NY Got Close to Passing Single-Payer Healthcare–Then Special Interests Squashed It

Many New Yorkers were expecting this year would be the one in which New York finally passed the “New York Health Act.”

30 years after being introduced, the prospect of the state realizing the possibilities of single-payer healthcare free from corporate influence has enough votes to pass.

But if New Yorkers think the for-profit insurance companies, lobbyists, and even some labor unions are planning on loosening their grip on the status quo, they are about to be disappointed–again.

Buckling to special interest pressure, New York lawmakers allowed the legislative session to conclude Thursday without an up-or-down vote. 

Despite unions’ necessity in representing public-sector workers’ needs and most Americans’ overwhelming support for a national healthcare system, labor leaders have been rejecting calls for single-payer healthcare.

Last month, the New York City Municipal Labor Committee (MLC) penned a letter to Speaker Carl Heastie to “register our strenuous objection to the New York Health Act 2021,” which states:

“To avoid any misunderstanding, the MLC supports universal health care coverage. But, as we have repeatedly stated in connection with prior attempts to pursue a single-payer system in New York, next to wages, the health care program for NYC workers is of primary importance.” 

That “primary importance” implies negotiations for better, cheaper healthcare coverage and past wage increase sacrifices that single-payer healthcare would supposedly negate.

Anti-NYHA group “Realities of Single Payer” coordinated with the United Federation of Teachers (UFT) in an open letter to the state legislature urging lawmakers to oppose the bill.

SEIU of Colorado recently “voiced serious concerns and strong opposition regarding House Bill 21-1232, which would create a new state government-controlled health insurance system, known as the state government option,” leading to the state legislature to pass a bill to create a public option in two years if private insurers refuse to reduce premiums 15 percent.

However, healthcare providers will not be required to accept the insurance, so the caveat is moot. 

The largest labor union in Nevada, the Culinary Workers Local 226, made headlines during the 2020 presidential campaign with its vociferous opposition to Vt. Sen. Bernie Sanders’ Medicare-for-All proposal.

Not all unions are opposed, though.

Some noticeable supporters are 1199 Service Employees International Union (SEIU), a health care workers union, and the New York State Nurses Association.

If there is anything the coronavirus/COVID-19 pandemic fiasco has exposed, it’s our societal inequities.

When it comes to public health, the most obvious inequity lies in the reality that we spend the most money on healthcare–20% of our national income–of any Organization for Economic Cooperation and Development (OECD) country on the planet, yet we are not the healthiest country.

Most countries offer healthcare as a human right to all its citizens.

But of the 25 wealthiest nations, the United States is the only one that fails to do this.

The response opponents to a Medicare-for-All-type single-payer national healthcare system similar to what Canada practices is, “We can’t afford it,” or “How do we pay for it?”

That question is seldom if ever proposed, though, whenever we feel the need to increase the military budget, print money to provide $2 trillion in economic relief to keep corporations afloat, dole out perpetual subsidies to the world’s most profitable corporations, or permanently cut taxes on those same corporations and their overlords to the tune of $1.5 trillion.

Those who complain “We can’t afford it” are often the same who also boast about us being the richest nation in the world.

The “We can’t afford it” argument is, of course, a lie.

We have always been able to afford to provide every man, woman, and child born in this country healthcare as a human right.

A report from the Congressional Budget Office (CBO) late last year illustrates that, not only could we always afford it, but Medicare-for-All could cost even less than what the most ardent Medicare-for-All advocates propose.

Upon the several single-payer models researchers examined, four fully implemented by 2030 would save the country from $42 billion to $743 billion in just that year.

The model closest to the Medicare-for-All framework most advocates support is based on low payment rates and low cost sharing, producing $650 billion in savings in 2030.

Right now, combining Medicare, Medicaid, insurance premiums, and out-of-pocket costs, we are expected to spend about $52 trillion on health care during the next decade.

But Medicare-for-All would eliminate premiums and out-of-pocket costs, reducing the price tag to between $20 trillion and $36 trillion over the same period.

That happens to be same amount the federal government set aside for corporate welfare since 2008.

After the 2008 financial crash, we granted $700 billion to big banks.

The Federal Reserve committed between $16 trillion and $29 trillion to large financial institutions.

Lawmakers recently handed $4 trillion in pandemic relief to large corporations.

Over the past twelve years we have spent in the neighborhood between $20-35 trillion on corporate bailouts.

Three years ago, Republicans jumped at the opportunity to cite a Koch Brothers-funded Mercatus Center study to prove once and for all single-payer health care is too expensive, despite its economic advantages and popularity among the public and U.S. lawmakers.

David Himmelstein and Steffie Woolhandler, health policy experts and co-founders of Physicians for a National Health Program (PNHP), explained:

“The Mercatus Center’s estimate of the cost of implementing Sen. Bernie Sanders’ Medicare-for All-Act projects outlandish increases in the utilization of medical care, ignores vast savings under single-payer reform, and fails to even mention the extensive and well-documented evidence on single-payer systems in other nationswhich all spend far less per person on health care than we do. [The] report undercounts administrative savings by more than $8.3 trillion over 10 years. Taking those savings into account would lower Blahous’s estimate from $32.6 trillion to $24.3 trillion.”

Those administrative savings could start by eliminating or significantly reducing the overhead produced in medical billing, on which the United States spends twice as much as Canada.

How much savings?

About $89 billion a year.

Another component: salaries and marketing expenses.

Health insurance companies are, fundamentally, just banks on which insurers spend more than 20% of total expenditures on overhead.

Medicare, on the other hand, spends around 2%.

Transitioning everyone away from private for-profit health insurance to a Medicare-for-All system would save around $200 billion in overhead alone.

Think about every time we visit a doctor (including via tele-medicine) or walk-in clinic.

If we are fortunate enough to have employer-based healthcare for which we pay premiums, we are also responsible for co-payments, which can vary–sometimes widely–from person to person depending on types of plans employers offer.

Those premiums and co-payments are functionally taxes even though we aren’t accustomed to thinking of them as such.

Under a Medicare-for-All-type system, we would all–ALL–be paying premiums Medicare already charges, without co-payments or deductibles.

This would bring in $210 billion in revenue.

We currently pay subsidies for two insurance columns: employer-provided plans and those offered via private insurers through the Patient Protection and Affordable Care Act (ACA); aka “Obamacare.”

A single-payer model would reduce it down to just one, saving about $161 billion.

Employers would no longer have to factor health insurance coverage in their books, saving them millions.

Unions would no longer have to negotiate with management over heath care coverage and costs.

We could see any doctor at any time without having to worry about how much it’s going to cost.

A hospital stay wouldn’t cast people into debt.

No more “surprise bills.”

The neo-liberal shift over the past forty years has prioritized Wall Street, the defense industry, and generally any individual or corporation ideologically committed enough to capitalize on the “money=free speech” argument the Supreme Court agreed is constitutional.

That includes health insurance companies.

More Americans favor a single-payer national healthcare system now than ever before, and they are sick (no pun intended) of sacrificing their sovereignty and security so another obscenely rich CEO can bilk from them another billion dollars in tax-deferred compensation.