Supporters of single-payer health care, in which the government directly pays the bills for all needed medical treatments using taxpayers’ money, were deeply disappointed when President Barack Obama and congressional Democrats sought to build on the existing system through Obamacare instead of pursuing single-payer.
Having struck out in Washington, DC, single-payer advocates have since latched on to another strategy. Instead of getting single-payer passed nationally, they are focusing on trying to get individual states to adopt it.
Vermont went the furthest down this path, passing legislation authorizing the state government to take over the state’s health care system if it could get the appropriate waivers and approvals from Washington, DC and devise a financing plan to pay for it. That last part was the trickiest, and Gov. Peter Shumlin scuttled his dream last month, citing tax increases his state could not bear.
Yet, at least one New York state legislator, Assemblyman Richard Gottfried (D), thinks New York should fire up the single-payer bandwagon. He plans to introduce legislation to that effect in 2015 and is holding hearings around the state trying to drum up support.
There is much to be said for allowing individual states to enact their own health care reform ideas rather than forcing them to accept whatever is passed down from Washington, DC. As Gottfried said in a recent radio appearance, states are often called the “laboratories of democracy,” where they can each experiment with different policies.
But New Yorkers probably should understand the single-payer experiment isn’t going to be overseen by responsible scientists. Instead, New Yorkers would be handing over their health care system to Albany politicians, interest groups, political insiders, inept or overwhelmed bureaucrats, and anybody else who can use their influence to get control of even a small slice of New York’s nearly $185 billion in annual spending on health care.
Consider Medicaid in New York, which is essentially a single-payer system for poor people. The program spends more per enrollee than any other state except for Alaska, which has unique factors driving its costs. New York’s spending per enrollee is nearly twice the national average.
A big factor in those exorbitant costs is rampant fraud. According to a former Medicaid investigator, at least 10 percent of all money spent on Medicaid in New York is related to fraud, and another 20–30 percent is for unnecessary care.
In just the past few weeks, three pharmacies in New York have been charged with bilking the state Medicaid program of $5 million, and another indictment charges a different group with scamming $25 million from Medicaid and Medicare in New York.
The corruption isn’t limited to criminals submitting fraudulent bills, either; it includes corrupt politicians and the agencies running Medicaid. In late October, the U.S. Attorney’s Office for the Southern District of New York filed a lawsuit charging the city of New York and a private contractor with filing tens of thousands of false claims and collecting millions of dollars in improper reimbursements.
Many recent corruption cases against legislators in Albany involved the state’s health care system.
Former New York Senate Majority Leader Pedro Espada (D) was convicted of stealing $500,000 from a health care network he founded that received Medicaid funding; former Sen. Karl Kruger (D) pled guilty to accepting bribes from hospital executives and consultants; former Assemblyman Anthony Seminario (D) was convicted of influence peddling for a hospital; and former Assemblyman William Boyland Jr. (D) was convicted of bribery related to a hospital project.
New Yorkers interested in having their state be part of a single-payer experiment ought to think long and hard over who exactly is going to be running the lab. In New York’s case, a mad scientist would be far better than the gang they’re likely to get running their health care.
