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Health Care in Feudal New York
I have questioned, on this blog, whether my teenage children will still have health insurance as young adults. The answer, provided by Governor Paterson, is yes. Because my wife and I have health insurance through our employers, under Paterson's proposal we would be able to pass that gift onto them through age 29. Presumably with tax advantages, which means (given our marginal tax rate) the federal, state and local governments would in reality be paying for about half of it. Meanwhile, those whose parents do not have health insurance, or who have moved here from other states and countries, would not receive this benefit and its back-door taxpayer subsidy. And not just them. It is estimated that 800,000 would be eligible for the program, but just 80,000 would take advantage. Which 80,000? The richest of course, since they could afford it! This is what I fear about the Democratic road to "universal health care." Rather than figure out what the government can provide for everyone, and leave other to pay for more themselves, an open-ended commitment to ever rising expenditures (or back door tax expenditures) could be kept open for those who matter, even as others get nothing once limited resources intrude. More deals and breaks, and programs, layered onto the current mess, could take the place of root-and-branch reform. Governor Paterson's heart may be in the right place, but ironically our first Afro-American Governor has just proposed a Grandfather Clause for health insurance in New York.
According to the New York Times, “Gov. David A. Paterson will propose that private employers be required to offer health insurance to workers’ dependents who are ages 19 to 29, part of what the administration hopes will be a step toward universal health care coverage in New York.” But those who read my series of posts on Equity and Eligibility in August 2007 (will someone please honor all that work I did and publish it as a book?), particularly the post on the “Thin End of the Wedge” strategy, understands that expanding government benefits to the better off in the hopes that the less well off and influential will receive them later hasn’t worked in decades. Instead, this seems like an attempt to buy better off folks like myself off, the way “gifted” programs muted opposition to New York City’s poor public schools until recently. The Governor just may be looking for someone he can help (perhaps someone politically active who would be grateful in return in 2010), but we don’t need additional separate deals for separate people. We need to start over, or we face an institutional collapse. I'll respond when I can, but I lack internet and phone service. If you want to know my views on health care, I wrote a series of posts on the subject in January 2008 prior to Super Tuesday, laying it all out. If you are self-employed, just be glad you are not in NY. See my posts on (among other things) taxes & generational equity.
Because I am affiliated with the below program, I will not say much. But recommend that the self-employed in New York ( and other States) take a look at the programs offered through OPGUS.com. Think they will find a choice of excellent programs (with RX coverage) and lower rates Actually, the intention to improve the health care system is there. All we really need is the right people to go with it. Things will change for the better and I feel it.
It would be good is the health care coverage will be extended to dependents who are ages 19 to 29. This seems to be an improvement in the health care system since the cost of getting an insurance is really costly.
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Larry,
I found your blog while looking for data on the total Federal share of 3rd party health expense in the US, which the WSJ put at 48% yesterday. In another post, you estimate it could be as high as 80% including indirect costs, which I tend to believe.
My real interest is cost for the self employed, and living in Massachusetts, I currently pay a penalty of over $1000 a year for not having health insurance, since major medical is not available (HMO is only choice). I worked out a graph for the total tax load on the self employed here, but I'm aware that NY has a city tax in addition, and I'm curious how they'd compare. I'll stick in a link to my post:
http://www.fonerbooks.com/2008/12/massachusetts-health-penalty-and-real.html
If it doesn't come through, you can find it easy enough by googling Massachusetts Health Penalty - comes up #2. Since the Federal government now allows health insurance for self employed as a 1040 line item deduction, at least there's a bit of a discount, but self employed don't have the same playing field as large companies, for whom health insurance is an out-and-out business expense.
Side note. I'm fascinated by government employment numbers, clearly the government is the #1 employment sector in the US, and the health care industry is #2, so if the government is largely funding the latter, it just means the government has that much larger a share of employment. I can't help wondering how that compares with the pre-WWII era, but haven't found the data sources yet.
Morris