Gotham Gazette Gotham Gazette is an online publication covering New York policy and politics as well as news on public safety, transportation, education, finance and more. http://www.gothamgazette.com/component/tags/tag/health-care 2018-11-15T13:05:12+00:00 Webmaster webmaster@gothamgazette.com With Full Democratic Control, Sponsors of New York Single-Payer Health Care Hopeful About 2019 2018-11-13T05:00:00+00:00 2018-11-13T05:00:00+00:00 http://www.gothamgazette.com/state/8066-with-full-democratic-control-sponsors-of-new-york-single-payer-health-care-hopeful-about-2019 Ben Max <p><img src="http://www.gothamgazette.com/images/29874812518_530478a409_z.jpg" alt="Cuomo health care" width="600" height="399" /></p> <p>Gov. Cuomo (photo:&nbsp;Kevin Coughlin/Governor's Office)</p> <hr /> <p>Though Governor Andrew Cuomo has not expressed support for instituting a single-payer health care system in New York, his fellow Democrats campaigned on the issue as they flipped control of the state Senate, landing all of state government into Democratic hands and providing a significant boost of optimism to the lead sponsors of the New York Health Act, which would create a government-administered single-payer health care system.</p> <p>The bill has passed the Democrat-dominated state Assembly several times and all the members of Senate Democratic conference signed on as co-sponsors at the end of last legislative session in a unified show of support for the program heading into the election season.</p> <p>Cuomo has said he supports a Medicare for all-type system at the federal level, but cast doubts on the cost and complexity of doing it in New York, and since their resounding wins on Election Day, the incoming leaders of the Democratic Senate majority have indicated that the massive undertaking of single-payer is not at the top of the agenda.</p> <p>Still, with Democratic control of the Senate and the Assembly by wide margins, single-payer healthcare could be passed as early as the 2019 session, according to Assemblymember Richard Gottfried, chair of the Assembly Health Committee and lead sponsor of the New York Health Act.</p> <p>“It was clear in the country and New York that healthcare was the number one issue on voters’ minds,” Gottfried said, before pointing to his legislation. “A solid majority of the new state Senate has either been a cosigner, voted for it in the Assembly, or campaigned on it. So I think we’re on track to get it passed in the Assembly and state Senate.”</p> <p>The <a href="https://legislation.nysenate.gov/pdf/bills/2017/S4840" target="_blank" rel="noopener">New York Health Act</a> would replace health insurance companies with New York state government as the payer of healthcare costs for all New Yorkers. It has been <a href="https://www.pressconnects.com/story/news/local/2018/06/17/ny-assembly-oks-universal-health-care-bill-halted-senate/708708002/" target="_blank" rel="noopener">passed</a> in the Assembly four years running but has yet to be voted on in the Senate, where Republicans have held control. All of the other 30 Democratic senators joined lead sponsor Senator Gustavo Rivera of the Bronx to co-sponsor the legislation, though the Senate Democratic conference is seeing significant turnover due to primary wins by insurgent challengers. But, those challengers have in general been even more vocally supportive of single-payer health care than their more moderate predecessors. These facts give Gottfried confidence that the New York Health Act will pass during the 2019 session, which begins in January.</p> <p>But the bill still faces an uphill battle, in part because of the massive changes it would institute, and the fact that though it might reduce overall individual and business healthcare costs after implementation, for the state to run the system it would require raising taxes significantly, something many Democrats have <a href="http://www.gothamgazette.com/state/8047-tax-issues-at-center-of-new-york-elections-albany-year-to-come" target="_blank" rel="noopener">promised</a> not to do and Cuomo is vehemently opposed to. It would also drastically impact the state’s private and public hospitals, the health insurance industry, and more. Some of the changes would of course be beneficial to New Yorkers, but the undertaking is complex and the New York Health Act as currently written leaves a lot of detail undetermined, including funding.</p> <p>The governor has repeatedly opposed single-payer healthcare at the state level, <a href="https://www.timesunion.com/news/article/Cuomo-Universal-healthcare-easier-on-federal-13194080.php" target="_blank" rel="noopener">suggesting</a> that it would be more rational and financially feasible if administered by the federal government. Cuomo questioned in the past how a single-payer system could be put in place without doubling the tax burden, and cited <a href="https://www.forbes.com/sites/sallypipes/2018/06/25/is-statewide-single-payer-feasible-or-is-it-just-california-dreamin/#7e0d989c636a" target="_blank" rel="noopener">California’s</a> and <a href="https://www.politico.com/story/2014/12/single-payer-vermont-113711" target="_blank" rel="noopener">Vermont’s</a> debates over single-payer — which both ended when supporters were not able to answer one question: where would the funding come from? — as paragons of the impracticality of state-level single-payer.</p> <p>Gottfried, a Manhattan Democrat, is confident that with his fellow lead sponsor Senator Rivera, who is likely to be the Senate health committee chair come January, and other legislators, he will be able to sway Cuomo to support the legislation.</p> <p>“He’s obviously not on board yet, but he and his staff are very open to working with the Legislature on the issue,” Gottfried said. “I’m convinced we can satisfy their concerns.”</p> <p>And after a recent <a href="https://d3n8a8pro7vhmx.cloudfront.net/pnhpnymetro/pages/3980/attachments/original/1533068488/RAND_NYHA_full_study_RR2424_compiled.pdf?1533068488" target="_blank" rel="noopener">study</a> by RAND Corporation concluded that the New York Health Act would result in a reduction of administrative costs, provide all New Yorkers with healthcare, and reduce healthcare costs for most, Gottfried says the financing of the bill will not be a problem.</p> <p>“New Yorkers are all going to have to think about what they will do with the hundreds of thousands of dollars that will end up in their pockets, and that’s a nice problem to have,” Gottfried said.