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Surely New York could bankroll this.
by amiga_500 6y ago
Surely New York could bankroll this.
- sudosysgen 6y agoThey could indeed bankroll it, but I don't know that they would have the bargaining power to make it cost-effective.
- amiga_500 6y agoNearly 20 million people. Sweden seemed to do okay with their health system, with half that.
- sudosysgen 6y agoSweden is negotiating from a position of unshakable and absolute sovereignty, where if a drug company or medical supplier insists on an unreasonable price they can realistically pretend to either nationalize the company, switch to a state-owned competitor, in the case of suppliers and so on, or even decide not to observe the patent. Sweden is also insulated from lobbying in a way New York isn't, and is not reliant on direct and conditional funding from a higher government. New York has neither of these options.
- bhupy 6y agoNew York can FORCE Pharma providers, Hospitals, and doctors to accept its single payer insurance plan. These drug companies and medical suppliers would have to either cease to operate in NY or go out of business. The resulting vacuum from doing so presents an opportunity for new Pharma entrants, either other incumbent competitors, or new homegrown upstarts in NY. The demand doesn't go away, an there's revenue to be made.
- sudosysgen 6y agoSure, but the state of NY still has to respect patent law.
- bhupy 6y agoSure, the same way that Saskatchewan had to respect patent law in 1947 when it enacted its own single payer system — its population was 1/20th the population of all of Canada at the time.
- bhupy 6y agoThe least populous state in the US (Wyoming) has more people than Iceland, which is more than able to exert bargaining power in a cost-effective way.
- sudosysgen 6y agoNo, because Iceland is a sovereign government, and if they can't find an agreement with drug companies or suppliers, they always have the option of nationalizing them or ignoring patents. They also aren't reliant on funding from the U.S. Federal Government, which is a big deal in this case.
- bhupy 6y agoNew York is also a sovereign government and can operate a State-run drug company or supplier, just like they operate State-run universities, and the State-run MTA transportation system. New York can, by law, force companies to accept its prices in the same way that it can enforce Uber and Lyft to charge minimum prices, or employers to pay minimum wages. > They also aren't reliant on funding from the U.S. Federal Government, which is a big deal in this case. Besides Federal highway funding and Medicaid, neither is New York. New York's single payer system can be funded entirely through an increase in its own state tax rate — there's a lot of room to increase taxes back to WW2-levels, and a lot of room to raise the middle class tax-rate to Europe-levels.