Jeff Mikkelson of Cold Spring is a co-founder of Hudson Valley Demands New York Health.
What is the New York Health Act?
It’s a bill before the Legislature that would guarantee comprehensive health care to every resident and full-time worker in the state. It would cover primary and specialty care, as well as mental and reproductive health, dental, vision, hearing, prescriptions and long-term care. It would operate as a single-payer system, with no network restrictions, no premiums and no fees at the point of service.
How would it differ from the health insurance marketplace?
It would be infinitely simpler. The system we have now is a mix of hundreds of public and private insurance plans, each of which has its own network and terms. Under the Health Act, everyone would be covered by the same comprehensive plan. Funding would come through money that the state gets from the federal government for Medicaid, Medicare and other programs, and a progressive tax on income. Right now, I pay the same for a given health care plan that a billionaire would. Under the Health Act, your contribution would be based on your ability to pay.
It sounds too good to be true.
That’s a natural reaction because we’ve lived under this dysfunctional system for so long. Almost every developed country in the world covers its residents better than we do, and more cheaply. Medicare is the closest thing that we have to a single-payer system. It runs more efficiently than the private system, with administrative costs that are a fraction of the insurance industry’s. Two large-scale studies concluded that the New York Health Act would cover more people better than we do now, cost less for individuals and save the state billions of dollars each year. In addition to lower administrative costs, we would be bargaining collectively for better prices.
Why are you passionate about this?
My mother had many health problems at the end of her life and was constantly trying to figure out whether she was covered for this procedure or that. I developed a deep sense of the injustice of our system. I wanted to work toward change that I thought was possible in the midst of the chaos we have in this country. If we could get this passed, it would impact every single New Yorker. We could become a model for the rest of the country. I’m also a small-business owner, and for many years, at the beginning of my career, I didn’t have health insurance. I was lucky because I didn’t get seriously ill.
The bill was introduced in the Assembly in 1992 and has been reintroduced many times since. Why do you think this year will be any different?
It’s picked up steam in recent years. It’s passed the Assembly by large margins four times and last year was one vote shy of a majority in the Senate. A lot of proponents of the Act were elected in 2020, so we have people coming in who want to see it get done. If you look at the bigger picture, the pandemic has underscored the need for fundamental change in the way we administer health care. A lot of the inefficiencies in our system have been multiplied, especially in communities of color and disadvantaged areas. New York is facing a big budget crunch and the Health Act could become attractive to municipalities unable to meet their budgets in coming years.
I don’t understand this viewpoint on health care. I’m for a type of universal health care, whether it be from the state or federal government. In this case, though, how to pay for what is called for in the New York Health Act is a valid question.
New York state has one of the most progressive income taxes in the nation already and still doesn’t raise nearly enough for this. More than 50 percent of our state income tax comes from the top 1 percent of earners. If we increase taxes on that group, what’s to stop them from moving to New Jersey or Connecticut or change their primary residence to Florida? If half of the 1 percent leaves, that could sink the state budget. Is there a plan to deal with this aspect that I’m missing? [via Facebook]
Mikkelson mentions that “funding would come through money that the state gets from the federal government for Medicaid, Medicare and other programs, and a progressive tax on income.” He also mentions single-payer systems like this one cut out the administrative costs of middle-men, so it would save the state money in the long run. People are just so used to our inefficient and profit-minded insurance system that the idea that medical care shouldn’t be expensive seems like a big idea. [via Facebook]
Mikkelson talks about the government plan making it simpler. When’s the last time the government made anything simple? It can’t even distribute a vaccine, yet there are those who want to hand our entire health care system to the government. [via Facebook]
I do not need or want New York state or the feds running health care. If the government wants to have a plan out there for people to opt into as one of their health plan choices, then perfect, go for it. [via Facebook]
I enjoyed the comments from readers about the New York Health Act in response to 5 Questions. A robust debate on our health care system is exactly what’s needed. I’d like to address three of the questions raised.
How do we pay for it? The plan is funded through federal dollars and a progressive tax on income, replacing the regressive tax we pay now in the form of premiums, co-pays and deductibles. But the larger point is that the system we can’t afford is the one we have now. We pay twice as much for health care as other major countries and get worse results. Multiple studies have concluded the act would cover more people more cheaply. Local governments and schools would save millions, and the state would save billions. Property taxes would go down because counties would no longer be required to contribute to Medicaid.
Won’t rich New Yorkers leave if we raise their taxes? Tax flight is a perennial excuse (or threat) to keep taxes low on the wealthy and large corporations, but it is a myth. The rich can afford to live wherever they want. The top 1 percent does pay a large share of the income tax in New York, but not because they’re overtaxed — several states tax them more — but because they claim a disproportionate share of the income. New York has the highest level of income inequality in the country.
How can government be trusted to handle this? In the last year we’ve witnessed the catastrophic failure of public health and infrastructure systems thanks to decades of bad policies and bad governance. The way to address these failures is through better policies and governance, not by continuing to allow the private insurance industry to put profit over patients.
If you’d like to know more, visit nyhcampaign.org.