Advocates Urge New York City Council to Support the State Single-Payer Health Plan

Seven years ago, when Sandra Stein’s son was 2 years old, he woke up having a seizure. At the hospital a few days later, as his family saw him lose his ability to walk and speak, he was diagnosed with autoimmune encephalitis.

Since then, Stein and her husband have been through what she called “a maddening maze” of bureaucracies to make sure their son receives adequate medical treatment. During the first 15 months alone, he shuttled between three different hospitals, and the family dealt with endless billing and payment complications, Stein said.

“The fight to get everything we need to keep our son alive and to avoid bankruptcy is daily and draining,” she said.

Stain told her story Thursday to some 70 citizens and advocates who gathered to express their dissatisfaction and frustration with the state’s health care system during a press conference on the steps of City Hall. They were there to urge the City Council to support a bill that would create a public single-payer health plan for all New York State residents regardless of age, income, employment or legal status.

The bill, known as the New York Health Act, is pending in the New York state legislature. The City Council’s Committee on Health was holding a hearing in advance of voting on a resolution calling for the legislature to pass the proposal and for New York Gov. Andrew Cuomo to sign it.


City Councilmember Mark Levine, chair of the Committee on Health, speaking at the press conference before the hearing. (The Ink/Valeria Piantoni)

“The United States enjoys the largest economy on earth,” Councilmember Mark Levine, chair of the Committee on Health, said in his opening remarks.

“Yet inexplicably—unconscionably—this is a society in which tens of millions of our people lack the basic human right of affordable, accessible, quality healthcare,” he added.  Levine noted that while the U.S. spends more per capita than most other developed countries, the quality of care is “inferior to those of other developed nations.”

According to a report by the Organization for Economic Cooperation and Development (OECD), while the average spending on health in 35 OECD countries in 2016 was $4,000 per person, the U.S. spent $10,000 per person. At the same time, life expectancy gains in the U.S. from 1995 to 2015 were smaller than in other OECD selected high-income countries.

Lawmakers have been trying to tackle the inefficient and expensive health care system in the U.S. for decades. The idea of New York statewide universal coverage gained traction in the early 90s, Katie Robbins, campaign director for the advocacy group New York Health, said in a phone interview. According to Robbins, the proposal has been getting more support since the implementation of the Affordable Care Act in 2010.

“The passage of the Affordable Care Act helped people understand that the government has a role and increased people’s expectation,” she said, adding that recent calls from President Donald Trump to repeal the policy has mobilized citizens.

The proposed legislation passed three times in the Democratic-led State Assembly from 2015 to 2017 but was always stopped at the Senate level. The Assembly passed the bill again in June this year, and advocacy groups see the new Democratic majority in the state Senate as crucial to the final approval of the Act.

The state legislation could come up for a vote in early 2019. Cuomo, who has the power to sign or veto the bill once it’s approved, has expressed some concerns on its economic sustainability, preferring instead the idea of a universal health scheme at the federal level. New York State Assembly Member Richard N. Gottfried, sponsor of the New York Health Act and chair of the Assembly Health Committee, said at the press conference Thursday that the sponsors of the legislation are working to persuade Cuomo to support the policy.


New York State Assembly Member Richard N. Gottfried, sponsor of the New York Health Act and chair of the Assembly Health Committee testifying during the hearing. (The Ink/Valeria Piantoni)

During the hearing, around  50 representatives of doctors’ and nurses’ associations, trade unions, universities and advocacy groups, spoke in favor of the legislative proposal. One dissenting voice was David Richard, the executive vice president of the Greater New York Hospital Association.

According to Richard, “there are huge obstacles” in the way the New York Health Act plans to achieve universal health care. “We do not believe that these obstacles can be overcome,” he said. Obstacles include service disruptions and the financial sustainability of the program, in particular a significant increase in state taxes, he said.

“Our health coverage is a disaster, it needs to be disrupted,” said Gottfried during the hearing when asked to respond to concerns on whether the Health Act will cause disruptions in the current system. At the same time however, he said the disruptions would not affect patients or health care providers.

Gottfried also maintained that, far from being economically unsustainable, the universal program would save the state some $29 billion, as costs stemming from insurance companies and administration would be cut.

According to the legislation, the single-payer health program would be financed by both the state and federal government, by asking for a waiver to move federal funds that the state already receives for the health system into the program. The rest of the funding would come from progressively graduated taxes on income.

A study by the RAND corporation, a research think tank, on the financial viability of the legislation found that the spending under the new program could be slightly lower, 3 percent by 2031, than the current spending. The research noted that the law would require significant shifts in the types of payments as taxes would replace premiums and out-of-pocket payments. The RAND estimate showed that while taxes could rise substantially among the wealthiest residents, they could decline significantly among lower income residents.

“Our results suggest that a single-payer approach has the potential to lower payments among most New Yorkers,” the study said, adding that the results would depend on a number of factors “such as the state’s ability to reduce provider payment rates and administrative expenses, and the response of high-income residents facing new taxes.”

The resolution was passed unanimously, 5-0, by the Committee on Health Monday and is expected to be presented to the full City Council for a vote on Tuesday.

Header photo: New York Health Act advocates on the steps of the City Hall. (The Ink/Valeria Piantoni)