Gottfried Continues Upstate Single-Payer Push

Assemblyman Richard Gottfried, a Manhattan Democrat, is spending the winter months traveling through upstate New York holding hearings on a bill that has become a legislative priority for the upcoming session: creating a system of single-payer healthcare coverage in the state.

Gottfried has introduced the long-shot legislation for years without gaining much traction. But this year he is making a more concerted effort to garner support for a single-payer system, which would remove the current healthcare apparatus, including federal Medicare and Medicaid programs, and replace them with a single, publicly-funded system for New York. Under Gottfried's bill, funding would come through a payroll tax similar to the Medicare tax.

 “We’ve been building new support for it all across the state and I think virtually every problem we face in healthcare in New York … is more difficult to solve because of our insurance-based healthcare system,” Gottfried, the chair of the Assembly Health Committee, told City & State last month. “That means people will no longer be dealing with rising premiums, deductibles, copays, restricted networks, out-of-network charges and 20 to 30 percent of the healthcare doctor will no longer be paying for insurance overhead and profit.”

The second of six hearings on the legislation took place Monday in Rochester, where attendees frustrated with the rising costs of healthcare and the shortcomings of the federal Affordable Care Act echoed Gottfried's call to switch to a single-payer system. Consumers testified about their personal struggles with the high cost of life-saving treatments and astronomical hospital bills, while experts touted the advantages of a publicly-funded system, including a more equal distribution of services.

“I also believe that it correctly recommends a bold new approach to healthcare reform that is far better than the Affordable Care Act’s preservation, indeed enhancement, of the excessively complex and expensive for-profit health system that has made the United States the unchallenged international leader in widely expensive and outrageously inequitable healthcare,” Theodore Brown, a professor of public health and health policy at the University of Rochester, testified at the hearing.

Single-payer healthcare is strongly opposed by insurance companies and business groups. Kemp Hannon, a Republican who chairs the Senate Health Committee, called single-payer healthcare an “interesting concept,” but raised concerns about switching to another new system so soon after the massive overhaul brought on by the Affordable Care Act.

Critics argue that switching to single-payer would force providers to refuse effective treatments due to cost constrains, threatening the high quality of healthcare provided in the United States.

“The major difficulty of [single-payer] is the federal government has the rules for two of the biggest sources of medical payment in the state: Medicare and Medicaid,” Hannon told City & State last month. “Now, the challenge then if you want to change the system is, ‘How do you get the federal government to change their Medicaid and Medicare and not scare the population that’s being covered by Medicare—senior citizens—and Medicaid?’ ”

The November elections ensured a Republican majority the state Senate for the 2015 legislative session, which means the bill has virtually no chance of passing in the upper house this year. But Gottfried hinted at the reason he is pushing so hard for its passage in the Assembly.

“The insurance industry and its allies have always opposed this concept,” he said. “Fortunately, they don’t control the Assembly and I think this issue will help hasten the day where they don’t control the state Senate either.”