The Scary Truth about Single-Payer

State lawmakers will soon be packing their bags and putting the lid on another legislative session. They’ll head back to their respective districts without agreeing on a health care bill that, in my opinion, should never see the light of day. 

The New York Health Act, also known as single-payer, would provide government-sponsored health insurance to all state residents with no out-of-pocket costs and no network restrictions. Sound too good to be true? That’s because it is!

According to estimates from one not-for-profit think tank, a single-payer health care system would cost New York $226 billion a year. That’s almost $75 billion dollars more than the entire state budget!

Proponents of the bill have suggested paying for the plan with – you guessed it – new taxes. Specifically, they proposed a new payroll tax, as well as a new tax on dividends, capital gains, and investments. All in all, the tax increases would quadruple the tax burden in New York.

Payroll Tax

The first new tax needed to pay for single-payer would target employers and employees. Supporters are calling for a 15 percent increase in the state’s payroll tax, essentially doubling the tax burden here in New York. A similar proposal was pitched in California, where analysts say the average Californian earning $64,500 a year would pay an additional $9,675 a year in taxes.

Wall Street Tax

If the payroll tax increase isn’t bad enough, single-payer supporters are ALSO proposing a 15 percent tax increase on dividends, interest, and capital gains. This would essentially be a tax on Wall Street. You know, because New York’s business climate isn’t bad enough already.

According to State Comptroller Tom DiNapoli, security-related activities are a major source of revenue for the state. He estimates that Wall Street contributes $13.8 billion a year to the state budget and accounts for nearly 20 percent of all tax collections in New York. Imposing an additional 15 percent tax on the industry would unquestionably send many investors packing to a much more tax-friendly state.

Single-Payer: Fact vs. Fiction

Money aside, there are all sorts of misconceptions about single-payer that advocates don’t want you to know.

One of the biggest myths is that all people – regardless of income – are guaranteed access to high-quality care. The truth of the matter is that single-payer health care systems often suffer from a shortage of primary care doctors, and care is rendered based on availability. According to U.S. News and World Report, 40 percent of Canadian patients have been forced to wait two months or more to see a specialist, while 90 percent of spine surgery patients have been forced to wait at least six months.

Another misnomer about a single-payer system is that the government would be able to control prices by negotiating rates with doctors, hospitals, and pharmaceutical companies. The problem with this theory is that the government already negotiates prices through Medicare, Medicaid, and the VA, but has yet to drive down prices. Medicaid does a better job than the others, but many doctors refuse to accept Medicaid patients because reimbursement rates are lower.

Finally, there’s the myth that the government would be able to control administrative costs better than private insurers because it keeps Medicare’s administrative costs at 3 percent. This stat is very misleading, as multiple other agencies (IRS, Social Security, HHS) manage the accounting, auditing, marketing, and building expenses for Medicare. In addition, traditional Medicare does not provide the comprehensive benefits of private Medicare plans, and many Medicare patients are forced to purchase supplement insurance to fill the gaps. If you add all that up, the administrative costs of Medicare far outweigh that of private insurers.

We can all agree that the American health care system is broken. But if you think health care is expensive now, just wait until the government provides it for “free!” Single-payer is not the answer. Despite all of our shortcomings, the quality of care available in our community is second to none. This state has come too far to allow an ill-conceived solution like single-payer negate all the good work being done to promote high-quality care that patients have come to know and trust.