</p> <p>The study has a caveat, however, stating in its conclusion that “the estimated effects depend heavily on the assumptions about provider payments, administrative costs and drug prices.” <a href="https://www.politico.com/states/new-york/albany/story/2018/08/01/rand-study-finds-single-payer-viable-in-new-york-but-with-big-caveats-536072" target="_blank" rel="noopener">Politico</a> highlighted these assumptions as well as the likely tax increases that have largely been brushed aside by Democrats supporting the legislation. Wealthy people leaving the state, companies restructuring, the cost of hospital expenses rising at a faster rate or the Trump administration not issuing a federal waiver to redirect all healthcare-related funds to the new state entity are all possible events that could result in RAND’s conclusion falling apart.</p> <p>For it to work, while health care costs drop, taxes would undoubtedly increase significantly for many New Yorkers. As cited by Politico, “a household reporting $150,000 in income would see its state tax rate increase from 6.45 percent in 2017 to 18.3 percent,” under one model scenario. Additionally, those who receive Medicaid or fall under the state’s Essential Plan, which subsidizes health insurance for low-income New Yorkers, have less to gain from the expansion. According to RAND, though, 1.2 million New Yorkers would gain health coverage.</p> <p>It is likely that funds for New York single-payer health care would partially come from a new payroll tax, which RAND projects to fall largely on employers. However, RAND suggests the health act payroll tax would cost less for businesses already contributing toward employee health insurance and the Medicare payroll tax, estimating decreases in employer costs fairly quickly.</p> <p>Concerns about businesses and high-income individuals leaving the state persist, with a tax atmosphere in New York that many, including Cuomo, acknowledge is already burdensome and became more so for many taxpayers, especially top earners, under the new federal tax code.</p> <p>Senator Rivera, aware that cost is the primary argument against single-payer health care, repeatedly emphasized the need to work towards a version of the bill that would reduce the financial strain.</p> <p>“I will continue working diligently with Assembly Member Gottfried, Senate Majority Leader Stewart-Cousins and the Senate Democratic Conference to make the New York Health Act a bill that is not only fiscally responsible, but that provides comprehensive coverage to all New Yorkers,” Rivera wrote in an email to Gotham Gazette.</p> <p>The bill and its potential ramifications have been studied closely by Bill Hammond, director of health policy at The Empire Center, a think tank. "Regardless of which party controls the state Senate, the New York Health Act remains a wildly unrealistic idea," Hammond said by email.&nbsp;"It means putting New York's entire health-care system — representing one-fifth of the economy — in the hands of the same state government that struggles to run the subways.&nbsp;It requires massive, draconian tax hikes, enough to roughly triple total state revenues."</p> <p>"Plus, a true single-payer plan would need federal waivers that the Trump administration has vowed to block," Hammond continued, also noting a political angle -- that if Democrats spend great sums of money and political capital on a health care overhaul of this magnitude, what will they ignore, like fighting climate change or improving mass transit.</p> <p>"It was easy to cast a symbolic yes vote for a single-payer bill that had no chance of passing," Hammond said. "Now that that it might actually happen, supporters are going to be forced to confront the practical realities. Then, hopefully, they’ll focus on helping the 6% of New Yorkers who still lack insurance, rather than disrupting coverage for those who already have it."</p> <p>Rivera acknowledged that moving to single-payer would not satisfy everyone, especially those who benefit from the current system, and that there are negotiations to come that will likely adjust the bill to make it more palatable to holdouts.</p> <p>“The biggest challenge will be to reach a consensus among stakeholders that the NY Health Act is feasible [and] fiscally responsible,” Rivera wrote.</p> <p>Citing “healthcare practitioners, prescription drug companies, healthcare providers, employers, unions and New Yorkers,” as the various groups involved, Rivera also mentioned courting Cuomo as an important step to take in the coming legislative session.</p> <p>“Our main priority for the next legislative session is to continue shaping the bill so that it is feasible, affordable, that the Governor is willing to sign, and that primarily, provides quality healthcare for everybody,” Rivera wrote. “During the next legislative session, we will focus on making the necessary amendments to the bill so that it truly reflects the different healthcare needs affecting all New Yorkers.”</p> <p>For now, it may be difficult to imagine Cuomo coming on board, especially given the pains he’s taken to keep state spending increases at around 2 percent per year and to lower taxes.</p> <p>A variety of factors, including the challenge of getting Cuomo’s support and not wanting to come into power quickly pursuing something as revolutionary as single-payer health care, may be why the likely next Senate majority leader, <a href="http://www.gothamgazette.com/state/8061-agenda-2019-major-policy-tests-ahead-for-state-and-city" target="_blank" rel="noopener">Andrea Stewart-Cousins</a>, and her likely deputy, Senator <a href="http://www.gothamgazette.com/state/8024-two-tiered-agenda-for-democrats-if-they-take-state-senate" target="_blank" rel="noopener">Michael Gianaris</a>, have not highlighted it as top priorities for the coming session.</p> <p>Assemblymember Gottfried noted that state Senators’ public approval of the bill gives him no reason not to “take them at their word,” and said he expects the legislation to move through the Legislature. He knows that private health insurers are certain to vehemently oppose the continued push.</p> <p>“The insurance industry will be fiercely lobbying against the bill and they have a lot of money, going up against their lobbying will take a lot of work,” Gottfried said. “but I’m convinced with so many senators on the record in support of the bill, we will prevail.”</p> <p>

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by Victor Porcelli, Gotham Gazette

Read more by this writer.

