Could this be the year for single-payer health care?

By Casey Seiler
Times Union (Albany, N.Y.), Capitol Confidential blog, March 7, 2013

Probably not — but that didn’t stop Assemblyman Richard Gottfried from rolling out the latest version of his perennial bill establishing a statewide single-payer health care system, a structure often shorthanded by advocates nationwide as “Medicare for all.”

Backed by nurses, physicians, anti-poverty activist Mark Dunlea and a clutch of his fellow Democratic lawmakers, Gottfried discussed the bill at a Thursday news conference.

The Manhattan Democrat’s legislation, A.5389, has 73 co-sponsors in his chamber — though Speaker Sheldon Silver is not among them — and about a dozen in the Senate, where the measure is now carried by Bill Perkins. (Until this year, Tom Duane served as its Senate sponsor.)

Even though the nation is only beginning to implement the federal Affordable Health Care Act, Gottfried said the Empire State shouldn’t have to wait years before seeing where it falls short. “Federal health care reform has done a lot of good, but it still leaves us in the hands of insurance companies,” Gottfried said. “New York can do better.”

The New York Health Act would replace all private insurance coverage with comprehensive, universal coverage for every New Yorker, he explained.

“It would save the billions of dollars that we now spend on insurance company administrative costs. … You and your doctor would work to keep you healthy. New York Health would pay the bill with funding from broad-based revenue based on ability to pay,” Gottfried said.

The two sources of revenue: a progressive payroll tax paid for primarily by employers with contributions by workers, and a surcharge on investment income. It would also require the demise of the health insurance industry in New York — a transformation business groups view as only slightly better than the apocalypse.

The bill’s only appearance on the floor of the Assembly was in 1992, when it passed before being promptly ignored by the Republican-controlled state Senate.

“In the intervening years, as Gilda Radner said, ‘It’s always something,’” Gottfried said. “People who would have been focused on single-payer for a couple of years were focused on the Clinton health plan. Then people here in New York were focused on managed-care reforms and for many years fighting against drastic cuts in Medicaid that were on the table. And then for the last several years people were focused on getting health care reform enacted in Washington. Now that federal health care reform is done and people can now assess what good it has done and what it has left undone, I think we are really ready to refocus on single-payer.”

He called it a “superb year” to reconsider the plan. Perkins said that this appeared to be a good year for progressive legislation — an apparent reference to Gov. Andrew Cuomo’s new emphasis — but struck a realistic tone.

“Listen, let’s be for real: There are a lot of monied interests that are involved in this,” Perkins said. “The privatized model is about profit; it’s about paying for policies that do not necessarily speak to the best interests of the community, to the best interests of people. And therefore, to some extent it measures how valuable this is — because there’s so much effort over the years to prevent (the bill) from even getting to daylight.”

Advocates have been cheered by the passage of a single-payer bill in Vermont, although the Green Mountain State won’t be able to implement its system until at least 2017, at which point it will have to seek extensive federal approvals before moving forward. Gov. Peter Shumlin has commented that his state’s move is especially valuable because Vermont’s relatively small population makes it a better lab for a single-payer system. New York, in contrast, is one of the most populous states in the nation.

Casey Seiler is Capitol bureau chief for the Times Union.

For the text above and a link to a video of the press conference: