June 8, 2023


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New York State Could Finally Get Single-Payer Health Care

If you’re reading Jacobin, you’re probably impatient to pass Medicare for All — and rightly so. But Medicare for All can’t pass the current Congress. Even if Bernie Sanders had been elected president last year, he wouldn’t have had the votes, certainly not in his first term.

It’s one of many reasons we urgently need more socialists in Congress, especially in that undemocratic cesspit of reaction that is the US Senate. But that’s no reason to give up on the dream of enacting socialized medicine for millions of Americans this year.

In New York, it won’t be easy, but with enough organizing, we now have a shot at single-payer health care. The New York Health Act, which would create a single-payer system, was first introduced by Democratic Assembly member Richard Gottfried in 1992. Today, Gottfried, chair of the Assembly’s Health Committee, may finally have a chance to see his bill succeed.

That’s because, for the first time in its history, the New York Health Act has the votes to pass — at least on paper. In fact, the legislation’s cosponsors exceed (by one) the number of votes it needs. And the bill’s supporters are confident that, with a Democratic supermajority in the legislature, there are more lawmakers who could be persuaded to support it.

But that doesn’t mean the New York Health Act is a done deal — far from it.

It was safe for liberal legislators to support this overwhelmingly popular measure when it didn’t have the votes. They could get moral credit from progressives without having to face the political consequences of enacting genuinely redistributive policy. Now that it has a fighting chance, will the Senate and Assembly leadership actually introduce the bill?

Of course, many legislators may fear the inevitable ferocious backlash from the insurance and hospital industries, and from wealthy New Yorkers who don’t want to pay more in capital gains taxes (a key aspect of the bill’s proposed financing). Amplifying the uncertainty, some union members are vulnerable to scaremongering about losing their relatively decent health insurance, while their unions, which have whole benefits departments that are essentially health insurance companies, fear disruption and job loss to those operations.

Large municipal unions like DC 37 and the United Federation of Teachers have been especially slow to get on board. Fortunately, many unions do support the New York Health Act. It was the New York State Nurses Association that originally convinced Gottfried single-payer was needed. Now, Retail, Wholesale, Department Store Union (RWDSU), 1199SEIU, Central New York Area Labor Federation, United Auto Workers Region 9 and Region 9A (my own union), and many others have also endorsed it.

Members of the New York State Nurses Association campaign for the New York Health Act.

The New York Health Act can pass, but our state leaders — especially Senate majority leader Andrea Stewart-Cousins and Assembly majority leader Carl Heastie — will need popular pressure to get it done.

NYC-DSA (New York City Democratic Socialists of America) and its Campaign for New York Health partners are launching a campaign to do just that, starting by pressuring the leadership to introduce the bill. Coming off New York City’s successful “Tax the Rich” campaign (which we wrote about a couple weeks ago), NYC-DSA’s campaign for single-payer health care will follow a similar model (in fact, the “Tax the Rich” field organizers will be training the health care campaigners): mobilize people to knock on doors, make phone calls, and hang flyers to call their legislators and create politically significant pressure. Meanwhile, the socialist elected officials will work to persuade their colleagues and negotiate, making sure the bill remains a good one.

The campaign is reaching across the state, as DSA chapters in Buffalo and Rochester, as well as in New York City, have been working to pressure their representatives. There’s room for the campaign to grow in rural areas upstate, where the for-profit system has left many without access to hospitals or even ambulance service.

We surely do need it. Surveys show that 50 percent of New Yorkers avoid or put off seeking needed care because of the cost (whether because they lack health insurance or because their insurance might not cover care they need). Single-payer health care would vastly reduce our economic stresses and leave us healthier and happier.

In Canada, single-payer began as a provincial program. This happened not in French-speaking Quebec, and nowhere near cosmopolitan Toronto, but in Saskatchewan, where in 1944 the first socialist-led government anywhere in North America was elected, led by the Co-operative Commonwealth Federation (CCF). (My Jacobin colleague Luke Savage wrote about this history last year.)

In 1962, it was a CCF-led government that enacted socialized health care in the province, despite bruising resistance from private health care interests, which used all the same talking points and red-baiting falsehoods that Medicare for All opponents deploy in the United States to this day. Four years later, federal legislation laid the foundation for the single-payer program that Canadians continue to enjoy today.

As in Saskatchewan almost sixty years ago, if the New York Health Act passes this year, socialists will deserve credit. The six socialists in the state legislature all campaigned on the bill and bring new momentum and commitment to the fight. Their supporters in NYC-DSA, if they can mobilize, can bring the public pressure.

In an online town hall meeting on the bill late last year, with newly elected socialist legislators Phara Souffrant Forrest and Jabari Brisport, Gottfried thanked everyone who had supported the socialists’ election campaigns, pointing out that it was only because of such efforts that the New York Health Act was finally on the horizon of real possibility. If the New York Health Act passes, he said, addressing Forrest’s and Brisport’s voters and volunteers, “It will be because of you.”