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Opinion
Beware the Rise of JD 'Just-as-Dangerous' Vance
With Trump a distinct question mark and while the Trumpian current ebbs and flows, one wave is pushing the 2028 candidacy of Vice President JD Vance, but this shouldn't be a relief.
Jan 18, 2026
Donald Trump may, of course, be the Republican candidate for president in 2028, the US Constitution notwithstanding. Although it is clearly written in the 22nd Amendment that “no person shall be elected to the office of the President more than twice,” it may well be a majority vote of the Supreme Court that determines whether that applies to Trump.
In the past, that court has gotten around the Constitution without a single word of it being changed. Rather, its judges have let an innovative interpretation prevail. In 1896, for instance, in Plessy v. Ferguson, the court ignored the unambiguous language of the 14th Amendment that demanded “equal protection” and so upheld racial segregation by creating the fiction of “separate but equal.” It would take 58 years before that lie would be overturned.
Harvard law professor and Trump legal whisperer Alan Dershowitz has told the president that “it’s not clear” if it is constitutionally settled whether he can serve another term, even if elected. Reportedly, Jeffrey Epstein’s former lawyer is working on a book on the subject to be published in March 2026. And MAGA world—from the White House to members of Congress to far-right media figures—is stirring the pot on Donald Trump’s potential fourth bid for president.
Trump is also clearly worried about his legacy. Branding federal buildings and institutions with his name, building an outrageous ballroom, pimping out the Oval Office in gold, and constructing an unnecessary “Triumphal Arch” are all desperate attempts to be remembered as “great” at any cost. Yet, he has to know that the next Democratic president will be under tremendous pressure to remove most, if not all, Trump-brand edifices as quickly as possible. In the end, his real memorials will undoubtedly be the authoritarian policies and conduct that will label him as one of the worst, if not the worst, presidents in American history.
Keep in mind that Trump will be 83 by the time of the 2028 election and he’s already exhibiting so many of the behaviors generally attributed to the fabled “crazy old man” down the street.
That said, Trump remains a question mark when it comes to a third term. There are a number of reasons he might not try for one, not the least being his deteriorating mental and physical health. It didn’t take the New York Times to question his capabilities, not when anyone watching him could hear him slurring his words, dozing off in front of the cameras, barely moving even on a golf course, and sounding more incoherent than ever.
His manic putting up of sometimes hundreds of posts a day or in the wee hours of the night—although his staff may be responsible for some of it—should be considered a cry for help, if ever there was one. And it’s not just the volume of his postings, but their increasing extremity. The hate has become more hateful, the taunts more vicious and racist, and the fabrications more outlandish and divorced from reality. And keep in mind that Trump will be 83 by the time of the 2028 election and he’s already exhibiting so many of the behaviors generally attributed to the fabled “crazy old man” down the street.
Finally (should it get to that point), a majority of the Supreme Court—I certainly don’t think all of them, no matter the situation—could follow the Constitution and rule against a third term. It should be considered ironic at this point that the 22nd Amendment was proposed and passed in response to a Democratic president, Franklin D. Roosevelt, winning his fourth consecutive presidential race.
The Vance Option
With Trump a distinct question mark and while the Trumpian current ebbs and flows, another wave is pushing the 2028 candidacy of Vice President JD Vance. Trump found his avatar in 2024 when the junior senator from Ohio and former harsh Trump critic joined the crew of Republican senators fighting to be the most sycophantic to the party’s new Führer. Like his compatriots Ted Cruz, Lindsey Graham, and Marco Rubio, there were no morals or principles that superseded Vance’s ambition and lust for power. Under the circumstances, that “JD” could easily have stood for “just as dangerous.”
As Vance confirmed at the recent Turning Point USA gathering, not only are White nationalists like Nick Fuentes and unrepentant conspiracists like Candace Owens not denounced, but they are welcomed and embraced. Tucker Carlson’s friendly interview with Fuentes roiled MAGA, but before that he was interviewed by Owens on her podcast. Again, there are no discernible objections from GOP leaders, including Vance.
While Vance opportunistically inserted himself into the Charlie Kirk martyr-building project—he was a pallbearer and spoke at his memorial—he has yet to call out Owens for her wild and unfounded claims that Turning Point USA staff, Israel, the French Foreign Legion, and God knows who else were somehow involved in Kirk’s assassination.
If Trump doesn’t manage to run a fourth time and Vance wants to be president, he’ll be more dependent than ever on the MAGA base and the far-right, especially since he has little to no chance of winning over many Democrats or independents.
Vance’s most eye-raising statement at the TPUSA event was when he said, “You don’t have to apologize for being white anymore.” First, it is a pretty sure bet that no one at the event (or in MAGA) ever apologized for being white. Second, Vance reinforced the view that white supremacy will not be a barrier to any future campaign of his.
Vance’s message is clear: Every imaginable far-right extremist, from white supremacists and technofascists to offensive fabulists, is welcome in his coming 2028 campaign. And he will assumedly have Trump’s blessing (if the president doesn’t indeed decide to try to run again himself).
Poor Secretary of State Marco Rubio has as much chance of getting Trump’s support as Black GOP Congressional Representative Byron Donalds did of becoming his vice-presidential candidate in 2024. Trump 2.0 is wholly built on racial profiling, especially of Latinos, and asserting White power. Merely “looking” Latino is enough in these Trumpist times to attract armed masked men and a trip to an immigration hellhole. Rubio has vigorously defended such illegal arrests and detentions and the racist demonization of immigrants of color that’s gone with it, but he’s rolling the dice if he thinks the MAGA base will see him as the exception to their rule.
Just ask Vance. As hillbilly-centric and pro-white working class as he has tried to portray himself, despite being a millionaire many times over, the fact that he is married to Usha Vance, a woman of color and a non-Christian, has generated lots of racist blowback. Fuentes, for example, called Vance a “race traitor” for marrying Usha. Many MAGA adherents were shocked to discover Usha was not white. One report found that, between January and August 2024, there were at least 1,800 racist, gender, or religious-based attacks on Usha that reached an audience of an estimated 216 million.
While Vance has pushed back against such threats and insults, he’s ignored any possible relationship between Trump’s and his racism against Haitian and other immigrants of color and the blowback he’s experienced against Usha. His default position (rather than directly challenging MAGA bigotry): Usha is “tough enough to handle it.” In addition, instead of defending Usha’s right to practice whatever religion she chooses, he pandered to the religious extremist crowd by stating that he hoped she would convert to Catholicism and “eventually that she is somehow moved by the same thing that I was moved by in church.” He then added, “I honestly do wish that because I believe in the Christian Gospel, and I hope eventually my wife comes to see it the same way.”
Vance Courts the Extremists
If Trump doesn’t manage to run a fourth time and Vance wants to be president, he’ll be more dependent than ever on the MAGA base and the far-right, especially since he has little to no chance of winning over many Democrats or independents. Few will forget that he personally led the outlandish racist claims that Haitian immigrants were stealing pets and eating them in Springfield, Ohio. When busted on that fabrication, he admitted that he had known the truth, but didn’t care as long as it served his interests. He stated in an interview during the 2024 election campaign, “If I have to create stories so that the American media actually pays attention to the suffering of the American people, then that’s what I’m going to do because you guys are completely letting Kamala Harris coast.”
Vance’s “stories” were blatant lies about immigrants (of color) and their role in US society. According to him, undocumented (and perhaps, maybe, kinda legal) immigrants are to blame for high medical prices, rising housing costs, education crises, crime, antisemitism, and illegal voting. In other words, there isn’t a problem in the United States that can’t be linked to undocumented aliens.
A Time When Vance Was Truthful
The next time around, Democrats would be wise to highlight Vance’s past criticism of Donald Trump. After all, he referred to Trump as “Hitler” and as a “morally reprehensible human being” in emails that plausibly were not supposed to be publicly seen. However, he did publish an article in The Atlantic only weeks before the 2016 election that he clearly wanted to be on the record. In a piece entitled “Opioid of the Masses,” he called Trump “cultural heroin.” He argued that, while Trump’s blather might make people feel good, he was anything but the answer to the deeply rooted causes of the multiple crises facing poor whites, particularly and ironically, opioid drug addiction. Like heroin, he wrote, its poison “enters minds, not through lungs or veins, but through eyes and ears, and its name is Donald Trump.” Vance’s own mother, as he noted in the article, abused heroin and prescription opioids, giving him a highly personal stake in the issue.
What he wrote then is no less true today: “Trump offers an easy escape from the pain… Trump’s promises are the needle in America’s collective vein.” Continuing with that addiction metaphor, he added, “Perhaps the nation will trade the quick high of ‘Make America Great Again’ for real medicine.” That Vance is long gone.
It’s a maxim of today’s politics that all relationships with Trump end badly.
Of course, his most important pre-Trumpian links weren’t to his largely made-up hillbilly upbringing—he was born and raised in Ohio—but his ties to far-right billionaires in Silicon Valley. They have been dubbed “techno fascists” for their reactionary, racist, misogynist, and anti-democratic views. His bids for the Senate and then the vice presidency weren’t just supported by Elon Musk, Peter Thiel, and other big names in the billionaire tech world, but opened the door to their increasing role in shaping policy, especially but not exclusively in relation to the artificial intelligence and technology industries.
Vance has, of course, also been in lockstep with Trump’s imperialist and self-serving foreign policy. He crudely sided with the president when he attempted to browbeat Ukrainian President Volodymyr Zelenskyy in their infamous Oval Office meeting on February 28, 2025. He also defended, and even cruelly joked about, the deadly strikes on boats in the Caribbean by the US military. He justified Trump’s illegal abduction of Venezuelan President Nicolas Maduro and his wife, Cilia Flores, echoing all the false claims of Trump, Rubio, and Defense Secretary Pete Hegseth about drug trafficking and stolen oil.
It’s a maxim of today’s politics that all relationships with Trump end badly. Will Vance abandon Trump as he deteriorates yet more? The main lesson Trump learned from his late lawyer, the notorious Roy Cohn (of McCarthy-era fame), was to use people until they are no longer useful. Cohn counseled Trump in his early years and introduced him to influential and important people who facilitated his rise in New York City. They became “friends” until Trump (of course!) abandoned Cohn in his time of need once he contracted AIDS and was dying. Trump simply brushed him aside when he was no longer useful and reportedly did not even attend his funeral. Can Trump expect the same treatment from Vance?
Or will the vice president be like Kamala Harris and, as she did with President Joe Biden, pretend Trump is well when he clearly is not? As Trump struggles to make it for three more years, Vance will be questioned about his cognitive state and physical health. Will he gaslight the public and hope for the best?
Given what we have seen and that Vance has demonstrated no loyalty to principles or ethics, no one should be surprised if he turns on Trump at some point, should he determine that it is in his interest to do so.
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Don't Be Fooled: The Trump 'Peace Plan' Is Just Genocide Under a Different Name
The genocide in Gaza has not ended, but has taken on a different form.
Jan 18, 2026
The Trump peace scheme is not an imperfect plan that at least ends the genocide in Gaza. It is in fact a new plan to continue the genocide using a different strategy. It poses a mortal threat to the survival of Palestinians in Gaza. However this plan is not being implemented in isolation from the massive Israeli attack on Palestinians in the West Bank, but in conjunction with it. We are now witnessing, not merely a messy and complicated ceasefire in Gaza and stepped up attacks on Palestinians in the West Bank. Rather, we are witnessing a coordinated 2-pronged attack to destroy the very idea of Palestine. As a result we need to move from targeting the Gaza genocide as separate from what’s being done in the rest of Palestine to a focus on both Palestinian self-determination and opposing ongoing efforts to erase the reality of Palestinians as a people. To repeat: we must now insist on the national rights of Palestinians to live in a Palestine shaped by their own hands – and to counterpose that insistence to the Trump-Netanyahu plans being implemented throughout Palestine to savage Palestinians and destroy their existence as a people.
Gaza
Trump’s peace plan for Gaza is of course absurd. The Palestinians played no role in creating it. The country that has been committing an internationally recognized genocide is now going to “temporarily” occupy more than 50% of the territory on which it has carried out that genocide. And the President of the country who teamed up with Israel to commit that genocide is the Chairman of something bizarrely named the “Board of Peace”. As such he is given the power to oversee all aspects of Gaza’s future including an international “peacekeeping” military force and the appointment of Palestinians he judges should temporarily administer Gaza while Israeli troops directly occupy most of the area. The only party to be disarmed is the Palestinian resistance to the genocide.
On paper there was at least to be a ceasefire. But instead we see the Israeli military killing Palestinians on a daily basis. At the same time they violate their obligation to allow sufficient food, medicine and other basics of life to be brought in to Gaza by the United Nations Relief and Works Agency (UNRWA) as Israel creates all kinds of barriers to sufficient aid reaching the people. In addition the Israelis have blown up 1500 more buildings in the area of Gaza allotted to them and are taking over parts of Gaza beyond the area given to them in the plan. Nothing gets in the way of Israel doing whatever it wants.
In the ultimate act of betrayal, the United Nations security council has turned over the future of Gaza, not to Palestinians, but to Israel, Trump and his investors. Yet this brute reality is not seen clearly by most of the world. It is now our movement’s job to take on this plan directly and create a counter narrative that explains the continuing genocide and the need to immediately rise up in opposition to it. If the millions of people who rose up against the genocide in the past saw this plan for what it is, instead of seeing it as something that might benefit the Palestinians, they would increasingly roar their opposition.
The West Bank
In the West Bank the escalating violence includes land theft, murders, the expulsion of farmers from their fields, uprooting trees, burning home and cars, and systematic attacks during the olive harvests – a central source of their livelihoods. All this to lay the ground for almost complete ethnic cleansing and a vast expansion of Israeli settlements. The ultimate goal is to turn the West Bank into a part of greater Israel.
Meanwhile thousands of Palestinians from both areas are “interred” in the Israeli Gulag of torture centers where unspeakable conditions are just as bad—or even worse–than those at the notorious Abu Ghraib prison.
In short, we are seeing a wave of expulsions, arrests and murders by Israeli settlers and soldiers in the West Bank in combination with post-ceasefire killings, demolitions and restrictions on food, medicine and shelter in Gaza. The goal of these tactics is the same as that of the genocidal military operations and food blockade during the first 2 years of Israeli rampage that has left Gaza in ruins:The end of Palestine.
We must now shift our focus from Gaza alone to the preservation of Palestine, as Palestinians and their aspirations for freedom are under deadly attack throughout their country. We must educate the public on how the genocide in Gaza has not ended, but has taken on a different form, while Israel’s goal of eliminating the possibility of Palestinian life has broadened to include the West Bank.
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US Corporate Media Seems Very Afraid of Democracy
Maybe mild forms of socialism is not what they fear most.
Jan 18, 2026
Much as they did back in 2018, when New Yorkers stunned the political establishment by electing a little-known former bartender named Alexandria Ocasio-Cortez to Congress, the corporate political press covered the most thrilling Democratic victories of 2025 as if they were largely inexplicable, semi-miraculous flukes. While breathlessly covering the tweets, styles, preferred lipstick brands and personal qualities of individual politicians, establishment media outlets mostly ignored the organizing efforts led by ordinary people that put representatives like Ocasio-Cortez in positions of power.
In the view of these publications, recently sworn-in New York City Mayor Zohran Mamdani wasn’t a movement candidate who emerged after years of working on other insurgent campaigns and organizing with groups like the Democratic Socialists of America (DSA), of which I am a member, but a slick young upstart whose campaign was “built from nothing in a matter of months” (New York Times, 6/29/25).
