Lobbying for Health: a Fight for the New York Health Act
It was a gathering of medicine and policy, and we were sitting at the far end of a varnished wooden table dressed in our white coats and black suits. We were there to state our case: Get more votes for the New York Health Act.
For some background, the New York Health Act is a bill introduced by Assemblyman Richard Gottfriend and State Senator Bill Perkins. It seeks to create a universal single-payer health plan called New York Health. Under NY Health, every resident in the state of New York would be eligible for health coverage. Funding for the health care would be done through a publicly sourced pool that combines federal funds (such as those for Medicare or Medicaid) and state revenue.
Under the act, private health insurance would be phased out in order to keep individuals funding one pooled resource (having individuals split between public and private insurance may render the system unfeasible). This could reduce the financial burden on New Yorkers since publicly available health insurance wouldn't need to rely on the costly insurance representatives, marketers, or administration that represent private insurance firms.
Through the proposed program, New York providers would have to negotiate with only one health plan that deviates from the traditional fee-for-service.
Earlier forms of the bill have been introduced to the legislative process going back to 1999. This bill, however, has only seen progress within the last year when it passed through the New York State Assembly with an overwhelming vote (89-47). The Republican-controlled Senate still remains a major obstacle to passing New York Health Act, though.
“I’m just a lawyer,” said the bearded man sitting at the other end of the table. The lawyer's assistant sat next to him, earnestly taking notes as we exchange words. We share our stories about the dangers of denied or delayed care from the slow churning machine of the private insurance. Despite being the future physicians and health professionals of 2017, he remains unmoved. Eventually, we leave frustrated knowing that he wasn't swayed, but we go home that night with the small victory of Assembly Members Hunter and Hyndman agreeing to cosponsor the bill after seeing our efforts.
On the quiet bus ride home, I think about the implications of the New York Health Act. It would take work to transfer private health insurance customers into the program. And the absence of New Yorkers spending money on private insurance will inevitably cost some companies' employees their jobs. Furthermore, the act doesn’t seek to regulate health consumption to the same extent that its private counterparts do—meaning that overconsumption of care could become a problem.
On the other hand, I want to imagine a world without private health insurance. Yet, a world without co-pays, deductibles and ever-increasing premiums seems far-fetched. The mechanisms, devised to regulate the abuse of reimbursement almost seem necessary.
My thoughts circle around this conundrum: In order to receive good care, I must pay an extraordinary price, but as the price increases, what happens to those who cannot pay?
The New York Health Act promises no more co-pays, no more deductibles. The only premium you pay comes in the form of state tax. Coverage is universal and benefits are comprehensive. Outpatient and inpatient care, primary and preventive care, tests and rehabilitation, dental and vision – whatever benefits are currently required by state insurance laws are included in the potential law.
Specifics of the plan aside, I’m not drawn to the New York Health Act by political ideology or by economic reasoning. I’m drawn to its alignment with my belief as a future public health professional that health is a human right.
If you would like to contribute to Mailman Student Voices, please send a three to five-sentence pitch outlining your topic to mailmancomm@columbia.edu.