N.Y. single-payer health care bill gets wide support

Council member Corey Johnson and Raging Grannies face off against insurance brokers at daylong hearing

By Irina Ivanova
Crain's New York Business, Dec. 16, 2014

The Affordable Care Act has made an unwieldy system of health insurance even more complicated, and should be replaced with a centralized, tax-funded health care system.

That was the prevailing view at Tuesday's all-day hearing on the New York Health Act, Assemblyman Richard Gottfried's bill to create statewide single-payer health insurance that stands almost no chance of passing in the state Senate.

The handful of insurance representatives who testified for a wait-and-see approach followed their speeches with a swift exit, often to the tune of hisses and groans from patients, health care workers and unions in the audience who far outnumbered them.

“No one advancement is big enough to bend the cost curve in itself,” said Lawrence Thaul, president of Millennium Financial, an insurance brokerage. “It took many years to improve Medicare. Let us not be shortsighted and impatient—and you've been anything but that, chair,” he hastily added to Mr. Gottfried, who chaired the hearing.

Mr. Gottfried, who heads the Assembly’s committee on health, has carried a version of his single-payer legislation since 1999.

Many doctors and health care workers bemoaned the amount of time spent billing and collecting payment for medical care. 

“I employ 24 separate billing people,” said Dr. Neil Calman, president of the Institute for Family Health, “each of whom develops a relationship with one or two paying companies.” Dr. Donald Moore, who recently stopped accepting commercial health insurance, said he used to spend the equivalent of three to four weeks every year billing for his work.

But without this back-and-forth between providers and insurance companies to drive down providers’ charges, health care would cost even more, argued insurance executives.

“Price controls would not work because there would be no one on whom to shift the excess costs,” said Craig Hasday, the legislative chair of the New York State Association of Health Underwriters. “Over time, the issue of affordability will return, but as a tax issue."

Proponents of the bill included speakers from the nurses' union and other organized labor groups, Green Party activists and even eight elderly activists who called themselves the Raging Grannies. The grannies, decked in flowers, sang songs supporting the bill to the tune of "Rudolph the Red-Nosed Reindeer."

Councilman Corey Johnson spoke about the inconvenience of getting his prescriptions even under the City Council's generous health plan. Even the mayor's office weighed in, writing in a letter that "a single-payer system merits serious consideration because of its financial benefits for the city."

This iteration of the New York Health Act comes at a time when providers and insurers increasingly are turning to population health management and ever-larger systems as a way of controlling costs. One of the state’s largest Medicaid reform attempts to date, the $8 billion DSRIP waiver, asks hospitals, community providers and insurance companies to collaborate to reduce hospital admissions.

For Dr. Hemant Sindhu, a resident at Brookdale Hospital, Medicaid reform is single-payer in miniature.

“There is no doubt,” he said, “that having a unified payment system allowed to rapid transformation and improvement of health care."