With each passing year, there seems to be another state attempting to accomplish what the Federal Government could not – truly universal healthcare. Vermont, Michigan, Colorado and California have all proposed legislation or embarked upon aggressive plans to enact coverage for all its residents “at little or no cost.” That is, if you fail to consider the 15%+ tax burden that would need to be imposed on its citizens to fund these imaginative realities.
And New York has tried its hand repeatedly with passage of similar legislation in the assembly, but repeated challenges in the state senate. With the most recent election’s results pushing the New York State Senate heavily towards the Democratic side, it is only a matter of time until another expedition into this fantasy land is pursued.
But New York City is moving ahead. Last week Mayor de Blasio announced an ambitious program to fund doctor visits for 600,000 uninsured residents – including unauthorized immigrants. And he suggested there will be no tax increases to fund this endeavor. Instead, $100 million per year has been set aside to bankroll these services with the logic being it will ultimately generate meaningful savings by keeping many of these folks out of the emergency room and hospital – expensive uncompensated care that ultimately becomes the city and state’s burden anyways.
Though I applaud the ambition and effort, call me a skeptic. The program is light on details and $100 million is a pittance in the world of healthcare delivery. Professional services (i.e. physician costs) account for around one third of employer per capita healthcare spend, which now sits at more than $11,000 nationally – and is even higher in NY.
Local politicians are going to continue trying their hand at solving an intractable issue that is not rooted in local practices. Nearly a decade after the ACA’s passage, perhaps the country is ready to have another national debate on whether subsidized healthcare access is a right or a privilege. Though it does generate valuable sound bites for campaigning purposes, I don’t believe throwing large sums of money at it at local levels is an efficient or effective approach towards solving this problem. New Yorkers should strap in for what will undoubtedly be a bumpy road down which their politicians are heading.