Universal health care evolves

Posted 8/21/12

Priscilla Basset, co-chair of the Sullivan County Senior Legislative Action Committee, recently stopped by a meeting of the Sullivan County Health and Family Services Committee to thank county …

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Universal health care evolves

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Priscilla Basset, co-chair of the Sullivan County Senior Legislative Action Committee, recently stopped by a meeting of the Sullivan County Health and Family Services Committee to thank county legislators for their early backing of the New York Health Act (NYHA), which would provide single-payer health care for every New Yorker.

Activist Star Hesse gave brief remarks about NYHA, and noted that the state assembly voted in favor of the legislation by a margin of 89 to 47 on May 28. That’s a significant step forward for a bill that has been introduced every year by Assemblyman Richard Gottfried since 1992. Hesse said the county’s endorsement of NYHA played an important role in showing the state legislature that there is grass-roots support for universal, single-payer health care.

She noted that the Affordable Care Act (ACA), or Obamacare, which will either be upheld or struck down by the Supreme Court of the United States (SCOTUS) this month, was started with good intentions. But, she said, “The for-profit health insurance industry hijacked the [ACA] ensuring that their outrageous salaries, excessive bonuses, administrative costs and profit-driven policies and operations will continue to make health care unaffordable and unattainable for millions of Americans.”

Hesse said adopting NYHA would provide health care for every resident of the state at a cost much lower than either the ACA or the system that existed before it because of savings resulting from cutting out private insurance companies from the system.

She said, “Documentation from the Massachusetts Amherst Economics Department showed that implementation of this program could save New York State $45 billion [per year]. The City of Albany treasurer found that the city could reduce school tax by at least 20%, and property taxes in many counties could be eliminated entirely. This is important because, as we’ve seen, even the people who don’t care about getting quality health care for other people because they have the money to buy it for themselves do care about the money that’s being spent to provide that same kind of health care to the less fortunate.”

In New York, unlike most states, part of the cost of Medicaid is picked up by county taxpayers. In 2014, the cost in Sullivan County was about $21.5 million, or about 39% of the county tax levy. If NYHA were implemented, Hesse said the entire Medicaid bill would be eliminated.

Further, according to a report published on May 27 by David U. Himmelstein and Steffie Woolhandler, both professors at City University of New York School of Public Health, administrative costs of ACA are going to keep rising, and much of the increase will go to pay the overhead costs of private insurers. The report on healthaffairs.org said, “Between 2014 and 2022, the Centers for Medicare and Medicaid Services projects $2.757 trillion in spending for private insurance overhead and administering government health programs (mostly Medicare and Medicaid), including $273.6 billion in new administrative costs attributable to the ACA. Nearly two-thirds of this new overhead—$172.2 billion—will go for increased private insurance overhead.”

It seems likely that taking private insurers out of the mix would lead to savings for consumers and the government, and a growing number of people are calling for just that, including Democratic presidential candidate Bernie Sanders. But some question just how big the potential savings would be, and there are sizable obstacles to overcome before any single-payer plan is adopted in any U.S. state.

For instance, the success of NYHA depends on the state being able to use Medicare and Medicaid funding currently coming to the state in the new NYHA program. Sen. Kemp Hannon, chair of the Senate Health Committee, has said there is likely to be pushback from seniors who won’t be willing to give up Medicare in return for the new state program.

It’s pretty clear that NYHA will not come to New York State this year. There is no equivalent bill working its way through the state Senate, and even if there were, it’s not clear that Gov. Andrew Cuomo would sign it. Further, probably the most serious attempt to create a universal health care program so far, in the state of Vermont, failed recently when it appeared that the cost would be too high.

Nevertheless, regardless of how the Supreme Court rules on the ACA, there is likely to be continued evolution in the U.S. health-care system. As journalist Art Golab wrote on a blog on www.modernhealthcare.com, “The fact that this [NYHA] single-payer bill got as far as it did is strong testimony to the evolving health care policy landscape in the United States. Progressive leaders know that the Affordable Care Act is a highly-problematic health care ‘starter home,’ and we must continue pushing for true universal health care.” In New York, that means continuing to keep our eyes on NYHA, and encouraging our representatives to support it or similar single-payer options that may be proposed as the conversation develops. It may fail again this time, but we are getting closer.

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