The Health Insurance ‘Gangs of New York’

There’s a scene in the movie, “The Gangs of New York,” where two different fire brigades arrive at a burning house. Instead of fighting the fire, they fight each other (literally). Different brigades had to compete with each other for the opportunity to collect payment from the private insurance companies. Every house with insurance displayed a medallion indicating which insurance company that house paid for protection. And if you didn’t have the right medallion, your house would be left to burn to the ground.

This incredibly inefficient and dangerous system was how most cities dealt with fires once upon a time. New York City finally wised up in 1865 and created a publicly funded and publicly run municipal fire department. From that day forward, whether you lived in a humble shack or the governor’s mansion, you could rest assured that you would be protected in the event of a fire. Having a fire department today is recognized as an essential and universal service required for living in a modern world.

Progress on Single Payer

On May 27, the NYS Assembly passed another act in the same spirit, the New York Health act. This bill was passed by a vote of 92-52 and would provide universal health coverage to all New York residents, irrespective of their financial status, employment status, or immigration status. All necessary and preventative care — including mental health, dental, vision, and more — would be covered. No more co-pays, co-insurance, deductibles, or prescription drug costs. Every medical need would simply be covered.

Replacing every New Yorkers’ insurance card (think “medallion”) with a public system is no easy task. What comes as a surprise to many, is that this kind of health system (commonly known as a single-payer system) would not only provide better and more comprehensive care to every single New Yorker, but could do so with enormous savings for nearly every resident, and tens of billions of dollars in savings to the state in the first year alone.

At a recent workshop NYSNA held with our members to explain the bill and these issues in healthcare, a number of nurses asked “Why haven’t we done this already? If this makes so much sense, who could possibly be against such a plan?”

There isn’t just one answer to that question, but much of the energy behind health care reform got sucked into the national discussion with the fight to pass the Affordable Care Act. In the five years since it has passed, there is no doubt that the Affordable Care Act has taken huge steps to help many Americans obtain health insurance — especially with the expansion of Medicaid, and subsidies for those purchasing private insurance on the exchange. Yet the ACA left private insurance companies as the centerpiece in our healthcare delivery model. And while Medicaid expansion is burdened with enormous increasing costs to care for some of the most vulnerable in our society (just look at New York where the federal government has recently had to step up with billions of dollars in assistance), nearly a third of those with private insurance can’t actually afford to utilize it — and they simply delay or postpone seeking care.

A way to better health

In short, the fundamental problems endemic to private insurance are starting to come to the surface in a way that cannot be ignored. As a union of nurses, NYSNA is fighting for the New York Health Act — not only because we believe it makes the most economic sense for our members and working families, but because it will provide the best patient outcomes! We care about our patients and want to ensure that we can work in a healthcare system that puts health above profits.

Next stop: NYS Senate

We have brought this message to legislators, the public, and our members. And we will continue to do so until we can pass this bill in the Senate and bring it to the Governor for his signature. It is an uphill battle, but it is the right way to deliver care. The alternative is akin to letting our healthcare system go down in flames, while the insurance companies fight over who can make the most money from our collective sickness, pain, and misery.

Steven Toff is NYSNA’s Director of Strategic Campaigns; Marva Wade, RN, is a First Vice President of NYSNA.