To the editor:
I am struggling to understand why more people aren’t insisting on single-payer health care at both the national and local level.
Opposition from insurance companies protecting their profits is one factor, and it is formidable. They publish horror stories about long wait times for appointments and deterioration of care, but that is what we have now. The conflict between an insurance company and Montefiore Health System over profit has left thousands of patients scrambling to find new doctors.
According to New York Focus, “nearly 250,000 retired New York City employees and their spouses could have their health insurance changed to Medicare Advantage plans managed by private insurers.”
An increase of as much as $5,000 in annual out-of-pocket costs per retiree might be in the agreement.
The plans offer expanded benefits like gym memberships, but according to one retired city administrator, “The word on the street is that these Advantage plans are fine — as long as you don’t get sick.” Providing the insurance companies with more profit will not lower medical costs for the individual.
The insurance companies maintain that providing health care to every resident of New York as promised in the New York Health Act will make health care unaffordable. It seems to me it is unaffordable now. New York state today pays $55 billion to some 50 insurance companies — each with different doctor networks, formularies, and paperwork requirements — to pay for health care administration.
None of this money actually goes to health care.
The sponsors of the New York Health Act maintain that eliminating these contracts with insurers would result in savings of most of the $55 billion, thereby enabling New York state to afford universal health care. A progressive premium for health care based on income will be a more equitable solution to paying for care if there is a shortfall.
So what factors make people hesitate to demand universal health care? Some may fear “deals” like the proposed New York City arrangement for public employees. We can vote out legislators that sign such contracts.
Some may fear that one formulary for all New Yorkers may eliminate a drug they need. But the buying power of the state will certainly lower the cost of most drugs, and an appeal process in the state should be more lenient than one with the insurance company.
I think that the biggest factor in the New York Health Act hesitancy is simply fear of the unknown. It is hard to imagine what does not exist today. My own struggle to imagine life with the bill provides some insight.
For access to a new vision, I need to go back in time. During my childhood, medical care was routine, not noteworthy. We had regular check-ups, and our local doctor stitched up more serious cuts. Certainly that world seems gone forever.
I do remember both my husband and I losing our jobs just after my second daughter was born. I was so worried about paying for COBRA, I took a minimum wage job in a dental office. That was my health care trauma, my first awareness of how critical health insurance could be.
So I think that my vision of life under the New York Health Act is primarily about not having to worry about paying for health care, even when you lose your job.
The New York Health Act is comprehensively providing preventive care, and continuity with the same doctor. It provides many important services some of us might never need, including treatment for drug addiction, mental illness, and long-term care.
In my imagination, life with the New York Health Act provides the security of knowing there will be access to care, even if I lose my job. That is more important than any one service.
Each New Yorker may struggle as I do, trying to imagine the new system, characterizing the system without their own health care struggle. For everyone’s peace of mind, let’s pass the New York Health Act.