State run health care wouldn’t “save” Tompkins county $9.6 million per year. To be correct, it would shift those costs to the state and they would still be paid by taxpayers in Tompkins county and everywhere else in NY. True health care cost savings are very hard to achieve on a village, city, town, county or state level. If Ithaca had “free” or taxpayer paid health care, those who need a high level of care would move to Ithaca and soon the system would burden local taxpayers to the point of collapse. A national public health care option would have a far better chance to achieve cost savings. The tax burden would be shared by the broadest possible tax base. We are fortunate to live in a progressive state with fairly universal access to health care coverage via a mix of public and private programs and insurance providers. Focusing on universal free vaccinations and contraception would help to reduce the costs of avoidable disease and unplanned pregnancies across the system. This kind of approach has a very positive cost benefit ratio. Another, moderate approach, would be to gradually lower the age of medicare eligibility with a buy in at slightly higher premiums than for those who had contributed their entire working lives and are eligible at age 65. The success of this approach could be analyzed and further expanded if working well. We are currently burdened with a legacy health care system that is not a competitive free enterprise model nor a fully government run system. Dramatically changing such a model is politically unlikely. Incremental change would have the greatest chance of political success.