Tag labor

Testimony on the New York Health Act before the New York City Council

Testifying before the NYC Council in support of its resolution endorsing the New York Health Act, December 6, 2018

Testimony of Assembly Member Richard N. Gottfried

in Support of the New York Health Act

Public Hearing: City Council Committee on Health

New York City Hall

December 6, 2018

I am Assembly Member Richard N. Gottfried.  I chair the Assembly Health Committee and I am the introducer, along with Senator Gustavo Rivera, of the New York Health Act, to create single-payer health coverage for every New Yorker.  I appreciate the Council Health Committee holding this hearing on Speaker Corey Johnson’s resolution endorsing the bill.  I support the resolution.

In both houses of the State Legislature, we now have solid majorities who have co-sponsored, voted for, or campaigned supporting the NY Health Act.  And Governor Cuomo supports single-payer health coverage, although he says he has questions about whether it can be done at the state level.

Every New Yorker should have access to the health care they need, without financial obstacles or hardship.  No one says they disagree with that.  And the New York Health Act is the only proposal that can achieve that goal.

In NY State, we spend $300 billion – federal, state, and non-governmental – on health coverage.  Nationally, we spend far more than any industrial democracy as a percentage of GDP.  But 18 cents of the insurance premium dollar goes for insurance company bureaucracy and profit.  Our doctors and hospitals spend twice what Canadian doctors and hospitals do on administrative costs, because they have to fight with insurance companies.  We pay exorbitant prescription drug prices because no one has the bargaining leverage to negotiate effectively with drug companies.

Just about every New Yorker – patients, employees, employers, and taxpayers – is burdened by a combination of rising premiums, skyrocketing deductibles, co-pays, restrictive provider networks, out-of-network charges, coverage gaps, and unjustified denials of coverage.  I know I am, and I bet everyone in this room is.

And those financial burdens are not based on ability to pay.  The premium, the deductibles – the insurance company doesn’t care if you’re a multi-millionaire CEO or a receptionist.

In a given year, a third of households with insurance has someone go without needed health care because they can’t afford it – and usually for a serious condition.

The number one cause of personal bankruptcy is health care — even for those who have commercial health coverage.

We’ve put control of our health care in the hands of unaccountable insurance company bureaucrats. Nobody wants insurance company bureaucrats deciding what doctor you or your family can see and when.

The health insurance system means massive cost increases for most everyone and better health care for hardly anyone. It’s a disaster.

But it doesn’t have to be that way.

The NY Health Act will save billions of dollars for patients, employees, employers, health care providers and taxpayers – while providing complete health coverage to every New Yorker.

Everyone would be able to receive any service or product covered by any of the following:  NY Medicaid, Medicare, state insurance law mandates, and the current state public employee benefit, plus anything the plan decides to add.

And there will be no premiums, no deductibles, no co-pays, no restricted provider network, and no out-of-network charges.

We’ll actually save billions of dollars because we get rid of insurance company bureaucracy and profit, doctors and hospitals will be able to slash their administrative costs, and New York Health will be able to negotiate much lower drug prices by bargaining for 20 million patients.

And this lower cost will be shared fairly, based on ability to pay.  NY Health will be funded by broad-based progressively graduate taxes.

There will be one tax on payroll.  At least 80% of it must be paid by the employer.

There will be a similar tax on currently taxable “unearned” income – like capital gains and dividends.

Because of the savings and the progressively graduated tax mechanism, 90% or more of New Yorkers will spend less and have more in their pocket.

Pumping this money back into our economy will create 200,000 new jobs in New York.

And there will be money to completely cover everyone, and make sure doctors, hospitals and other providers are paid fairly – and today, most of the time, they are not.

The vast majority of our hospitals get most of their revenue from Medicaid, Medicare, and uncompensated care pools – none of which fully cover the cost of care.  The NY Health Act requires full funding for all hospital care, and hospitals will save billions in reduced administrative costs.

Here are 3 basic numbers:  The savings from insurance company bureaucracy and profit, provider administrative costs, and drug prices will total $55 billion.  The increased spending for covering everyone; eliminating deductibles, co-pays and out-of-network charges; and paying providers more fairly will cost $26 billion.  So the net savings to New Yorkers is $29 billion.

The way our society deals with long-term care – meaning home health care and nursing home care – for the elderly and people with disabilities is a moral outrage.  NY’s Medicaid does a much better job than other states.  But today, New Yorkers spend $11 billion a year out-of-pocket for long-term care.  And family members – usually women – provide unpaid home care worth $19 billion.

In January, Senator Rivera and I will be announcing that the NY Health Act will cover long-term care.

