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Sunday, June 17, 2018

Watching New York Commit Suicide

The lower house of the New York legislature just passed a single payer universal health plan again for the fourth year in a row.  The plan lets people sign up for medical coverage that has no network restrictions, no co-pays and no deductibles.  It's the kind of plan that New York's liberals think is great.  Of course, were it to be passed by the State Senate, it would be the end of the road for New York.

Imagine what would happen.  Companies across New York would drop providing health care coverage for their employees.  There's no need to give coverage if it is available under the single payer state plan.  Individuals who get coverage through the Obamacare exchange would also drop their plans.  After all, the policies sold by Obamacare in New York are expensive, come with huge deductibles and have restrictive networks that exclude the better hospitals and no coverage for out of network care.  The wealthy would, no doubt, pay for their own care at one of the many doctors and facilities that don't take insurance or most insurance.  Still, this would surely lead to a reduction in the amounts paid to hospitals, doctors, and other facilities for care.  Instead of crazy high prices with the hospitals getting only 25 or 30% approved by insurance, the prices overall would come down.  That would be a boon to the wealthy.  A two part problem, however, would then develop.  First, all those cutting edge teaching hospitals in New York would probably go under.  Surely, the state plan won't pay enough for people to get their cancer care at Memorial/Sloan Kettering, the premiere cancer hospital in the region and, likely, the country.  That hospital would fail as would the many other high quality facilities that dot New York.  Second, nurses, doctors and technicians would have to see a big decline in their incomes.  The old days of nurses working long hours for very low pay would be back again.  On the whole, the quality of care would surely decline.  It would be time for care to be reduced in many ways to giving grandma the pain pill (as president Obama once described it).

Think of the British example.  In the UK, they've had the national health service for some 60 plus years.  It takes a long time to get a great many types of procedures.  If you need a knee replacement, you may have to wait for a year or longer, for example.  The wealthy don't use the system, and they get first class care while the average person gets third rate care.

Then there's an even bigger problem for New York.  The level of taxation that would be needed to fund this system is extraordinary.  New Yorkers already pay some of the highest taxes in the country.  Would anyone actually move to New York if the income tax level were 20% (on top of the federal taxes due?)  I don't think so.  I also don't think many companies would move their plants or offices to a state with a massive corporate income tax either.  People would flee.  Companies would flee.  Jobs would flee.  But hey, New Yorkers could tell each other that they had universal single payer healthcare.  It could be a big topic of conversation among the millions who would eventually leave the state.

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