</p>
<p><img src="http://www.gothamgazette.com/images/29874812518_530478a409_z.jpg" alt="Cuomo health care" width="600" height="399" /></p> <p>Gov. Cuomo (photo:&nbsp;Kevin Coughlin/Governor's Office)</p> <hr /> <p>Though Governor Andrew Cuomo has not expressed support for instituting a single-payer health care system in New York, his fellow Democrats campaigned on the issue as they flipped control of the state Senate, landing all of state government into Democratic hands and providing a significant boost of optimism to the lead sponsors of the New York Health Act, which would create a government-administered single-payer health care system.</p> <p>The bill has passed the Democrat-dominated state Assembly several times and all the members of Senate Democratic conference signed on as co-sponsors at the end of last legislative session in a unified show of support for the program heading into the election season.</p> <p>Cuomo has said he supports a Medicare for all-type system at the federal level, but cast doubts on the cost and complexity of doing it in New York, and since their resounding wins on Election Day, the incoming leaders of the Democratic Senate majority have indicated that the massive undertaking of single-payer is not at the top of the agenda.</p> <p>Still, with Democratic control of the Senate and the Assembly by wide margins, single-payer healthcare could be passed as early as the 2019 session, according to Assemblymember Richard Gottfried, chair of the Assembly Health Committee and lead sponsor of the New York Health Act.</p> <p>“It was clear in the country and New York that healthcare was the number one issue on voters’ minds,” Gottfried said, before pointing to his legislation. “A solid majority of the new state Senate has either been a cosigner, voted for it in the Assembly, or campaigned on it. So I think we’re on track to get it passed in the Assembly and state Senate.”</p> <p>The <a href="https://legislation.nysenate.gov/pdf/bills/2017/S4840" target="_blank" rel="noopener">New York Health Act</a> would replace health insurance companies with New York state government as the payer of healthcare costs for all New Yorkers. It has been <a href="https://www.pressconnects.com/story/news/local/2018/06/17/ny-assembly-oks-universal-health-care-bill-halted-senate/708708002/" target="_blank" rel="noopener">passed</a> in the Assembly four years running but has yet to be voted on in the Senate, where Republicans have held control. All of the other 30 Democratic senators joined lead sponsor Senator Gustavo Rivera of the Bronx to co-sponsor the legislation, though the Senate Democratic conference is seeing significant turnover due to primary wins by insurgent challengers. But, those challengers have in general been even more vocally supportive of single-payer health care than their more moderate predecessors. These facts give Gottfried confidence that the New York Health Act will pass during the 2019 session, which begins in January.</p> <p>But the bill still faces an uphill battle, in part because of the massive changes it would institute, and the fact that though it might reduce overall individual and business healthcare costs after implementation, for the state to run the system it would require raising taxes significantly, something many Democrats have <a href="http://www.gothamgazette.com/state/8047-tax-issues-at-center-of-new-york-elections-albany-year-to-come" target="_blank" rel="noopener">promised</a> not to do and Cuomo is vehemently opposed to. It would also drastically impact the state’s private and public hospitals, the health insurance industry, and more. Some of the changes would of course be beneficial to New Yorkers, but the undertaking is complex and the New York Health Act as currently written leaves a lot of detail undetermined, including funding.</p> <p>The governor has repeatedly opposed single-payer healthcare at the state level, <a href="https://www.timesunion.com/news/article/Cuomo-Universal-healthcare-easier-on-federal-13194080.php" target="_blank" rel="noopener">suggesting</a> that it would be more rational and financially feasible if administered by the federal government. Cuomo questioned in the past how a single-payer system could be put in place without doubling the tax burden, and cited <a href="https://www.forbes.com/sites/sallypipes/2018/06/25/is-statewide-single-payer-feasible-or-is-it-just-california-dreamin/#7e0d989c636a" target="_blank" rel="noopener">California’s</a> and <a href="https://www.politico.com/story/2014/12/single-payer-vermont-113711" target="_blank" rel="noopener">Vermont’s</a> debates over single-payer — which both ended when supporters were not able to answer one question: where would the funding come from? — as paragons of the impracticality of state-level single-payer.</p> <p>Gottfried, a Manhattan Democrat, is confident that with his fellow lead sponsor Senator Rivera, who is likely to be the Senate health committee chair come January, and other legislators, he will be able to sway Cuomo to support the legislation.</p> <p>“He’s obviously not on board yet, but he and his staff are very open to working with the Legislature on the issue,” Gottfried said. “I’m convinced we can satisfy their concerns.”</p> <p>And after a recent <a href="https://d3n8a8pro7vhmx.cloudfront.net/pnhpnymetro/pages/3980/attachments/original/1533068488/RAND_NYHA_full_study_RR2424_compiled.pdf?1533068488" target="_blank" rel="noopener">study</a> by RAND Corporation concluded that the New York Health Act would result in a reduction of administrative costs, provide all New Yorkers with healthcare, and reduce healthcare costs for most, Gottfried says the financing of the bill will not be a problem.</p> <p>“New Yorkers are all going to have to think about what they will do with the hundreds of thousands of dollars that will end up in their pockets, and that’s a nice problem to have,” Gottfried said.