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Single-payer coverage eyed in New York State

Conservative House Republicans, flush from their 2010 victory over the perceived overreach of the Obama health care law, flooded the Capitol with heroic-sounding legislation last winter.

The titles include the No Taxpayer Funding for Abortion Act, the Reclaiming Individual Liberty Act and my favorite, the Revoke Excessive Policies that Encroach on Individual Freedom Act. There are scores of these ideological bills, most written by health insurance lobbyists or special interest groups. None will become law this session because of the Democratic-controlled Senate and President Obama.

Momentum is moving in a very different direction in liberal Vermont, and maybe in New York State. A month ago, Vermont Gov. Peter Shumlin signed a law that will create a single-payer health care system, parallel to Canada's.

In New York, Assemblyman Richard Gottfried, D-Manhattan, has introduced legislation creating a single-payer plan for all residents of the state. Gottfried is Health Committee chairman. His bill has more than 60 Assembly and Senate co-sponsors. Among them are Democratic Assembly Members Sam Hoyt, Crystal Peoples-Stokes and Mark F. Schroeder, of Buffalo.

The bill creates the State Health Plan, which would become an authority, drawing revenues from the State Health Trust Fund. The fund would get its money from federal and other funds already going to the state from Medicaid and other sources, plus new payroll taxes. The payroll taxes would be 2 percent on employees, 8 percent on employers and 10 percent on the self-employed. Private health insurance premiums now are about 22 percent to 25 percent of payroll.

New York and Vermont have this in common -- both states have a much higher share of their residents covered by either Medicare or Medicaid. In New York, it's 41 percent and in Vermont, it's 43 percent, according to the Kaiser Family Foundation. Nationally, the number is 34 percent. The Kaiser data is two years old, so the percentages of public coverage are probably much higher now.

"We can get better coverage, get all of us covered and save billions by having New York provide publicly sponsored single-payer health coverage," Gottfried said.

He said this may be the closest New York could get to an economic silver bullet, making the state much more "job friendly" by eliminating the need for employers to pay for health insurance.

Right now, the state is in the cellar as a place to do business. Health care costs are at least 16 percent of all goods and services produced statewide, or nationally. Most other industrialized nations spend 8 percent to 10 percent on health care and get better quality.

More importantly, a single-payer system would provide coverage for individuals, as more and more private employers say they are planning to end paying for this defined benefit when the weaker federal plan becomes effective in 2014.

Gottfried's bill has miles to go before becoming law. Gov. Andrew M. Cuomo has no known position on it. Cuomo was by turns friendly and critical of the insurance industry as attorney general. The bill at least has early strong support from some Democrats from across the state.

In Congress, most Democrats are scared to death of the term "single-payer." This is because of the propaganda blanket the insurance industry has spread over Washington, huge amounts the health business invests in elections, and the infiltration of ultra-rightists into the national tea party movement.

The Commonwealth Fund notes that Sen. Bernie Sanders, I-Vt., has a bill calling on all states to create a single-payer system. It has no co-sponsors. Only veteran Rep. John Conyers, D-Mich., has introduced a comprehensive federal single-payer bill called Medicare for All. Among the 60 co-sponsors of the bill, six are from New York; but none from Erie-Niagara.


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