At podium: Assemblymember Richard Gottfried, at a New York State Assembly Health Committee hearing on the New York Health Act held at NYU on Dec. 16, 2014.
BY DONATHAN SALKALN | Life seems to revolve around insurance companies. They’re everywhere. After Sandy, this writer even had nightmares about them. That’s what made New York State Assembly’s Chair, Committee on Health, Richard Gottfried’s “Single-Payer” discussion with the Chelsea Reform Democratic Club (CRDC) so intriguing — a plan that will eliminate health care insurance companies, with their costs and profits, from the family budget.
The meeting, moderated by CRDC’s Executive Board member, Joel Vatsky, was held at Chelsea’s Elliott Center on the cold evening of February 19. It had passionate and sometimes heated exchanges on the pros and cons of Assemblymember Gottfried’s “Single-Payer” health care bill: New York Health, A7860. The bill would form a single public agency that would organize health care financing. It largely reflects the universal health care that Canada has used for the past 45 years. And, according to the World Bank, since then, the average Canadian’s life span has expanded to 2.5 years longer than the average American life (Can: 81.24 yrs., USA: 78.74 yrs.).
“If you want to find a country that rations care according to wealth, if you want to find a country where people have to go without health care in the midst of enormous wealth, if you want to find a country where people go bankrupt trying to keep themselves healthy, you’re living in it. And I want to change that!” declared Gottfried. “Last year, due to high deductibles, one third of American households who had health care coverage had someone in their family go without it, for financial reasons. And for two thirds of them, it was for a serious condition,” he stated, adding, “Healthcare is the leading cause of bankruptcy in America.”
Gottfried detailed how his New York Health would be less expensive, while including more coverage. “Today, whether you’re the multi-million dollar CEO of the company, or the lowest paid receptionist or janitor, the insurance company wants the same health care premium. If you’re at the top of the income range, instead of it being 25 percent of your household income (NYS medium households), it is more likely to be one or two percent.” The New York Health plan, Gottfried continued, “is to be funded by assessments, progressively graduated based on payroll and non-payroll taxable income.” He also noted that the costs will be brought further down by the elimination of insurance company administration costs, the costs of providers that have to hire a lot of people to deal with insurance companies, and insurance company profit. Gottfried surmised, “The reason the plan will work pretty well, is the same reason suburban schools work pretty well. People with wealth and influence will be using the system and they will make sure that the system works well. The rest of us will benefit.”
An audience member asked, “Wasn’t the Affordable Health Care Act supposed to solve all this?” — to which Gottfried responded, “Under the Affordable Care Act, while the marketplace is inducing the insurance companies to lower their premiums, they are both jacking up the deductible, the amount that you have to pay before the insurance company pays a nickel, and cutting back on what they spend, by having very limited provider networks with providers who are willing to work, at the minimal amounts that the insurance company is offering.”
Several in the group wanted to know how the plan would impact those now covered by NYS employee unions and those that now qualify for Medicare, but will have to continue to pay, if they have taxable income. Gottfried responded: “Anything that is now covered by Medicaid, Medicare, by state insurance mandates or any benefits available to state public employees, plus anything the plan chooses to add, would be available to every New Yorker.” He went on to state, “Those covered by Medicare are going to have better coverage and spend less out of pocket than they now do. They’ll have more choice of doctors, no co-pays, no deductibles, no out of network charges, and no premiums for supplemental policies. Long term coverage won’t kick in until we devise a plan for that, but for everything else, that’s it.”
In adding yet another government agency to New York, State Committeewoman Francine Hasselkorn asked Gottfried “What are the start-up costs and which entity would be created to do this?” Gottfried said that the Health Department would administer it, noting, “The administration costs would be in the three percent range, maybe lower based on what traditional Medicare spends on administration. For start up costs, an awful lot of machinery is already up and running in the state, as it pays bills under the Medicaid program.”
District Leader Sylvia DiPietro was very concerned about the possible fleeing of wealth and doctors. She warned, “Under this system we will have a flight of quality doctors from the state and will have lines around the block just to see an average doctor.” DiPietro continued, by asking, “How do you tell a quality doctor that they’ll get the same amount of money as a much less experienced doctor, and how do you stop them and the people that can afford it now from fleeing the state, when it’s mandatory?” Gottfried countered, “Today, insurance companies pay doctors whatever they please. If doctors flee New York they will find themselves in the hands of insurance companies that will pay them what the insurance company wants to pay. If the doctors are out of network that will be zero.”
Gottfried was the first to admit that the Canadian plan had its flaws, that it needed tweaking, and is open to suggestions for his plan. CRDC Executive Board member Carol Demech reflected on her years of living in Vancouver. She recounted a story of how she was told that she might have kidney cancer and then informed that she would have to wait three months for a kidney exam. She also spoke of an injured teenager who would have to wait a year for an MRI, and chose instead to go to Seattle.
Another member cited the extremely high cost of malpractice insurance for US doctors. Due to tort laws, Canadian doctors pay one tenth of the malpractice insurance of their USA counterparts. Gottfried responded that there are no tort reforms included in his bill.
Most heartfelt was CRDC’s Executive VP Judy Richheimer’s conversation with a Canadian doctor concerning a Stage 4 cancer that her partner died from, here in New York. The doctor told her that in Canada they never see patients presenting at Stage 4, because the patients have been in the system too long. Richheimer concluded, “It is definitely cheaper and with better outcomes to treat someone when they’re precancerous, or a little bit cancerous.”
Well past the meeting’s cut-off time, the CRDC voted to endorse and promote Richard Gottfried’s New York Health Bill (New York Health, A7860), then bundled up so as to not catch pneumonia, and went home.