</p> <p>The study has a caveat, however, stating in its conclusion that “the estimated effects depend heavily on the assumptions about provider payments, administrative costs and drug prices.” <a href="https://www.politico.com/states/new-york/albany/story/2018/08/01/rand-study-finds-single-payer-viable-in-new-york-but-with-big-caveats-536072" target="_blank" rel="noopener">Politico</a> highlighted these assumptions as well as the likely tax increases that have largely been brushed aside by Democrats supporting the legislation. Wealthy people leaving the state, companies restructuring, the cost of hospital expenses rising at a faster rate or the Trump administration not issuing a federal waiver to redirect all healthcare-related funds to the new state entity are all possible events that could result in RAND’s conclusion falling apart.</p> <p>For it to work, while health care costs drop, taxes would undoubtedly increase significantly for many New Yorkers. As cited by Politico, “a household reporting $150,000 in income would see its state tax rate increase from 6.45 percent in 2017 to 18.3 percent,” under one model scenario. Additionally, those who receive Medicaid or fall under the state’s Essential Plan, which subsidizes health insurance for low-income New Yorkers, have less to gain from the expansion. According to RAND, though, 1.2 million New Yorkers would gain health coverage.</p> <p>It is likely that funds for New York single-payer health care would partially come from a new payroll tax, which RAND projects to fall largely on employers. However, RAND suggests the health act payroll tax would cost less for businesses already contributing toward employee health insurance and the Medicare payroll tax, estimating decreases in employer costs fairly quickly.</p> <p>Concerns about businesses and high-income individuals leaving the state persist, with a tax atmosphere in New York that many, including Cuomo, acknowledge is already burdensome and became more so for many taxpayers, especially top earners, under the new federal tax code.</p> <p>Senator Rivera, aware that cost is the primary argument against single-payer health care, repeatedly emphasized the need to work towards a version of the bill that would reduce the financial strain.</p> <p>“I will continue working diligently with Assembly Member Gottfried, Senate Majority Leader Stewart-Cousins and the Senate Democratic Conference to make the New York Health Act a bill that is not only fiscally responsible, but that provides comprehensive coverage to all New Yorkers,” Rivera wrote in an email to Gotham Gazette.</p> <p>The bill and its potential ramifications have been studied closely by Bill Hammond, director of health policy at The Empire Center, a think tank. "Regardless of which party controls the state Senate, the New York Health Act remains a wildly unrealistic idea," Hammond said by email.&nbsp;"It means putting New York's entire health-care system — representing one-fifth of the economy — in the hands of the same state government that struggles to run the subways.&nbsp;It requires massive, draconian tax hikes, enough to roughly triple total state revenues."</p> <p>"Plus, a true single-payer plan would need federal waivers that the Trump administration has vowed to block," Hammond continued, also noting a political angle -- that if Democrats spend great sums of money and political capital on a health care overhaul of this magnitude, what will they ignore, like fighting climate change or improving mass transit.</p> <p>"It was easy to cast a symbolic yes vote for a single-payer bill that had no chance of passing," Hammond said. "Now that that it might actually happen, supporters are going to be forced to confront the practical realities. Then, hopefully, they’ll focus on helping the 6% of New Yorkers who still lack insurance, rather than disrupting coverage for those who already have it."</p> <p>Rivera acknowledged that moving to single-payer would not satisfy everyone, especially those who benefit from the current system, and that there are negotiations to come that will likely adjust the bill to make it more palatable to holdouts.</p> <p>“The biggest challenge will be to reach a consensus among stakeholders that the NY Health Act is feasible [and] fiscally responsible,” Rivera wrote.</p> <p>Citing “healthcare practitioners, prescription drug companies, healthcare providers, employers, unions and New Yorkers,” as the various groups involved, Rivera also mentioned courting Cuomo as an important step to take in the coming legislative session.</p> <p>“Our main priority for the next legislative session is to continue shaping the bill so that it is feasible, affordable, that the Governor is willing to sign, and that primarily, provides quality healthcare for everybody,” Rivera wrote. “During the next legislative session, we will focus on making the necessary amendments to the bill so that it truly reflects the different healthcare needs affecting all New Yorkers.”</p> <p>For now, it may be difficult to imagine Cuomo coming on board, especially given the pains he’s taken to keep state spending increases at around 2 percent per year and to lower taxes.</p> <p>A variety of factors, including the challenge of getting Cuomo’s support and not wanting to come into power quickly pursuing something as revolutionary as single-payer health care, may be why the likely next Senate majority leader, <a href="http://www.gothamgazette.com/state/8061-agenda-2019-major-policy-tests-ahead-for-state-and-city" target="_blank" rel="noopener">Andrea Stewart-Cousins</a>, and her likely deputy, Senator <a href="http://www.gothamgazette.com/state/8024-two-tiered-agenda-for-democrats-if-they-take-state-senate" target="_blank" rel="noopener">Michael Gianaris</a>, have not highlighted it as top priorities for the coming session.</p> <p>Assemblymember Gottfried noted that state Senators’ public approval of the bill gives him no reason not to “take them at their word,” and said he expects the legislation to move through the Legislature. He knows that private health insurers are certain to vehemently oppose the continued push.</p> <p>“The insurance industry will be fiercely lobbying against the bill and they have a lot of money, going up against their lobbying will take a lot of work,” Gottfried said. “but I’m convinced with so many senators on the record in support of the bill, we will prevail.”</p> <p>

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by Victor Porcelli, Gotham Gazette

Read more by this writer.

