Amy Traub

A Simple Plan for Universal Health Care in New York

In New York State, Child Health Plus and Family Health Plus are pretty good programs. They allow participants to choose from a variety of managed care plans that contract with the state to provide coverage. Families making up to 150 percent of the poverty line pay no premiums and there are no deductibles and few co-payments. Despite the fact that people enrolled in these programs tend to be less healthy than those enrolled in commercial plans, the premiums the state pays are much lower and have remained virtually flat even as the cost of private insurance has skyrocketed.

So why don’t we open these successful state program to every New Yorker, regardless of income?

That simple idea is the basis of New York Health Plus, a new universal health care proposal from Dick Gottfried, Chair of the NYS Assembly Health Committee.

Under Gottfried’s plan, any New Yorker could get free health coverage from the state, and have their pick of the plans contracting with the state. Everyone would also be free to opt out and keep paying for their own private health care coverage. Businesses would no longer have the burden of employee health care costs. The more than 2 million uninsured New Yorkers would face no barriers to coverage. Gottfried also argues that plans under New York Health Plus would have incentives to offer higher quality care more preventive services, providing a better choice for New Yorkers who already have insurance too.

The hitch, of course, is the cost. Gottfried estimates that New York Health Plus would cost about $59 billion a year. He is quick to point out that New Yorkers currently pay $63 billion a year for health care, including the cost of premiums, deductibles, co-pays, and taxes for existing public programs. But the big difference is, most of these costs are now paid to purchase coverage from insurance companies. Under New York Health Plus, the cost would be paid in taxes.

A universal, publicly administered health plan is going to require big tax increases. There’s no way around it. But consider how we pay for health care now. It’s a hodge-podge, with costs falling particularly hard on families trying to buy coverage for themselves in the open market, who are among those least able to afford the high premiums. Small businesses struggle to offer coverage to their employees, while big, highly profitable companies offer skimpy coverage and push costs on the public. By paying for health care through progressive taxation, the costs could be distributed fairly.

The benefit of Gottfried’s plan is its simplicity and the way it builds on the state’s existing successful programs. Gottfried argues that because it continues to offer individual choice of plans and opportunity to opt out, it overcomes the main objections people have raised to a single-payer plan. While a variety of different organizations are currently working to develop comprehensive health plans for New York, Assemblyman Gottfried’s proposal deserves serious consideration.

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Posted at 11:59 AM, Dec 12, 2007 in Health Care
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