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Bill number A4738, New York Health Act – Is the 3rd time really a charm?

Author: Melissa Switzer 

In the case of a single payer “Medicare for all” plan in New York State, it might very well be.   NYS is in the home stretch to enact a single payer system for all New York residents. The New York State Assembly passed bill number A4738, New York Health Act.

This act makes all New York state residents eligible to enroll in a single payer system, regardless of age, income, wealth, employment or other status. This proposal would provide comprehensive health coverage to all who enrolled. There would be no copays, no deductibles and no network restrictions. This plan would cover outpatient and inpatient medical care, primary and preventive care, prescription drugs, laboratory tests, rehabilitative, dental, vision and hearing.

Versions of this bill have been passed in the Assembly both in 2015 and 2016, but never got past the New York Senate.   The 2017 version of the bill has been introduced into the Senate and is currently at the committee.   From here, the Senate will need to debate and vote on the measure before being sent to Governor Cuomo to sign or veto.

Free health care! Sounds great, right? Not so fast.  Although there will be no traditional methods of cost sharing for your health plan, you will still shoulder some of the cost to help fund this system. A proposed progressively-graduated payroll based premium is included in this bill split between employer and employee.

  • Employers would no longer provide premium contributions to private insurances. They would pay a proposed payroll tax based on their employees’ wages totaling 4.5% in addition to their current Medicare tax of 1.45%
  • Employees would contribute to this fund by a proposed payroll tax of 3.3% in addition to their current Medicare tax of 4.45%.   This would in theory replace their premium charges and all traditional out-of-pockets expenses.
  • Self Employed individuals would cover 100% of payroll tax costs.

In addition to the above payroll tax, the bill also allows for a progressively-graduated premium based on other taxable income such as interest, dividends and capital gains.   Funding will also come in other forms, such as federal funds and grants.

This bill changes the health insurance industry for New Yorkers as we know it. It essentially replaces private insurance and traditional ways of obtaining insurance.   What does this mean for the thousands of workers in the insurance industry in Western New York area? It is too early to know. However, the bill includes a provision that will provide funding to retrain and assist in job transition for any individual displaced as a result of this new law.

There are more questions than answers at this point. Even if this bill makes it through the Senate, there will be a significant amount of time before the wrinkles are smoothed out and it is implemented.

Will the 3rd time really be a charm or will this bill ultimately fail in the senate again and simply become a case of déjà vu?

Image: clarita

Melissa Switzer is Vice President of Sales at Choice Employee Benefits Group. CEBG is an independent broker servicing the WNY business community since 2000. Melissa is a lifelong resident of WNY. When she isn’t consulting on employee benefits, she is raising two little boys with her husband in Hamburg.

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  • Johnny Pizza

    I have always believed single payer is the way to go.

    • rubagreta

      Hey, it’s “free.” Why not?

      • No_Illusions

        Do you have any idea how much your employer contributes to your overpriced insurance policies?

        Insurance is expensive enough where Toyota decided to build a plant in Canada instead of the US, because health benefits are too expensive here.

        Nobody likes employer based healthcare. Employees often get shafted or specific needs go unmet, and companies have to deal with a whole host of HR hassle and other costs.

  • grovercleveland

    No, the third time will not be the charm.

  • rubagreta

    Great. Let’s bankrupt New York. Vermont wanted to do this, ran the numbers, and realized that they would be bankrupted.

    It absolutely amazes me that people think a monstrous government bureaucracy run by one of the most corrupt states in the country will be able to run our healthcare system. Meanwhile, we are going to fire how many people who work for private insurance companies?

    The only good news is that my property taxes will go down because I won’t have to fund the Mercedes healthcare plans of the public employees.

    Any cops, teachers, firefighters or other public employees reading this? Will you be happy giving up your Mercedes health plan and have the same crappy Yugo plan we’re all going to get? Because with everyone going to the doctor for “free,” healthcare will be rationed, and you will be waiting on long lines for that hip surgery you were hoping for.

    • Randy503

      You mean like Canada? If’s free there, and Canadians love their system. And the Britains. And the Japanese. And the Europeans.

      • rubagreta

        Canada pays $17 billion for defense. We pay almost $600 billion, which includes paying for their real defense. If we knocked our defense budget down to $170 billion (10X Canada because we have 10X the population) we could do it.

        And by the way, few countries have Canada’s system where private insurance is ILLEGAL, and it is ILLEGAL to pay a doctor directly. Why not?

        • No_Illusions

          What about the British system which has private insurance companies and private medical clinics?

          You’re treating all single payer systems the same, when they can be very different.

        • No_Illusions

          You do realize Canada has more people than New York right?

          Germany has 4x the population and Japan 7x.

          • rubagreta

            I’m talking more about the DC plan to have FEDERAL health insurance. That’s what the Left wants. One insurance company for the entire country. Good grief.

          • No_Illusions

            Great, but this bill isn’t about that.

      • rubagreta

        Google Canada and hip surgery. But if you have the money, you can skip the line and get the surgery in Buffalo. No wait.

        • rubagreta

          Canada limits doctor’s salaries. With no limits, and the so-called “free” plan offered by New York, doctors can charge anything they want, and patients won’t care. IT IS NOT SUSTAINABLE.

        • No_Illusions

          Google Mexico and hip surgery.

          If healthcare is currently so great why do Americans go to Mexico and other countries as medical tourists?

          Also, nobody is suggesting adopting the Canadian system verbatim.

          • rubagreta

            BECAUSE IT’S CHEAP, that’s why. Low cost of living, doctors probably don’t even make 100K, and nurses make nothing.

