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Times-Union: N.Y. Health Act would give control to doctors, patients

By Dick Gottfried & Bill Perkins, December 18

If the governor announced tomorrow that taxes would “only” go up 6 percent next year and fees would go up too, you’d probably be shocked. But that’s essentially what is happening to individuals and families who buy their health insurance through the New York state exchange, because while health insurance premiums aren’t taxes, that’s in name only. You must have insurance and you have very little control over what it costs.

Health plans with an attractive cheaper premium usually hit you with a high deductible. You may have to pay thousands of dollars for care before your insurance even kicks in. That’s like local school taxes going up, and public school parents shelling out money for the first month or two of classes. Then they charge co-pays and make you pay even more out-of-pocket if you go outside the plan’s restricted network of providers.

It’s happening to people who buy insurance on the New York exchange as well as people who get their health coverage through their jobs. Businesses are passing on more and more health care costs to their employees, making them pay a higher percentage of the premium or a higher deductible, or having plans with more restricted networks.

Health costs are so expensive in large part because health insurers have made a mess of things.

Practically everyone is fed up with the current system. Employers, especially small businesses, spend billions for health benefits instead of paying employees more or investing in expansion.

Health care providers waste countless hours and resources navigating multiple health insurance bureaucracies to get paid.

Insured New Yorkers struggle to keep up with changing plans and providers, rejected claims, and ever-increasing costs. And over 1.5 million New Yorkers still don’t have coverage, even after the Affordable Care Act and New York’s exchange helped 900,000 New Yorkers get private insurance or Medicaid.

While the Affordable Care Act has done a great job of getting more people coverage, it hasn’t changed what is wrong with our health care system: Health insurance companies waste way too much of every health care dollar they touch, make us pay thousands of dollars more out-of-pocket, and restrict what providers we can go to and what care they’ll cover.

There really should be a better way — and there is. A bill in Albany — the New York Health Act — would create truly universal coverage, cutting health insurers out of the equation and saving the average New York family thousands of dollars while making sure everyone has access to the care they need. Health care providers wouldn’t change — every New Yorker would be free to go to any provider they choose — and health care decisions would be made by patients and their doctors — not insurance companies.

Under the New York Health Act, individuals and employers would not pay premiums, deductibles, co-pays and out-of-network charges. Instead, the coverage would be funded through a dedicated assessment based on an individual’s or employer’s ability to pay. We’d save billions of dollars by eliminating the insurance company overhead and profit.

Local governments would save billions more because they wouldn’t have to pay as much for health care for their employees or for Medicaid.

For most New Yorkers, it will be a substantial reduction in what they now spend, increasing their take-home pay. And because local governments would save money, property taxes would go down.

Why haven’t we done this yet? Chalk it up to the powerful health insurance lobby, which spends millions each year to keep the status quo.

Big health insurance companies and their allies will fight this. We’ll hear scare stories about “socialized medicine.” But they said that when Medicare was first proposed, too.

Today, almost nobody opposes Medicare, because it’s a critical program for getting seniors the health care they deserve. Why shouldn’t those of us under 65 benefit too?

The Affordable Care Act is cleaning up some of the damage caused by the way we pay for health care, but fails to fix the basic flaw — the insurance industry.

Fortunately, support is growing for New York Health, as consumers, businesses, unions and local governments recognize that the current health insurance system is unsustainable.

New York can and should do better — by passing the New York Health Act.

Richard N. Gottfried, D-Manhattan, is a state Assembly member. Bill Perkins, D-Manhattan, is a state senator. Also contributing to this article was Jill Furillo, executive director of the New York State Nurses Association.