</p>
Democrats in Swing Districts Run On, Not From, Single-Payer Health Care 2018-10-15T04:00:00+00:00 2018-10-15T04:00:00+00:00 http://www.gothamgazette.com/state/7995-despite-lack-of-support-from-cuomo-democrats-in-swing-districts-run-on-not-from-single-payer-health-care Ben Max <p><img src="http://www.gothamgazette.com/images/graphics/2018/andrewcuomo-affor.jpg" alt="andrewcuomo affor" width="819" height="281" /></p> <p>Gov. Cuomo &amp; Long Island Democratic Senate candidates (photo: @andrewcuomo)</p> <hr /> <p>Since the Affordable Care Act has failed to tame the beast that is America’s private health insurance system, and a new presidential administration is actively hostile to even that modest attempt at near-universal coverage, activists and many Democrats in New York have recently come to embrace a way forward. Single-payer, state-government-administered health care coverage has become something of a rallying cry for progressive activists in New York even as Governor Andrew Cuomo has argued it’s a program better-suited for the federal government to tackle.</p> <p>While often thought of as a politically risky issue to embrace outside of solidly progressive areas, candidates in swing districts across the state are carrying the torch for single-payer and calling it a morally correct thing to do that will also save the state money. And with criticism of the proposal from Republicans, the issue has become a flashpoint in the battle for control of the New York State Senate, the GOP’s only source of power at the state level and the key for Democrats hoping to enact a long list of progressive goals.</p> <p>The New York Health Act, the proposed law that would set up single-payer health insurance in New York, has <a href="https://www.villagevoice.com/2017/05/16/new-yorks-legislature-is-on-the-brink-of-passing-universal-healthcare/" target="_blank" rel="noopener">gained</a> <a href="http://gothamist.com/2017/05/26/new_york_healthcare_battle.php">momentum</a> in the state Senate after years as an Assembly-focused effort. Every Democrat in the upper chamber of the state Legislature, where the party is in the minority by one seat, signed on to the bill last session.</p> <p>The push saw added attention as Democratic gubernatorial candidate Cynthia Nixon <a href="http://www.wamc.org/post/single-payer-health-care-becomes-issue-race-ny-governor" target="_blank" rel="noopener">made passing the bill a centerpiece of her campaign</a>, although unlike on other issues like legalizing marijuana, Nixon didn’t appear to push Cuomo left on healthcare. But while Nixon and New York City Democrats -- the lead sponsors of the NYHA are Manhattan Assembly Member Dick Gottfried and Bronx Senator Gustavo Rivera -- have received the most attention for their embrace of the plan, Democratic state Senate candidates in the Hudson Valley and Long Island are also running on the passage of the bill despite the risk that an embrace of big government socialism could be a liability in their swing districts.</p> <p>Conventional wisdom about the relative conservatism in many areas outside of New York City, and Cuomo’s own reluctance to embrace statewide single-payer (during his debate with Nixon he said it is a good idea “<a href="https://www.timesunion.com/news/article/Cuomo-Universal-healthcare-easier-on-federal-13194080.php" target="_blank" rel="noopener">in theory</a>,” but that it would double the state’s tax burden and he supports single-payer at the federal level), would suggest that Democrats in tight races would avoid the New York Health Act. Prominent Cuomo-led events where he’s endorsed suburban Democrats haven’t included mention the bill at all, <a href="https://www.newsday.com/long-island/politics/andrew-cuomo-suffolk-democrats-tilles-1.21355038" target="_blank" rel="noopener">instead focusing on issues</a> like the continuation of the two percent property tax cap, the passage of the Reproductive Health Act and a “red flag” gun control law, and funding an effort to fight the MS-13 gang.</p> <p>As Cuomo avoided the issue, Senate Majority Leader John Flanagan brought up the specter of socialism and high taxes <a href="http://www.nystateofpolitics.com/2018/10/flanagan-oped-the-stakes-for-the-senate/" target="_blank" rel="noopener">in an op-ed column</a> arguing for the GOP’s continued control of the state Senate. “The Democrat Conference vows to enact single payer health care, and so do all the candidates they are running. Medicaid for All would double the state’s budget while taking away Medicare from our seniors. You cannot support a cap on spending and a permanent cap on property taxes, while supporting budget-doubling policies like socialized medicine.”</p> <p>But for some suburban Democrats, single-payer is as much of a winning issue as any other. “There's definite support [for the New York Health Act],” said candidate Pete Harckham, running to unseat Republican Terrence Murphy in the Senate’s 40th District, in the Hudson Valley. “People are tired of fighting with insurance companies, hospitals are tired of fighting with insurance companies, doctors are tired of fighting with insurance companies. So I think there's a very high appetite for the discussion and the dialogue with the New York Health Act as the starting place.”</p> <p>Jen Metzger, running against Ann Rabbit in the 42nd District for the retiring Senator John Bonancic’s Hudson Valley seat, also said that she’s heard support for the bill out on the trail. “I come right out and say I'm a supporter of the New York Health Act and no one has said yet that it's a terrible idea or a scary idea,” Metzger told Gotham Gazette. “People understand that this system is not working and that major change is needed.”</p> <p>“We've got to put every option on the table, because we're coming to a breaking point,” John Mannion, running against Bob Antonacci in the race to replace retiring Senator John DeFrancisco in western New York’s 50th District, told Gotham Gazette.