Single Payer Health Care Won’t Work In New York

We’re sure we’re not done hearing about the wonders of a single payer health care system in New York state.

New Yorkers can thank U.S. Sen. Bernie Sanders, D-Vt., for that. After making single payer health care a focus of his presidential campaign in 2016, of course progressives in New York’s Democratic Party were going to pick up the torch for Sanders’ progressive giveaway. Cynthia Nixon, Gov. Andrew Cuomo’s challenger in a Democratic Party primary for governor, has already taken the single payer pledge. No one should be shocked to see the Rand Corporation issued a report last week saying a single payer system is feasible in New York if certain conditions are met.

It doesn’t appear those conditions will be met anytime soon — and that should make single-payer a non-starter regardless of the fate of legislation that has passed the Democrat-led state Assembly.

First, as long as Donald Trump is president, New York state will not receive the waivers necessary to transform federal health care program funding into the dollars necessary to run a single payer health care system in New York state. The system is simply too costly without the federal dollars.

Second, as long as Gov. Andrew Cuomo is concerned about the impact of the federal government’s tax reform law on high-income wage earners, he should not, in good conscience, try to implement a single payer health care system that will be paid for on the backs of high-income wage earners in New York state. The plan analyzed by the Rand Corporation shows the lowest income individuals contributing 17 percent of their income toward health care and the highest-income individuals contributing the most at 36 percent of their earnings. One can’t try to protect those wage earners when it suits a political purpose only to levy a new tax on them to curry favor with the state’s progressive wing of the Democratic Party.

Progressives are trumpeting the Rand Report’s potential long-term cost savings of 3.1 percent by 2031 compared to the existing health care system and the report’s conclusion that a single payer health care system is feasible. A deeper read of the Rand report, however, shows issues that shouldn’t be glossed over. That 3 percent savings is only achievable if administrative costs and growth in provider payment rates are reduced. And, nonfinancial factors would still limit access to health care. The Rand report mentions a 10 percent increase in patient demand for hospital care and a 15 percent increase in demand for physician services — meaning longer wait times for patients trying to get appointments and doctors who aren’t accepting the patients who now have a state-backed insurance plan.

And, while progressives are likely to trumpet the 2031 cost savings, they probably aren’t talking much about the 156 percent increase in state tax revenue needed by 2022 to pay for single payer until the savings kick in. We haven’t dealt with the elephant in the room yet — what happens if you like your employer-provided health care plan?

Single payer health care shows that a plan may be feasible and still be bad policy at the same time.