Now, that will use up $19 billion of the net savings.  But it means no NY family will have to wipe out lifetime savings, and no family member will have to give up a career, to provide long-term care for a loved one.  That’s profoundly important.

How much tax revenue will we need?  With the net savings, we’ll need $129 billion from the NY Health taxes.  When we add home care and nursing home care, we’ll need $159 billion.

How do we know the NY Health program will treat us – and our doctors and hospitals – fairly?  Two ways.

First, the legislation explicitly requires that provider payments be reasonable, related to the cost of providing the care, and assure an adequate supply of the care.  No coverage today has that guarantee.

Second, we’ll all be in the same boat; rich and poor.  Every New Yorker – every voter – will benefit from the program.  And every voter will have a stake in making sure our elected officials keep it as good as possible.

Remember where we started:  Every New Yorker should have access to needed health care, without financial obstacles or hardship.  We’re not there today.  The NY Health Act will get us there.  If anyone doesn’t like the NY Health Act, they should either put on the table another plan that will get us there, or admit that they’re OK with depriving millions of New Yorkers of health care or family financial stability.

Concerns have been raised by many of NY City’s municipal labor unions.  They are justifiably proud of the good deal they have won for their members over the years.  Good scope of coverage.  The City pays the full premium.  And the contract says that if there are savings in the health benefit, the savings go into a stabilization fund to pay for salaries and benefits.  As they remind us: at the bargaining table they have given up wages and benefits to protect this deal.

Under NY Health, by law, every municipal employee, like every New Yorker, would have an even broader scope of benefits, and without deductibles, co-pays and restricted provider networks and out-of-network charges.

Under the bill now, collective bargaining could continue to have the City pick up the whole tab for the payroll tax and pass on the savings to the stabilization fund.  But Sen. Rivera and I have offered to add bill language that by law would require the City to do that, without the need to bargain for it.

Our parents didn’t raise us to screw workers.  Period.  Sen. Rivera and I are determined to make sure that labor’s concerns are protected under the NY Health Act.  We are continuing the dialogue with them.

Thank you for letting me testify.

City & State: Gottfried’s Janus Workaround Reopens Labor Debate

By Max Parrott, July 10

When information leaked to the Empire Center, a fiscally conservative think tank, that Assemblyman Richard Gottfried, a Democrat from Manhattan, was planning to sponsor legislation that would reverse the effects of the Supreme Court’s recent Janus decision limiting the power of public sector unions, it swiftly attacked the bill as unconstitutional.

The Janus ruling on June 27 held that public sector unions cannot force employees covered by collective bargaining agreements to pay membership dues. Five days later, Gottfried circulated a memo to members of the Assembly summarizing his proposal, which would allow unions to collect reimbursement for the costs of collective bargaining from the state rather than from employees who opt out through agency fees.

Absent an intervention like Gottfried’s, the Janus decision will start draining funds from unions. Last week, it was reported that the National Education Association, the nation’s largest teachers union, announced it will cut its budget by $28 million.

The Supreme Court’s 5-4 decision, which was split along the usual conservative-liberal dividing line, ruled that the government cannot compel employees to support collective bargaining because to do so infringes on the free speech rights of anti-union workers.

NY Post: Dem lawmaker has “workaround” to SCOTUS unions decision

By Nolan Hicks, July 4

New York’s most senior Democratic lawmaker is proposing an end-run around a US Supreme Court ruling that could cost the state’s powerful public-employee unions more than $100 million a year.

Assemblyman Richard Gottfried (D-Manhattan), a longtime labor ally, plans to introduce legislation that would allow unions to include collective-bargaining costs in their contracts with government agencies to replace the mandatory fees banned under last month’s Janus v. ­AFSCME ruling.

“I would call it a workaround,” said Gottfried, who has served for 50 years in Albany. “I don’t think there’s a lot of logic to the Janus decision to start with, but New York state — in our Constitution and law — has long recognized that public employees have the right to collectively bargain.”

WCBS Newsradio (audio) – NY Assemblyman Gottfried has plan to circumvent SCOTUS union dues ruling

(Audio in link) – July 5, 2018

NEW YORK (WCBS 880/CBS News/AP) — A U.S. Supreme Court ruling issued last week will make it more difficult for unions to collect dues from people who do not want to pay.

Now, a New York state lawmaker has a plan to circumvent the decision.

“I think this is about fundamental fairness,” said Assemblyman Richard Gottfried (D-Manhattan).

