Hacker News Reader

Comment by VWWHFSfQ | Hacker News Reader

If this is anything like the ACA then the vast majority of New Yorkers will end up paying twice for insurance. Once in taxes to subsidize the single-payer marketplace, and then again for their own employer-based insurance. Have to start somewhere though, I guess.

View on HN

There are UK employers who have offer health insurance as a benefit on top of the healthcare available from the NHS. There's not much point to it, but it is available.

I have such an arrangement and it's extremely useful.

If doing something is going to make the situation worse, it is better to do nothing instead.

It may only appear to make things worse. Sometimes you have to take drastic measures, like amputating a limb, to make progress on saving people.

You seem to believe employees wouldn't be able to opt out of their own employer-based insurance. Why is that?

For the employee it doesn't matter. Either I keep my existing insurance or I opt out and take the state provided one, but I don't get any more money the money I'm saving the company.

Yeah, the penalty for ACA non-compliance is zero at this point, so I think they could just opt-out entirely without cost, right?

I looked at it last year in terms of whether I'd need to pay for COBRA to cover the tax penalty and... nope. You can retroactively opt into COBRA for 90 days after the fact (iirc, check this yourself before using), so you can job hop and then if you happen to smash every bone in your body during that one week then just sign up for retroactive coverage.

From the summary of the bill:

> Private insurance that duplicates benefits offered under New York Health could not be offered to New York residents.

---

My interpretation of that is that private insurance (which includes employer-based insurance) would be banned.

That's an incorrect interpretation. Private insurance would be restricted to cover things not already covered by the public insurance.

> The benefits will include comprehensive outpatient and inpatient medical care, long-term care, primary and preventive care, prescription drugs, laboratory tests, rehabilitative, dental, vision, hearing, etc. all benefits required by current state insurance law or provided by the state public employee package, Family Health Plus, Child Health Plus, Medicare, or Medicaid, and others added by the plan.

I'm struggling to understand what is not covered beyond that.

Nooo! Public option is not a half measure, it's a ~zero measure.

Single payer >>> public option. Public option is really easy to kill, just kneecap it any of a hundred ways, call it a failure, and then sell killing it as a tax break. It has the staying power of a cobweb on a car wheel. Failure is inevitable and it won't just be dead, it'll be held up for decades as proof that our government is uniquely incapable of doing insurance.

Contrast to single payer, which is hard to kill because people are yes paying a tax but also seeing a benefit and seeing a benefit that they didn't have before (healthcare doesn't go away if they lose employment). It doesn't suffer from adverse selection, it isn't an easy target for kneecapping, and it has a chance in hell of actually working.

I would advocate for Medicare-for-all but that isn't going to happen in my lifetime. So if states want to try their own single-payer systems then go for it. But I'm still going to grumble if I see (yet another) big number taken out of my paychecks for it.

How/why is failure inevitable?

>Contrast to single payer, which is hard to kill because people are yes paying a tax but also seeing a benefit and seeing a benefit that they didn't have before

Isn't that true for a public option as well?

No because it is a public option. Thus not everyone uses it.

Reply on news.ycombinator.com