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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

#481

Post by jorblumesea »

manuelabeledo wrote: post #92
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.…

I come from a country with universal healthcare too, and my experience is the opposite. Yes, to this day, it doesn’t cover dental or vision, which is BS if you ask me, and there is some co-pay for certain prescriptions; regardless, it is a fantastic system, and I miss it so much every time I need to go to the doctor here in the US. The main reason is uncertainty: in the US, I can never know how much something is goin…

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 touch many Americans are with how the rest of the world works.

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

#482

Post by revnode »

colinmhayes wrote: post #391
revnode wrote: post #286

Earlier quoted context omitted.

You're making a pretty fundamental mistake. I am not speculating about the elasticity of rent. If taxes went to 0, would rent go down? Probably not. So what? The percentage of rent that is taxes is exactly the amount paid in taxes by the landlord. Period. It is an absolute number.

But if property taxes go up you'd still be paying the same rent. I don't see how it makes sense to say you're paying property taxes when they have next to zero effect on your cost of living.

> I don't see how it makes sense to say you're paying property taxes when they have next to zero effect on your cost of living.

Why do they need to have an effect on rent for you to understand that you're paying them?

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.

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

#483

Post by colinmhayes »

revnode wrote: post #482
colinmhayes wrote: post #391

Earlier quoted context omitted.

But if property taxes go up you'd still be paying the same rent. I don't see how it makes sense to say you're paying property taxes when they have next to zero effect on your cost of living.

> I don't see how it makes sense to say you're paying property taxes when they have next to zero effect on your cost of living. Why do they need to have an effect on rent for you to understand that you're paying them? 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.

It’s not Bobby’s money that went to the government. It’s Lisa’s.

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

#484

Post by kevin_thibedeau »

nradov wrote: post #388
kevin_thibedeau wrote: post #173

Earlier quoted context omitted.

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.

If a property sells for $10M and it's assessed at $100K that's objectively unfair. NYC's deficit spending means that their intentional under taxation of property is subsidized by the rest of the state.

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

#485

Post by OrvalWintermute »

debacle wrote: post #75
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…

New York is losing population at a breakneck pace. Our government is to blame. I am for single payer to some extent, but if done poorly medical staff (who are already leaving due to pandemic policies) will just pick up and leave. We recently expanded the privileges of nurse practitioners which is great, but two large nursing unions are less than 60 days away from striking.

> We recently expanded the privileges of nurse practitioners which is great, but two large nursing unions are less than 60 days away from striking.

The problem is that NPs are not fundamentally trained in diagnosis and have huge gaps in their medical training compared to physicians.

In the best case you go to an NP for a simple scrip. In the worst case you see a series of NPs and never get an accurate diagnosis, leading to a circular series of appointments.

NP = 2 year program on top of a 4 year nursing degree.

Physician = 1-3 years of fellowship (optional) + 3-7 years of residency + 4 year medical school on top of a 4 year bachelors degree

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

#486

Post by TuringNYC »

bdzr wrote: post #292
TuringNYC wrote: post #147

Earlier quoted context omitted.

cost of living isnt the reason for high salaries in Medicines. Unlike tech, salaries in medicine increase as you go to rural and/or underserved areas. It is driven by supply/demand and quality of life in urban vs rural areas.

Sort of, the supply of physicians is artificially limited by the AMA - which dictates how many physicians there are. That keeps the cost of physicians nice and high.

100% agree but note that the AMA's limits are at a national level. So the [very high] base salaries are indeed driven by scarcity (as dictated by medical boards.) However the local scarcity is not driven by the AMA (note the salaries just get even higher! in remote locales as the local scarcity compounds atop national scarcity.)

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

#487

Post by Aunche »

revnode wrote: post #476
Aunche wrote: post #457

Earlier quoted context omitted.

Prices are determined by supply and demand. Both are rather inelastic, especially in a highly desirable city like NYC, so very of the property taxes gets passed to the renters. If this weren't true, then renters in California would see savings from prop 13, but clearly that isn't happening.

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.

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

#488

Post by TuringNYC »

ceejayoz wrote: post #252
TuringNYC wrote: post #139

It would be great if they could handling things already successfully resolved in other places, like Balance Billing https://en.wikipedia.org/wiki/Balance_billing#United_States When I was with a Virginia employer, it was WYSIWYG on billing. In NY, you never know since there is the co-pay, and then there is the surprise 2nd bill that comes in the mail. It is a solved problem, not sure why such obvious solved problems c…

Balance billing was banned federally. https://www.dfs.ny.gov/consumers/health_insurance/surprise_m...

Sort of. But if you read the article:

"""Consumers in New York are protected from surprise bills when treated by an out-of-network provider at a participating hospital or ambulatory surgical center in their health plan’s network. Additionally, consumers with health insurance coverage provided by an insurer or HMO are protected from surprise bills when a participating doctor refers them to a non-participating provider. Consumers in New York are also protected from bills for emergency services in hospitals, including inpatient care following emergency room treatment."""

Note that part of balance billing is from in network providers who are billing the difference, that doesnt seem to be covered in the above ban from what I'm reading.

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

#489

Post by kevindong »

akimball wrote: post #358
kevindong wrote: post #156

Earlier quoted context omitted.

From the summary of the bill: > Private insurance that duplicates benefits offered under New York Health could not be offered to New York residents. --- My interpretation of that is that private insurance (which includes employer-based insurance) would be banned.

That's an incorrect interpretation. Private insurance would be restricted to cover things not already covered by the public insurance.

> The benefits will include comprehensive outpatient and inpatient medical care, long-term care, primary and preventive care, prescription drugs, laboratory tests, rehabilitative, dental, vision, hearing, etc. all benefits required by current state insurance law or provided by the state public employee package, Family Health Plus, Child Health Plus, Medicare, or Medicaid, and others added by the plan.

I'm struggling to understand what is not covered beyond that.

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

#490

Post by OrvalWintermute »

jorblumesea wrote: post #481
manuelabeledo wrote: post #92

Earlier quoted context omitted.

I come from a country with universal healthcare too, and my experience is the opposite. Yes, to this day, it doesn’t cover dental or vision, which is BS if you ask me, and there is some co-pay for certain prescriptions; regardless, it is a fantastic system, and I miss it so much every time I need to go to the doctor here in the US. The main reason is uncertainty: in the US, I can never know how much something is goin…

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 her opinion given her experience with their systems, and our systems, and also being on the provider end.

"excellent emergent care, comparable to better US hospitals"

"horrible waiting periods for elective care, and non-emergent surgeries"

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