NY Post: Cuomo’s budget would scrap audits protecting doctors from being overworked

By Carl Campanile, 3/19

Gov. Cuomo’s budget plan scraps rigorous state audits of hospitals that help make sure resident doctor-interns aren’t severely overworked and exhausted on the job — and critics worry that could imperil patient safety.

The audits — conducted by an independent contractor hired by the state — enforce the Libby Zion Law, named after the 18-year-old daughter of the late New York Times writer Sydney Zion, who died from botched care at a Manhattan hospital in 1984.

The law requires that doctor-interns at 100 teaching hospitals work no more than 80 hours per week, or 24 consecutive hours — and facilities hit with violations get slapped with financial penalties.

But Cuomo’s $68 billion spending plan would eliminate the audits — considered the nation’s most stringent because the law allows for surprise inspections and reviews of payroll data.

Crain’s New York: State issues emergency regs on how it pays home care workers for 24-hour shifts

By Caroline Lewis, October 13

The state Department of Labor has issued an emergency update to its minimum-wage regulations that reinforces its longstanding guidance to home health care employers to pay workers for just 13 hours of a 24-hour shift.

The policy, known as the ’13-hour rule,’ helps control state spending on home care, which accounts for about 11% of the Medicaid budget. But it conflicts with three New York appellate court decisions issued in April and September that threw the home care industry into a panic.

The rulings said home health aides who don’t live full time with their elderly or disabled clients should be paid for every hour of a 24-hour shift. Although the Labor Department says workers don’t need to be paid for time spent sleeping and eating, the courts ruled they should be paid as long as they’re required to be at work.

Broadway World – Stage Directors and Choreographers Society Takes a Stand on Health Care Reform

June 20, 2017

The Executive Board of SDC, the theatrical union representing Stage Directors and Choreographers across the United States, unanimously voted to endorse the New York State Health Act (S4840) and the New York Health Program (A4738), sister bills designed to establish universal single-payer health care for all New York residents.

SDC’s endorsement of S4840 and A4738 is combined with a rejection of H.R. 1628 (AHCA), the GOP sponsored bill that passed the House of Representatives in May. The AHCA will reverse the expansion of Medicaid under the Affordable Care Act and is estimated to remove health care coverage from over 20 million Americans, discriminate against preexisting conditions, allow states to opt out of coverage like maternity care, and defund Planned Parenthood.

CNHI: Home health aide shortage leaves some without care

By Joe Mahoney, 3/3/17

ALBANY — Across upstate New York, agencies that provide health care services to home-bound patients say they are struggling to recruit and retain health aides, a shortage that is expected to become more acute as the population ages.

Home health aides are the lowest-paid workers in New York’s health care system, with many earning less than $13 an hour for work that often involves late-night and weekend shifts helping the home-bound with bathing, meal preparation and other personal needs.

Times-Union: Lawmakers hear of crisis in home care

By Casey Seiler, 2/27/17

The system that provides home care for New York’s ailing, elderly and disabled populations is in crisis due primarily to economic pressures, including a state reimbursement formula that has pushed some rural care providers to the brink of not being able to make payroll.

That was the message conveyed by dozens of witnesses who attended a Capitol hearing Monday called by the Assembly committees on health, aging, labor and health. The Legislature returns to Albany on Tuesday to begin the final month of negotiation of the budget.

PRESS ADVISORY – Workers, Patient Advocates, Providers to Testify on Home Care Workforce Needs

Contact:                                                         February 21, 2017
Mischa Sogut
518-455-4941
SogutM@nyassembly.gov

On Wednesday, February 22, the Assembly Committees on Health, Aging, Labor, and Task Force on People with Disabilities will hold a public hearing in New York City on the crisis of New York’s inadequate home care workforce.

Home care allows individuals to receive health care and personal services to live at home instead of in a nursing home or other facility. There is a growing shortage of home care services for the elderly, people with disabilities, and people who are chronically ill. Advocates note that there is a shortage of home care workers that is causing waitlists for these services across the state at a time when demand is increasing. Inadequate Medicaid funding for home care may be a significant obstacle to hiring and keeping people in the home care workforce.

The hearing will focus on obstacles to recruiting, employing, and retaining a sufficient workforce. Witnesses are expected to include patient advocacy groups and self-advocates, home care and disability service providers, and home care workers and organized labor groups.

What:
NYS Assembly public hearing on home care workforce

Who:
-NYS Assembly Committees on Health, Aging, and Labor, and Task Force on People with Disabilities
-Patient advocates and self-advocates
-Service providers
-Home care workers

Where:
250 Broadway
19th Floor
New York, New York
10007

The hearings will also be webcast live at:
http://assembly.state.ny.us/av/

When:
Wednesday, February 22
11 AM

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