ASPS Publicly Opposes Single-Payer Legislation in New York State
ARLINGTON HEIGHTS, Ill. - The American Society of Plastic Surgeons announced today its opposition to the New York State legislation (A.5062), which would create "New York Health." Under this bill, the New York government would assume control of paying for health care services, fundamentally altering the state's health care landscape.
"From what is known about the potential "New York Health", I'm able to liken it to the structure and practice of nationalized health care systems, such as, in Canada and the United Kingdom, which have both demonstrated failures in patient access and patient care," said ASPS president Scot Glasberg, MD, and private practice plastic surgeon based in Manhattan, N.Y. "Another major red flag with New York Health is the lack of detail in way of financing: identifying its true cost and who will bear those costs."
Patient Access and Quality Care
If history is any indication of how this bill will impact New Yorkers, reduced access to care and significant wait times for needed medical services will become a standard practice. For example, the Canadian system's wait time from the point of referral by a general practitioner to actual care by a specialist is at an all time high, increasing from 17.7 weeks in 2012 to 18.2 weeks in 2013. This is a 95 percent increase over wait times in 1993.¹ Perhaps more alarming, the average wait in 2013 from when a patient first saw a specialist to when treatment was provided was 29 percent longer than what Canadian specialists consider to be "clinically reasonable."
Proposed Bill's Economics
On the matter of costs, the bill's proponents have only said that its intent is to reduce them. The actual legislative language provides no clear guidance on how that will be achieved, only saying that "the Commissioner may establish by regulation payment methodologies for health care services" and "all payment rates under the program shall be reasonable and reasonably related to the cost of efficiently providing the health care service."²
On the matter of funding the program, A.5062 does specify that new taxes will be required and that those taxes will affect payroll and non-payroll income. But it does not detail how large these tax increases will be. Instead, it calls on the governor to "submit to the legislature a revenue plan and legislative bills to implement the plan."
Additionally, there has been no meaningful fiscal impact study or economic analysis of A.5062. The most recent study of a single-payer option in New York was conducted in 2009,³ which found that a single-payer system would result in a $57 billion (202 percent) increase in state government health care expenditures. Those expenditures will be funded by new taxes. Furthermore, the study found that a single-payer system would fail to achieve the overall cost savings that its proponents consistently offer as its primary benefit. Instead, total expenditures were projected to grow by $2.4 billion under a single-payer system.
"To enact such a sweeping change without an economic projection specific to the bill is reckless. If such a projection is ever produced and it shows that massive tax increases, price setting, limiting access to care or some combination thereof is required to make it viable, then proceeding with this plan is destructive," concluded Dr. Glasberg. "It will tear the social and economic fabric of New York, and once it is implemented it will be impossible to return to the previous system."
Due to the lack of historical success on improving patient care as result of government-run health care systems, coupled with the ambiguity of the New York Health bill's financial structure, the ASPS cannot support New York State legislation (A.5062).
¹Barua, Bacchus & Esmail, Nadeem, "Waiting your turn: Wait times for health care in Canada, 2013 Report," (Fraser Institute, 2013).
²All references to legislative language in A.5062 are taken from New York State Assembly Bill Search.
³Blumberg, Linda J. & Garrett, A. Bowen, "Achieving Quality, Affordable Health Insurance for All New Yorkers: An Analysis of Reform Options," (Partnership for Coverage, 2009).
The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery.