There are a lot of building issues in the run-up to the 2020 presidential campaign. Among Democrats, one major issue is Medicare for All. Moday night, a group in Orchard Park talked about New York State's proposed version, the New York Health Act.
The proposal has gone through the State Assembly the last four years and with Democrats taking control of the State Senate, it is likely to pass that house. Then it is up to Gov. Andrew Cuomo to decide if a single-payer health plan would come to New York.
Cost of the plan isn't clear. It would be paid for with all of the federal healthcare money that comes into the state and with a progressive income tax, possibly all replacing the property taxes that help pay for Medicaid.
Lawyer Kevin Ketchum said the plan would replace all private health insurance and be paid for with federal dollars and a progressive state income tax structure.

"It's universal, meaning all, everybody in, nobody out," Ketchum said. "Like Nate was saying, you've heard of Medicare for all. Think of guaranteed healthcare for all. Every resident would be eligible to enroll, regardless of age, income, wealth, employment or other status. Resident means an individual whose primary place of abode is in the state. So you have to be a resident of the state."
Buffalo physician Frances Ilozue said she saw a woman who had delayed seeking care until she had a Medicare card.
"I have a little lump here. I checked. She was eaten up by cancer. I could not believe," Ilozue said. "So I come from Africa. You can see that in Africa. It's something that happened often in a Third World country. I didn't imagine to see it in Buffalo, where we have hospitals like Roswell."

Ilouzue said the current situation is better because the Affordable Care Act provides free mammograms. Other speakers at the meeting critized the current healthcare system as expensive, erratic, badly run and producing sometimes poor outcomes.
Former businessman Mark Fera said health insurance coverage was a constant problem for him and his workers.
"That is one of the hardest issues. When you start negotiating, late summer, early fall with the insurance company, talking to them," Fera said. "Very often, he has cut benefits and it was just a nasty cycle. And then, always, we have to meet with our employees, tell them what the news was."