After the general election, the New York Times (11/4/25) wrote that while Mamdani had won the primary by uniting “a new coalition of Brooklyn gentrifiers and Queens cabbies,” he triumphed in the general by running an “improbable backroom campaign” that “wooed, charmed and delicately disarmed some of the most powerful people in America.” This framing, by New York politics reporter Nicholas Fandos, suggested that Mamdani—undeniably a “megawatt talent”—had blandished his way into the mayoralty virtually singlehandedly.
NBC News (11/4/25) wrote of his “meteoric rise” from a “virtually unknown state assemblyman who barely registered in polling” to the mayor of America’s largest city without substantially analyzing how that came about.
‘Building civic architecture’
This framing obscures both the crucial role that ordinary people played in these campaigns, and the potential they have to organize and win even political changes the rich and powerful bitterly oppose. And it misses the real story of Mamdani’s win: the unprecedented army of volunteers, young people and first-time voters who propelled him to victory. That story was mostly covered by left-wing outlets like Dissent (11/25/25) and Jacobin (7/15/25), which put out sharp analyses of how campaigns like Mamdani’s were structured and organized, and how they were able to succeed against such long odds.
Grassroots formations that provided crucial support to Mamdani’s campaign, such as DSA and DRUM Beats, which organizes working-class Indo-Caribbean and South Asian communities, are membership-based organizations. They differ in structure and strengths from the top-down, consultant-driven campaign model corporate political outlets see as the norm.
These groups also spent years planting the seeds of victory by organizing people who had long been overlooked, ignored or shut out of conventional politics to participate in local elections. In other words, Mamdani’s campaign was the opposite of the Times‘ characterization as being “built from nothing in a matter of months.”
As Chris Maisano explained in Dissent, “people on the ground have been quietly building civic infrastructure” in neighborhoods Mamdani won. The mobilization of these communities “transformed the electorate and helped Mamdani offset Cuomo’s strength in neighborhoods that shifted sharply to the former governor in the general election.”
Establishment media’s obsession with portraying democratic socialism as divisive and/or fatally alienating to voters blinded it to what was truly radical about Mamdani’s campaign: It empowered ordinary people to lead, changing individual lives and history. What most scares the establishment isn’t socialism; it’s people-powered democracy.
Discouraging mass political participation is not new—in a 2019 Politico article (4/25/19) headlined “Politics Is Not the Answer,” Matthew Continetti suggested that “we might begin to see ourselves, and all of our virtues and our vices, more clearly” if we would only lower our expectations “of what politics can achieve”—but it’s newly salient in the run-up to the 2026 midterms.
‘Too much emphasis’ on ‘far-left positions’
One function of the corporate political press is to funnel popular energy and outrage into what its backers see as the proper channels: lawsuits, think tanks and voting for establishment-backed candidates. This is reflected in how these outlets are covering contemporary opposition to Donald Trump.
The New York Times (9/17/25) wrote about a new Democratic think tank, the Searchlight Institute, that attributes the party’s recent losses to “too much emphasis on issues like climate change and LGBTQ rights…at the expense, some argue, of appealing to voters in battleground states.”
Paraphrasing the think tank’s founder, Adam Jentleson, the paper’s Reid J. Epstein noted that
organizations focused on climate change, gun control and LGBTQ rights have all managed to get Democratic presidential hopefuls on the record taking far-left positions to the detriment of their general election performance.
The Times quoted operatives who disagreed with Jentleson, but didn’t bother to analyze his essential claims: Were those positions really “far left” and alienating to the party’s base? What evidence is there that candidates who took certain positions on climate change and/or LGBTQ rights underperformed in general elections as a result of those positions?
To the Times, the needs and preferences of the party’s “liberal base” are inscrutable and beside the point; what matters is the guidance of self-appointed experts like Jentleson, whose think tank is “subsidized by a roster of billionaire donors,” including prominent hedge fund managers and real estate investors.
‘A lot of compromise’
In a New York Times column (4/17/25) calling for a “national civic uprising” against Trump, David Brooks argued that the mass rallies Ocasio-Cortez and Sen. Bernie Sanders led in 2025 were “ineffective” because they were “partisan,” and made opposition to Trump “seem like a normal contest between Democrats and Republicans.”