</p> <p>Both Metzger and Harckham don’t hedge their support either; each candidate told Gotham Gazette that they view healthcare as a human right and believe in a single-payer insurance system. It’s a view that’s become common enough among Democrats that Andrew Gounardes, running against state Senator Marty Golden in a relatively conservative district in southern Brooklyn, said, “frankly I don’t think it’s out of the mainstream to talk about universal health care in the year 2018,” during <a href="http://www.gothamgazette.com/city/7947-democrats-target-previously-ignored-brooklyn-shot-at-state-senate-majority" target="_blank">a previous interview with Gotham Gazette</a>. Cuomo has also endorsed Gounardes, at a rally in Brooklyn where there was no mention of single-payer healthcare.</p> <p>Support for the bill, even in districts currently held by Republicans, may not be as much of a liability in a wave year for the candidates who’ve expressed their support for it. The 40th and 50th Districts <a href="https://docs.google.com/spreadsheets/d/1YZRfFiCDBEYB7M18fDGLH8IrmyMQGdQKqpOu9lLvmdo/edit#gid=1513373530" target="_blank" rel="noopener">went for Hillary Clinton in 2016</a> by more than 5 points each, though the 42nd District went for Donald Trump by 5 points.</p> <p>Gounardes and his primary opponent Ross Barkan were hardly the only New York City Democrats banging the drum for the New York Health Act this primary season. It was one of a slew of issues that challengers to the former members of the Senate’s Independent Democratic Conference (IDC) regularly used to explain how the incumbents had not represented progressive values while forming a power-sharing agreement with the Republican conference.</p> <p>Jessica Ramos <a href="https://www.ramosforstatesenate.com/new-page/">promoted single-payer</a> on her website, Alessandra Biaggi <a href="http://www.thisisthebronx.info/weekday-magazine-healthcare-in-america-an-ongoing-series-14/">explained her support for it</a> using her own father’s Parkinson’s Disease as an example of how the current healthcare system was failing, and Zellnor Myrie <a href="https://twitter.com/zellnor4ny/status/1024672126203248642">promoted a recently-released RAND Corporation study</a> that suggested the New York Health Act would save the state money over time -- all three of them defeated former IDC members in the primary.</p> <p>Even John Brooks, a Long Island Democrat running a tough re-election campaign for his seat on Long Island <a href="http://brooks2018.com/issues/" target="_blank" rel="noopener">states on his website</a> that he supports the New York Health Act, and has called affordable health insurance “<a href="https://www.nysenate.gov/newsroom/press-releases/andrea-stewart-cousins/senate-democrats-blast-president-trump-and-unveil">a right, not a privilege</a>.” Harckham though, said that the bill has appeal outside of the city because “the economic and the healthcare hardship is the same in the suburbs as it is in the city.”</p> <p>Just under 5 percent of New Yorkers lack health insurance, <a href="https://nypost.com/2018/09/05/number-of-new-yorkers-on-medicaid-has-skyrocketed-in-the-last-decade/" target="_blank" rel="noopener">according to a recent report</a> by Comptroller Tom DiNapoli, and 7 million New Yorkers are receiving Medicaid, the federal program administered by the state with localities. Beyond the rhetoric of health insurance as a right and not a privilege, these Democratic candidates are also insisting the move to a single-payer system would actually save taxpayers and businesses money in the long run. “Shifting to a single-payer system would actually reduce property taxes, because it would reduce the cost of local taxes and government costs from how they pay for their employees' health insurance,” Metzger, a member of the Rosendale Town Council, told Gotham Gazette.</p> <p>This is of course disputed by state Senate Republicans, who have cast the possible change to a single-payer system as a big government takeover of the healthcare sector. “You can’t hold the line on taxes and spending when you’re calling for creation of a new government-run health care system that would double the size of the state budget and cost taxpayers hundreds of billions of dollars more than they already pay,” Senate GOP spokesperson Scott Reif <a href="http://www.nystateofpolitics.com/2018/10/cuomo-with-li-dems-finds-common-ground-with-pledge/" target="_blank" rel="noopener">said in response</a> to a Democratic pledge -- signed by Cuomo and Long Island Democratic Senate candidates -- that included a promise to keep property taxes low, but made no mention of single-payer health care.</p> <p>The RAND Corporation study concluded the change to a single-payer system in New York could (if certain assumptions were made true) save the state money in the long run, as even the bill’s primary sponsor in the Assembly, Gottfried, has said, that <a href="https://www.politico.com/states/new-york/albany/story/2018/08/01/rand-study-finds-single-payer-viable-in-new-york-but-with-big-caveats-536072" target="_blank" rel="noopener">payroll and other taxes would need to increase</a> to pay for the new system. The New York Health Act legislation itself doesn’t provide an exact way to pay for the single-payer system, instead authorizing a commission to figure out how to fund the plan should the bill pass. But Mannion posited that it’s not as if health insurance costs are affordable or helpful at the moment.<br /><br />“I spoke to someone, a small business owner in my district, who said the entire health insurance premium he paid was $300,000 for his employees six years ago, and this year alone it increased by $300,000,” Mannion said, in response to a question on whether he’s prepared to explain tax increases necessary for a single-payer system.