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Another Voice: Single-payer health insurance proposal is unrealistic

By Don Ingalls

The Buffalo Common Council passed a symbolic resolution Feb. 22 supporting state legislation to create a single-payer health system in New York.

The proposal presents an unrealistic view of universal health care, where everyone would be covered, everything would be covered and the system would magically pay for it all. There is a great chasm between this idealized world and reality, and this proposal lacks any infrastructure to bridge it.

The most significant flaw is the idea that coverage would be publicly funded using federal monies now used for Medicare as well as federal and state dollars, magnified by the vast uncertainty about health care emanating from Washington. The funds would also supposedly come from what now goes to Medicaid and Child Health Plus, coupled with an enormous state personal income tax increase and a surcharge on business income taxes or a payroll tax.

This action would destroy Medicare as we know it and disrupt the health care delivery system for nearly 3 million elderly and chronically disabled New Yorkers. This proposal ignores the fact that New York has no authority over another almost 7 million New Yorkers who are covered by self-insured plans – approximately 36 percent of the state’s insured population.

Not only would the bill propose forcing these people to give up coverage they have and presumably like, it would also impose new taxes to pay for it. Moreover, the proposal presumes providers will accept reimbursement at a government-set level, which doctors and hospitals already argue does not cover their costs.

Except for setting government price controls, the proposal does nothing to realign myriad factors that contribute to our current escalating health care costs. Failing to take any steps to rein in rising hospital and drug costs, price controls will have the undesired effect of virtually eliminating innovation and efficiency.

The bill also promises to promote improved quality of, and access to, health care services and improved clinical outcomes, yet offers no mechanisms to deliver the promises.

At the same time, it disregards current tools – including the Healthcare Effectiveness Data and Information Set and New York’s Quality Assurance Reporting Requirements – that measure and report quality, and have a track record of improving quality of care delivered over time.

Finally, the New York Health bill completely ignores the significant contributions New York’s health plans like BlueCross BlueShield of Western New York make to the state and local economies as employers and strong corporate citizens.

Don Ingalls is vice president of state and federal relations for BlueCross BlueShield of Western New York.

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