A little-discussed hazard of creating a state-run single-payer health plan in New York would be its vulnerability to the business cycle. It would depend heavily on taxes collected from high-income New Yorkers, a source of revenue that's especially prone to booms and busts. A recession – or a downturn in the stock market – could easily open a budget hole not just in the billions of dollars, but in the tens of billions of dollars.
One new aspect of the bill is a dispute resolution process for negotiating fees with providers. The process would involve, if necessary, the appointment of a three-member fact finding panel to advise the health commissioner. Such a process could hinder the state’s ability to control costs, which is critical to making the plan feasible, said Bill Hammond, director of health policy at the Empire Center in Albany.
New revisions to a proposed single-payer health plan for New York State would add tens of billions dollars to the already enormous price tag – and further hinder the state's ability to control costs going forward.
The Empire Center hosted a conference examining the New York Health Act, a proposal to create a state-run single-payer healthcare system. Videos of both panels can be viewed here.
The New York City Council's vote of support on Tuesday for a statewide single-payer health plan showed curious timing from a fiscal point of view. Two weeks before, sponsors of the New York Health Act told union officials that they were changing the bill in ways that could cost the city billions of dollars per year. Details of these high-stakes changes won't be available until next month, yet Council members chose to back the measure anyway – effectively endorsing a blank check.
The already extraordinary cost of a proposed state-run single-payer health plan jumped even higher this week when the chief sponsor, Assembly Health Chairman Richard Gottfried of Manhattan, announced that it would be expanded to cover long-term care.
The latest too-good-to-be-true argument for single-payer comes from Albany City Treasurer Darius Shahinfar, who claims that a government-funded statewide health plan would dramatically reduce property taxes. In reality, the savings for local taxpayers, if any, would likely be a fraction of what Shahinfar estimates. And they would come at the cost of the largest increase in state taxes that New York has ever seen, not to mention wholesale disruption of the entire health-care system.
Analyzing the impact of single-payer health care on New York's hospitals