</p> <p>Still, some Democrats are wary to discuss their views on the issue, even if they list it as an issue they’re running on. Jim Gaughran, running against Republican Senator Carl Marcellino in Long Island’s 5th District, called healthcare a right and not a privilege <a href="http://gaughran2018.com/issues-page-gaughran#health-act" target="_blank" rel="noopener">on his website</a>, but did not respond to a request for comment, even after he was reached on his cell phone and promised a return call that did not materialize. The same situation came up with candidates Karen Smythe, whose website <a href="https://karen4nysenate.com/issues/" target="_blank" rel="noopener">calls for universal single-payer</a>, and <a href="https://votepatstrong.com/issues/">Pat Strong</a>, who said she would pass the New York Health Act. In the case of Assembly Member James Skoufis, running to represent the 39th Senate District, he’s already voted for the bill <a href="https://www.recordonline.com/news/20180929/control-of-state-senate-could-be-decided-here" target="_blank" rel="noopener">more than once</a> in his time in the Assembly, but doesn’t list is as one of his main issues on his campaign website. Skoufis <a href="https://twitter.com/JamesSkoufis/status/1042066707299397633" target="_blank" rel="noopener">released a campaign ad</a> touting his a fight with insurance companies on behalf of a constituent, but his campaign did not respond to multiple requests for comment on whether or not he would support the New York Health Act in the Senate the way he did in the Assembly.</p> <p>The candidates who spoke to Gotham Gazette did insist that even if they won and Democrats capture a majority in the state Senate, voters shouldn’t expect an immediate passage of the bill in the first budget session.</p> <p>“During the gubernatorial primary, Cynthia Nixon said ‘Oh just pass [the bill] and pay for it,’ but that's not how you pass and craft legislation,” Harckham said, referring to when Nixon <a href="http://www.nydailynews.com/news/politics/ny-pol-nixon-deblasio-nycha-lead-cuomo-20180905-story.html" target="_blank" rel="noopener">told the Daily News editorial board</a> “Pass it and then figure out how to fund it” when its members asked her about the New York Health Act. “My starting point is New York Health, and let's sit down with the experts. The Assembly has passed this version, so it's pretty far along, but that doesn't mean the Senate can't alter it,” she continued. “Let's do our due diligence, with the goal of providing universal single-payer coverage for all New Yorkers.”</p> <p>Harckham did say, though, that he felt “two years of legislative time” is long enough to debate and pass a bill, which he called <a href="http://peteforny.com/issues/" target="_blank" rel="noopener">a first-term priority on his website</a> (state legislative terms are two years long).</p> <p>“The Assembly bill has to be revamped, and we have get it right,” Mannion said. A spokesperson for Mannion later told Gotham Gazette that “getting it right” meant that Mannion believed “a transition from the current system to universal coverage as per the bill would likely require a transitional period in which purchasing into a Medicare-for-all like system would be a possible step, including offering that option on the NY State of Health exchange website.” That website is currently where New Yorkers can purchase health insurance plans under the Affordable Care Act.</p> <p>And even though the governor has said he prefers single-payer on a federal level, Metzger said there might be hope of convincing him to embrace the New York Health Act by playing to <a href="https://www.andrewcuomo.com/issues" target="_blank" rel="noopener">his love of New York being first</a>. “I think we can show that [single-payer] can be done, I think there's a lot of value in demonstration value,” Metzger said. “It's been these academic debates in this country for a long time. If anyone can do it, I think New York can do it.”</p> <p>

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by Dave Colon, Gotham Gazette
     

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</p>
<p><img src="http://www.gothamgazette.com/images/graphics/2018/andrewcuomo-affor.jpg" alt="andrewcuomo affor" width="819" height="281" /></p> <p>Gov. Cuomo &amp; Long Island Democratic Senate candidates (photo: @andrewcuomo)</p> <hr /> <p>Since the Affordable Care Act has failed to tame the beast that is America’s private health insurance system, and a new presidential administration is actively hostile to even that modest attempt at near-universal coverage, activists and many Democrats in New York have recently come to embrace a way forward. Single-payer, state-government-administered health care coverage has become something of a rallying cry for progressive activists in New York even as Governor Andrew Cuomo has argued it’s a program better-suited for the federal government to tackle.</p> <p>While often thought of as a politically risky issue to embrace outside of solidly progressive areas, candidates in swing districts across the state are carrying the torch for single-payer and calling it a morally correct thing to do that will also save the state money. And with criticism of the proposal from Republicans, the issue has become a flashpoint in the battle for control of the New York State Senate, the GOP’s only source of power at the state level and the key for Democrats hoping to enact a long list of progressive goals.</p> <p>The New York Health Act, the proposed law that would set up single-payer health insurance in New York, has <a href="https://www.villagevoice.com/2017/05/16/new-yorks-legislature-is-on-the-brink-of-passing-universal-healthcare/" target="_blank" rel="noopener">gained</a> <a href="http://gothamist.com/2017/05/26/new_york_healthcare_battle.php">momentum</a> in the state Senate after years as an Assembly-focused effort. Every Democrat in the upper chamber of the state Legislature, where the party is in the minority by one seat, signed on to the bill last session.</p> <p>The push saw added attention as Democratic gubernatorial candidate Cynthia Nixon <a href="http://www.wamc.org/post/single-payer-health-care-becomes-issue-race-ny-governor" target="_blank" rel="noopener">made passing the bill a centerpiece of her campaign</a>, although unlike on other issues like legalizing marijuana, Nixon didn’t appear to push Cuomo left on healthcare. But while Nixon and New York City Democrats -- the lead sponsors of the NYHA are Manhattan Assembly Member Dick Gottfried and Bronx Senator Gustavo Rivera -- have received the most attention for their embrace of the plan, Democratic state Senate candidates in the Hudson Valley and Long Island are also running on the passage of the bill despite the risk that an embrace of big government socialism could be a liability in their swing districts.