Yet one day earlier, the Times (4/16/25) reported that the Sanders and Ocasio-Cortez rallies had “drawn enormous crowds” and were “energizing a beaten-down Democratic Party.” And according to a Sanders adviser, the paper noted, “21% of those who signed up to attend Mr. Sanders’ events reported that they were independents, and 8% said they were Republicans.”
Organizing mass rallies that expose thousands of listeners in conservative areas to critiques, not just of Trump, but of oligarchy in general, seems like an effective means of diluting right-wing power and demonstrating that leading Democrats and their allies care about Americans throughout the country, not just in blue states. But to those in corporate media, the point of politics is not to inspire regular people to organize and win broadly popular demands, but to “build power” and “do good things” by, as the New York Times’ Ezra Klein suggested in a recent interview with the New Yorker’s David Remnick (9/29/25), engaging in “a lot of compromise and a lot of working with people who we have very, very deep disagreements with.”
Klein is far from the only Democrat who believes we should take “an approach to politics that we think will expand our coalition such that we are not always within two points of losing to Donald Trump or the people around him.” But to Klein, that means penning paeans to hatemongers like the late Charlie Kirk (New York Times, 9/11/25), not standing up to plutocrats.
‘A better story’
Despite evidence that mass issue-based organizing campaigns can and do politicize people, bring them into effective coalitions and achieve significant victories, corporate media outlets and establishment leaders remain laser-focused on encouraging the rank and file to elect centrists rather than build mass movements.
As CBS News (12/16/25) recently reported, former President Barack Obama—still one of the Democratic Party’s most popular figures—is urging Democrats to “focus on winning the midterms and developing ‘a better story’ to tell voters, rather than on ‘nerdy’ internal disagreements.” The man once touted as the nation’s “organizer in chief” has long since abandoned encouraging Americans to organize, fight for and win life-changing policies; he is advising them to focus on winning the midterms by burnishing their brand.
The endurance of Trump, who won more votes than Kamala Harris in 2024 but has never won the consistent support of a majority of Americans, revealed to many that they cannot trust US political leaders to protect the rights and interests of ordinary people. Campaigns like Mamdani’s in New York, and recently elected Mayor Katie Wilson’s in Seattle, have shown people around the world that they have the power to win the policies and elect the leaders they want, without top-down instruction or management from—and despite interference by—elites.
To pundits and corporate media outlets, this is a dangerous lesson: If everyday people realize they don’t need overpaid consultants or self-declared experts to win real change, how long can the status quo be maintained by its beneficiaries?
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State-Level Single Payer a Good Step Toward Medicare for All
Will passage of a state-based program serve as an initial step towards a national program or derail the nationwide effort for a federal plan?
Jan 18, 2026
The consequences of President Donald Trump’s One Big Beautiful Bill Act (OBBBA) are already apparent. Millions have already lost health insurance. Millions more face soaring costs.
Nevertheless, fierce political opposition to a national Medicare for All legislation remains. The only possible path forward is to enact universal health care programs in those states where the electorate will be receptive. To facilitate this process, the State Based Universal Health Care Act (SBUHCA) has been introduced into both the United States Senate (S. 2286) and House (HR. 4406). This bill establishes minimal standards for state-based healthcare delivery programs and codifies the transfer of funds for healthcare services from Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) to states with state-based programs.
Over the past 60 years, repeated attempts to improve the quality and availability of healthcare have had some success. In 1965, President Lyndon Johnson passed our first national healthcare legislation: Medicare for those age 65 and over and for younger adults with disabilities. Medicaid for indigent people. Most working- and middle-class Americans were excluded. Presumably working Americans would get health insurance via their workplace. Presidents Clinton and Obama, neither of whom pushed for passage of a universal program, were able to pass legislation providing incremental change. Clinton’s “Healthcare Act of 1997” and Obama’s “Affordable Care Act” of 2010 reduced the number of uninsured Americans. These bills, however, did not insure everyone or address segregation within the insurance system. They did not stem the rising cost of health care or reduce the number of underinsured persons with medical debt. They are responsible for the convoluted and cumbersome healthcare system we have today.
