By Leonard Rodberg, Ph.D.

Anthony Weiner, the former congressman and now candidate for mayor of New York, is gaining a lot of attention, but also creating a great deal of confusion, with his proposal for what he calls a “single-payer plan” for New York City.

Weiner has provided almost no details on his plan. In fact, the only document he has provided is his “Keys to the City: 64 Ideas for New York City.” In that document, the closest he comes to a description of the plan is that it would be “a single-payer plan like Medicare for all the uninsured and underinsured in our city.”

He elaborated a bit on his concept in a speech on June 20, where he said that (1) the objective would be to contain the cost to the city government of paying health care costs for its employees and for Medicaid, (2) city workers, retirees, and undocumented immigrants in the plan would be expected to pay part of the premium cost, and (3) the plan might be administered by an insurance company. He said he would appoint a task force to develop the actual plan.

This doesn’t bear much relation to PNHP’s concept of a universal, comprehensive, publicly financed single-payer plan having no out-of-pocket payments. It’s not universal, comprehensive, publicly financed, or without cost-sharing. In fact, 95 percent of city employees already are covered through a plan provided and funded by the city, with most paying nothing towards the cost of the plan. Weiner did not explain how his plan would improve on this in any way.

In fact, PNHP clearly rejects a central feature of his plan. In “Key 35,” he links his “single-payer model like Medicare” to a belief that premium payments by recipients of city coverage should be used to impose greater fiscal discipline on them in order to reduce health care inflation. He says “our present policy of having employees pay none of their premium costs should change. It is a driver of an unsustainable fiscal liability [for the city government] … it dilutes true accountability, since beneficiaries don’t feel the pinch of premium costs and demand efficiencies.” In other words, city employees use too much health care because they don’t have enough “skin in the game.”

While PNHP does not support or oppose any candidate for public office, we do periodically evaluate health reform proposals that emerge during election campaigns. Our conclusion in this case: we should not in any way give support to Anthony Weiner’s so-called single-payer plan.

Leonard Rodberg, Ph.D., is professor and chair of the Urban Studies Department at Queens College, City University of New York. He serves as coordinator of the N.Y. Metro chapter of Physicians for a National Health Program.