[Credit: Pictures of Money / flickr]
Editorial Note: This piece is written by a Marxist Unity member and may not reflect the views of the caucus as a whole.
"Health is capitalism’s vulnerability. There is no capital without health—it is capital’s host. And capitalism’s greatest trick is convincing us that it exists independent of this parasitic grasp. That it is indifferent."
“Health Communism,” by Beatrice Adler-Bolton and Artie Vierkant
My lips are flapping explaining the New York Health Act (NYHA) over and over, because this simple bill is the best kept secret in NY. You, me, Governor Hochul, Mayor Adams would all have the same coverage and access to quality healthcare. Health outcomes would not be determined by ability to pay. Every New Yorker and everybody working in NYS would be covered for all medical costs from the cradle to the grave. Medical decisions would be between you and your doctor without an insurance agent denying or pre-approving. The NYHA would expand and improve Medicaid and Medicare. No network restrictions, you choose any doctor, any hospital, any clinic. The state through the NYHA board would pay all the costs (single payer). Private insurance companies would be gone.
So what’s the problem? Why hasn’t this bill passed now that for the last 4 years the Democrats have majorities in both the assembly and senate, and with a majority of those Democrats co-sponsoring the bill, at least on paper? It could be a number of reasons:
Co-sponsors in some cases are only “paper” supporters but have secretly signaled to leadership (Carl Heastie in the assembly, Andrea Stewart-Cousins in the senate) that they will not vote for it if brought to the floor.
Some unions, in particular the big two public sector unions UFT (who used to support the bill not that many years ago), and DC37 are opposing the bill. Legislators, including the leaders, have said they will not push the bill without union support
Other unions are not as vocal or militant as they could be in their support of the bill. A visit to their websites shows you an absence of open and notorious support.
Some legislators and the governor are taking donations from private insurance firms and others opposed to the bill.
Meanwhile health insurance companies are forever pushing for higher premiums. This year they began by asking for 12% increases. The unions and everybody else are scrambling to negotiate or find plans that will work for them as hospitals and clinics close around the state and city and network restrictions blow patients off like lawn clippings under the mower. New Yorkers are taking a beating as individuals, as families, and as part of the economy as a whole. Aside from the suffering of illness and death for lack of adequate care, medical debt is causing families to lose their homes, become bankrupt, and go unable to buy food, diapers, and other stuff that keeps our economy going.
It would be misleading to portray the NYHA as socialized medicine, however it is an imperative struggle that DSA might well choose to lead the way in or at least to join in. Here’s why.
The single payer program is funded by a progressive tax on income, not just payroll. Dividends, capital gains and interest would be taxed. So, it would be paid for by a tax on the rich with 95% of the families in NYS actually paying less than they pay now in premiums, copays, and deductibles.
Unions would not have to negotiate healthcare benefits and could focus their collective bargaining might on wages and work conditions, breaking the patterns set during WWII under the federally mandated wage freezes of that time, when employers offered health insurance to attract new hires and retain their workforce and unions bargained for those benefits because higher wages were not an option.
Equal quality healthcare would be guaranteed to all regardless of employment or documentation.
Studies have shown that the savings would allow long term care, ie. home care and nursing home care to be covered for all as mandated in the bill and still cost less overall than the current expenditure.
With the pool of 20 million New Yorkers, negotiations with big pharma would drive down drug prices and hospital prices. This would mean more savings which could in turn be directed at expanded health programs to perhaps include things like pool and gym memberships, as well as public green spaces.
As a part of the “minimum” program the fight for the NY Health Act allows us to expose the bad actors in the state legislature and to expose capitalism and our enemies in the insurance industry and big pharma as the villain we know them to be. It allows us to build seasoned troops and to enter into coalition with groups of our choosing, including the highly successful movement of the retirees in NYC rattling the established order with their fight against privatized Medicare
It is seeing growing support from democratic caucuses and rank-and-file within the unions, where even DC37 is being threatened with possible premiums for their members and SAG of whom more than 70% have zero coverage through their union
It would get the privatizers and profiteers out of the picture at a time when private equity firms are trying to shoehorn their way into our last remaining public institutions like the schools and post office as well as extending their reach into healthcare. The NYHA would for example eliminate the private MCOs already subcontracted to manage parts of Medicaid.
The bill could, of course, be improved. One we could get behind is that positions on the board governing and implementing the NYHA be elected instead of appointed. For more on the NYHA look for a series of webinars, town halls and NYHA 101’s coming up in the next couple of months.