Assembly member Richard Gottfried rallying for single-payer in Albany.
Have you heard of the New York Health Act? Most of us haven’t, but it’s important – New York State could lead the United States into the developed world in terms of modern health care. The New York Health Act, backed by Assembly member Richard Gottfried and State Senator Gustavo Rivera, would provide comprehensive, universal health coverage for every New Yorker, replacing private insurance companies with a universal state-wide system. The goal is everybody in, nobody out, a plan that will include not only our faculty and staff, but all of our students and their families. Think about it – no network restrictions, everything covered – primary, preventive, specialists, hospital, dental, vision, drugs, long-term care – all of it. And without the profit-making private insurers, this will save money for all of us, the state, the city, CUNY, and individual people.
Save the time negotiating with insurance coverage, time spent by doctors, hospitals, employers or patients trying to fill out the forms in the right way, the way that will get costs covered. The administrative savings alone will be in the millions of dollars. By the state directly negotiating for drug costs and medical devices is expected to bring prices down by over a third. No more premiums, deductibles, co-pays. No more systemic inequality, no more different standards of care for uninsured, Medicaid, or privately insured. We would all be equal, equally covered, equally cared for.
NEW YORK LEADING WAY
New York is on the verge of doing what every other country in the developed world does: guarantee all of its residents access to medical services.
Americans have taken the unthinkably high, unaffordable costs of medical services as a given. We know we cannot afford these services if needed, so we buy private insurance. Medical services drive Americans into bankruptcy because these services cost a fortune. This country spends more on medical services than any other country in the world, often twice as much – and has worse outcomes.
We call it “health care” – the industry that provides those services has encouraged that. But it’s not actually about health or care – health care is actually publicly available and funded, however poorly. Fresh air, clean water, protective food laws, those are about health and we do see them as “public health,” as governmental functions. They are not, we know well, evenly distributed and very much vary along class and race lines. That is something we acknowledge as a social problem to be solved socially, and collectively. The covid pandemic made that all the more clear: crowded living and lack of access to fresh air played out in higher death rates. And lack of access to medical services meant some people were forced to keep going to work in spite of the risks, even when they suspected they might have and be spreading COVID-19.
Medical services – doctors’ appointments, drugs, surgeries, hospitalizations – those are provided one-on-one, not neighborhood by neighborhood, or state by state. And unlike everywhere else in the developed world, Americans have come to view such services as individual not public problems. The closest we have come to responding collectively has been through the work of unions. Workers in unionized jobs can get insurance for these expenses as a “benefit” of their employment. Having your suspected early cancer treated while it’s still treatable is a nice benefit. Getting your child’s developing scoliosis treated before she’s permanently damaged by her curving spine – nice benefit.
Unions are about a collective, an “us.” We need, we deserve, we will negotiate and bargain for our needs. Some countries have a national sense of “us,” of who “we” are. Explaining why medical costs are covered by the state, Dutch, German and British folks explain – “It can happen to anyone.” Any of us. The other country that did not have national medical coverage was South Africa. Then they ended apartheid and got a national system. Take what lessons you will from that.
MORE THAN THE UNION
As a union, the PSC has done a good job of negotiating medical coverage for us. But is that the most meaningful “us” in your life? Your fellow union member has coverage, but your aunt does not. The adjunct down the hall who helped you pick out the new intro text – maybe they have medical coverage. Some of our adjuncts qualify and the union fought for that, but many of them do not.
Nowhere in the developed world, nowhere but in the United States, do students, faculty and university staff have to depend on their university to figure out how to afford medical care. Why should the CUNY community have to depend on the university for this basic need? Why do we have to take this on?
Think about what it would mean for CUNY to have a state-wide insurance program. Graduate students wouldn’t have to compete for fellowships so they can afford to treat their asthma. Being an adjunct or on a tenure-track won’t determine whether you can afford the bills for the birth of your new baby, let alone get new glasses or a toothache treated. The part-time department secretary won’t have to try desperately to move to full-time status so her husband’s diabetes medicines get covered. The university’s human resources department won’t need to keep part-time staff under 20 hours to avoid providing health coverage.
More and more of CUNY is moving to part-time, adjunct status. We saw it first with the faculty, and we’re seeing it now along administrative lines. Full-timers retire and adjunct lines replace those positions. One of the driving factors is avoiding the benefits costs of full-timers. Take those benefits off the negotiating table and think about what the PSC could be working on: smaller classes, academic freedom, wage increases, even the “public health” issues of better air quality and food on campus.
Given its long-standing commitment to single payer, the PSC supports the New York Health Act as a work in progress. A payroll tax, where employers pay the costs for lower paid workers and a cost sharing system for higher paid, will mean that most New Yorkers – and specifically PSC members – will pay less and our union can work on other issues we care about. Unions in the public sector, like ours, will work on the New York Health Act to make sure that our members do not face added payroll taxes, but once that system is in place, our time can be spent working on other issues.
Access to basic medical services should not be a privilege, a benefit our university, or any other institution, doles out selectively. Nor should such services be something a university has to skimp on so it can afford to pay its teachers. Our students, most of all, have more than enough to worry about, to strive for. They should be able to spend their time studying, not seeking medical care for their parents, not researching ways to get an undocumented relative early cancer treatment, not trying to figure out how to get their little brother’s hearing loss attended to. These services should be universal, as they are in most of the world. New York State can choose to join the developed world.
Let’s work for universal guaranteed health care for all New Yorkers by building support for the New York Health Act. Let’s lighten our load. We have more than enough to do for our students, our staff and our faculty to assure all of us have access to the medical services we need.
This could really happen, and we have to work to make sure it does.