It is helpful to look back at the Social Security Amendment of 1965 that created the Medicare and Medicaid programs. In the days before the 1965 Civil Rights Act, Democrats usually enjoyed wide majorities in both the Senate and the House. There was however a confounder. Their majority included a block of Southern politicians whose principles were akin to those of their Civil War era Democratic Party predecessors. To gain their support, Johnson had to craft legislation that would somehow assure continued inequality between White and Black Americans. A true Medicare program was offered only to older retired Americans. That legislation required that hospital funding would be contingent upon hospital desegregation. In fact, hospital desegregation was achieved. Working age people however would be served by Medicaid, a program with means testing that provides care only to people at the poverty level. Details of the program are left to the discretion of the states. Most wage-earning, working-class people are thus excluded from the government program. Practical details of the program are left to the discretion of each state. The drawback became apparent during Covid when ten red states rejected the Medicaid supplements offered via the Affordable Care Act. Covid mortality in those states was greater than in those that participated in the Medicaid expansion.
Passage of a state-based program thus poses a conundrum: will passage of a state-based program serve as an initial step towards a national program? Or, with single-payer programs in place in progressive states, will the push for true national universal program be abandoned? The Medicaid experience bodes poorly for the success of a state-based plan. On the other hand, the history of the Canadian healthcare system shows that a state-based program may serve as a solid foundation for evolution to a nationwide plan. The Canadian program began in 1947 as a Saskatchewan-wide hospital insurance program for that province. Over the years, health programs were developed in other provinces such that in 1984, these coalesced into one: the Federal Canada Health Act.
With its New York Health Act (NYHA), New York State is now at the forefront of the movement toward state-based healthcare legislation. The notion that progressive legislation should originate in New York State has precedent. In the aftermath of the early 20th century Greenwich Village Triangle Shirtwaist Company fire, Frances Perkins, then a social worker and executive secretary of the newly formed Statewide Committee on Safety, was instrumental in crafting minimum wage, child labor and worker safety laws for the State. These State laws would later become the template for much of FDR’s New Deal legislation.
The NYHA would provide comprehensive coverage to all New York residents. The bill would establish a trust fund to hold money for patients and pay providers. Providers would bill the fund for services. Fees would be negotiated. Patients’ choices of physicians would not be limited by networks or prior authorizations. Nor would the bill dictate physicians’ methods of practice. All New Yorkers would pay a progressive graduated annual tax scaled according to income. Capital gains and stock transfers would be taxed as well. Additional funds would be available from Medicare, Medicaid, and CHIP. While these funds could be transferred to the states via a wraparound process, SBUHCA would codify this transfer of funds. Patients would make no further healthcare payments. No co-pays, deductions, payment at the point of service, or denials. No one would have medical debt. It is projected that 9 of 10 New Yorkers would pay less for medical care under the NYHA than they pay now.
New Yorkers can afford the NYHA. All other industrial nations provide better care to their citizens and at lower cost. New York can do the same. The cost of providing comprehensive care to include those services now not covered by Medicare, e.g., dental, visual and auditory along with long term care, is large. But eliminating the middlemen in the insurance, pharmaceutical and other provider industries would produce sizable savings. A recent Rand Corporation analysis assumed that the rates for physicians’ fees and other service providers would be greater than Medicare rates but less than that of more generous providers. The analysis concluded that the NYHA would reduce the overall cost of healthcare by 4%.
Where does the NYHA stand today? The process of advancing legislation from its drafting toits passage is arduous. Presently, the NYHA has a majority of co-sponsors in both chambers: 32 in the Senate; 78 in the Assembly. More public support for the bill is necessary, however, before legislators will advance the bill to the legislative chambers for a vote. Opposition from two major public service unions has also hindered efforts to bring the bill to a vote.
Passage of the NYHA would be a meaningful forward step toward adequate health insurance for all. We must continue the fight.
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