            And Mexico is one of the most private systems in the world. That’s real competition. Medical care is cheap. Although I have no idea how they handle cancer and other serious illnesses.

            My wife had a 10-minute procedure. It was billed as surgery and cost $450! That’s why our healthcare is so expensive.

        • BlackRockLifer

          I worked in Niagara Falls for 10 years and many of my co-workers were Canadians, also several were Americans that married Canadians and moved to Canada. They complained about their health care system just like we do but NONE of them especially the Americans would ever consider trading theirs for ours.

          • rubagreta

            Not here to defend our healthcare system. But do go from one extreme (health care tied to employment) to another (single-payer, including outlawing private insurance and making it a crime for a doctor to take direct payment) is beyond ridiculous.

    • No_Illusions

      How? If the tax is less than what you’re employer and yourself are contributing towards your health plan, you’re going to be saving money, and will likely have a better policy.

      If you make $40,000 a year, 3% is $1,200 a year, or $100 a month..

      Not sure about you but I contribute $100 biweekly for my private health plan.

      Also it is neither business friendly or a benefit to employees that it’s an employers job to provide healthcare to employees.

      • rubagreta

        Whatever they say it will cost, double it. Do you really think $1,200/year pays for the type of health insurance where you walk into any doctor’s office you want to and it’s “free?”

        Bad deal for the public employees. Right now they pay virtually nothing for their platinum plan. Now they’re going to have to pay 3% (and it will be 6%) for a crap plan. They actually want this?

        • No_Illusions

          You do realize how insurance works right?

          The more people you have on a plan, the more negotiating power you have.

          If the entire state is on a single plan, then that gives us a tremendous amount of negotiating power when it comes to the price of medicine and procedures.

          • rubagreta

            Doctors and top hospital administrators better get set to take paycuts in the 50% range, which will get them to Canadian salaries. We can’t have $2 million executives, and $2 million dollar oncologists milking the system.

          • No_Illusions

            How does the current system solve this issue?

          • rubagreta

            It doesn’t. All I am saying is cutting luck trying to make massive pay cuts to administrators, doctors, and pharma.

            The real way to solve the problem is to live a healthy lifestyle. That would really make insurance rates plummet. But the medical and pharma establishments would hat a country of healthy people.

  • rubagreta

    Self-employed pay everything. So if you are self employed and make 200K (not close to being rich downstate), what would you pay for health insurance? GIVE ME THE NUMBERS.

    • No_Illusions

      Do the math. Its 6.3% in additional taxes.

      That’s just over $5,000 which is well less the cost of a decent private insurance policy for an individual.

      • rubagreta

        These numbers are pulled out of thin air. They are being pushed because the left has an ideology that private health insurance is evil, that paying for the doctor for small stuff is evil, and that everybody should be rounded up and placed into a health insurance system that is 100% controlled by the left.

        That’s what this is all about. It has nothing to do with healthcare. It has to do with control.

        Can’t wait to see the lines when 20 million people are lined up at the doctors office for every little malady because the treatment is “free.”

        • Farras09

          I highly doubt the numbers are being pulled out of thin air. They are forecasts and will likely change but they are not based on nothing.

          This is about control and not healthcare? Um…okay. You just claimed that the numbers are completely made up and then shelled out a tin foil hat theory with no evidence.

          There are plenty of issues that need to be addressed with this but

        • No_Illusions

          “Can’t wait to see the lines when 20 million people are lined up at the doctors office for every little malady because the treatment is “free.””

          I hope this is true. Means more medical related jobs and more people receiving preventive care which is waaaay cheaper than waiting until you need expensive treatments and medicines just to stay alive.

  • BufChester

    “The 2017 version of the bill has been introduced into the Senate and is currently at the committee. ” From whence it will never emerge.

  • Pete

    NYS is still losing its tax base and is now accelerating again after the recession. NYS cannot afford a single payer system and they turn into absolute disasters after a while. Enjoy waiting 6 months to see your doctor. Liberals see no end to government involvement with every aspect of your life. The only difference between ny and russia is that there are many other non socialist ststes to move to that are actually adding population and good long term jobs.

    • No_Illusions

      Soooo instead we’re suppose to rely on our employers to provide us with decent healthcare?

      How is that any better? At least we can keep the government accountable…since you know we’re the ones voting politicians into office. Don’t have that control over the private sector.

      Our current healthcare system is already a disaster. This is a solution that will make it cheaper for the majority of people and employers alike.

      Do you have any idea on how much employers can save by no longer having to provide overpriced health policies for their employers and the cost of overseeing and negotiating policies?

      • rubagreta

        Yes, the employer-based healthcare system, a relic of WW II so companies could get around wage freezes, is beyond ridiculous.

        But so is a government monopoly of insurance.

        Everyone thinks western European countries have 100% government-run insurance. Nothing could be further from the truth.

        Instead of Medicare of All, why don’t we study each of these countries and import their best ideas?

        • Farras09

          what is your solution then if both systems are bad?

        • BlackRockLifer

          Agree with your last sentence

        • Mr_Custard

          There is nothing wrong with studying what each of those countries did and importing their best ideas. In fact, that’s exactly what Taiwan did in 1995 and came up with its system that is based on…Canada’s system (and US Medicare). In the end, though, all those Western European countries have a not-for-profit (or a very tightly regulated system where the insurers make extremely low profits—they’re treated like public utilities—as in Germany)—none of them have for-profit, private insurers in the way we do.

  • Arcot Ramathorn, Jr.

    This is the best idea I heard out of Albany. I’m keeping my fingers crossed they do something for once that makes sense and is the best for its’ citizens. If it becomes a reality we can all forget about ObamaCare, Trump-care.