Even (especially) with UCSF I was getting screwed by their chaotic billing. Labs that were part of an office visit were officially covered by my insurance but as they were billed separately they were not considered part of the office visit (and therefor not covered).

https://www.beckershospitalreview.com/hospital-physician-rel...

Average wait time for an appointment as a new patient 24 days, worst metro area was Boston at 52 days. 45 days to see a cardiologist in Boston, 51 days to see an ob-gyn in Philly. We're already rationing care (by financial means instead of need), and that's largely due to insurance.

While there was a multi-month waitlist for a GP that took new patients and insurance, the fee-for-service practice I used could typically schedule even new patients same day or same week at least. Hell, their rates weren't even obscene as their practice was almost entirely MDs and a single receptionist. They didn't have to fund an army of people to battle insurance bureaucracy. Over the years my GP went out on her own practice for a bit, and then as her circumstances changed she went back to a practice she'd been with years before. From a patient POV the biggest problem she had was finding competent non-degreed office staff.

I can't say for certain that single payer (or even just a dominant federal government run system) would crate a "renaissance of PCPs", but anything that reduces the administrative burden will reduce the cost of running a medical practice and by extension will reduce the urge to focus on specialties.

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

#569

Post by erosenbe0 »

kmonsen wrote: post #382
erosenbe0 wrote: post #343

Earlier quoted context omitted.

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"…

This is a good criticism. High wage-earners in the US like a hardworking GP doctor pay the biggest effective tax rates.
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