</p> <p>Conventional wisdom about the relative conservatism in many areas outside of New York City, and Cuomo’s own reluctance to embrace statewide single-payer (during his debate with Nixon he said it is a good idea “<a href="https://www.timesunion.com/news/article/Cuomo-Universal-healthcare-easier-on-federal-13194080.php" target="_blank" rel="noopener">in theory</a>,” but that it would double the state’s tax burden and he supports single-payer at the federal level), would suggest that Democrats in tight races would avoid the New York Health Act. Prominent Cuomo-led events where he’s endorsed suburban Democrats haven’t included mention the bill at all, <a href="https://www.newsday.com/long-island/politics/andrew-cuomo-suffolk-democrats-tilles-1.21355038" target="_blank" rel="noopener">instead focusing on issues</a> like the continuation of the two percent property tax cap, the passage of the Reproductive Health Act and a “red flag” gun control law, and funding an effort to fight the MS-13 gang.</p> <p>As Cuomo avoided the issue, Senate Majority Leader John Flanagan brought up the specter of socialism and high taxes <a href="http://www.nystateofpolitics.com/2018/10/flanagan-oped-the-stakes-for-the-senate/" target="_blank" rel="noopener">in an op-ed column</a> arguing for the GOP’s continued control of the state Senate. “The Democrat Conference vows to enact single payer health care, and so do all the candidates they are running. Medicaid for All would double the state’s budget while taking away Medicare from our seniors. You cannot support a cap on spending and a permanent cap on property taxes, while supporting budget-doubling policies like socialized medicine.”</p> <p>But for some suburban Democrats, single-payer is as much of a winning issue as any other. “There's definite support [for the New York Health Act],” said candidate Pete Harckham, running to unseat Republican Terrence Murphy in the Senate’s 40th District, in the Hudson Valley. “People are tired of fighting with insurance companies, hospitals are tired of fighting with insurance companies, doctors are tired of fighting with insurance companies. So I think there's a very high appetite for the discussion and the dialogue with the New York Health Act as the starting place.”</p> <p>Jen Metzger, running against Ann Rabbit in the 42nd District for the retiring Senator John Bonancic’s Hudson Valley seat, also said that she’s heard support for the bill out on the trail. “I come right out and say I'm a supporter of the New York Health Act and no one has said yet that it's a terrible idea or a scary idea,” Metzger told Gotham Gazette. “People understand that this system is not working and that major change is needed.”</p> <p>“We've got to put every option on the table, because we're coming to a breaking point,” John Mannion, running against Bob Antonacci in the race to replace retiring Senator John DeFrancisco in western New York’s 50th District, told Gotham Gazette.</p> <p>Both Metzger and Harckham don’t hedge their support either; each candidate told Gotham Gazette that they view healthcare as a human right and believe in a single-payer insurance system. It’s a view that’s become common enough among Democrats that Andrew Gounardes, running against state Senator Marty Golden in a relatively conservative district in southern Brooklyn, said, “frankly I don’t think it’s out of the mainstream to talk about universal health care in the year 2018,” during <a href="http://www.gothamgazette.com/city/7947-democrats-target-previously-ignored-brooklyn-shot-at-state-senate-majority" target="_blank">a previous interview with Gotham Gazette</a>. Cuomo has also endorsed Gounardes, at a rally in Brooklyn where there was no mention of single-payer healthcare.</p> <p>Support for the bill, even in districts currently held by Republicans, may not be as much of a liability in a wave year for the candidates who’ve expressed their support for it. The 40th and 50th Districts <a href="https://docs.google.com/spreadsheets/d/1YZRfFiCDBEYB7M18fDGLH8IrmyMQGdQKqpOu9lLvmdo/edit#gid=1513373530" target="_blank" rel="noopener">went for Hillary Clinton in 2016</a> by more than 5 points each, though the 42nd District went for Donald Trump by 5 points.</p> <p>Gounardes and his primary opponent Ross Barkan were hardly the only New York City Democrats banging the drum for the New York Health Act this primary season. It was one of a slew of issues that challengers to the former members of the Senate’s Independent Democratic Conference (IDC) regularly used to explain how the incumbents had not represented progressive values while forming a power-sharing agreement with the Republican conference.</p> <p>Jessica Ramos <a href="https://www.ramosforstatesenate.com/new-page/">promoted single-payer</a> on her website, Alessandra Biaggi <a href="http://www.thisisthebronx.info/weekday-magazine-healthcare-in-america-an-ongoing-series-14/">explained her support for it</a> using her own father’s Parkinson’s Disease as an example of how the current healthcare system was failing, and Zellnor Myrie <a href="https://twitter.com/zellnor4ny/status/1024672126203248642">promoted a recently-released RAND Corporation study</a> that suggested the New York Health Act would save the state money over time -- all three of them defeated former IDC members in the primary.</p> <p>Even John Brooks, a Long Island Democrat running a tough re-election campaign for his seat on Long Island <a href="http://brooks2018.com/issues/" target="_blank" rel="noopener">states on his website</a> that he supports the New York Health Act, and has called affordable health insurance “<a href="https://www.nysenate.gov/newsroom/press-releases/andrea-stewart-cousins/senate-democrats-blast-president-trump-and-unveil">a right, not a privilege</a>.” Harckham though, said that the bill has appeal outside of the city because “the economic and the healthcare hardship is the same in the suburbs as it is in the city.”</p> <p>Just under 5 percent of New Yorkers lack health insurance, <a href="https://nypost.com/2018/09/05/number-of-new-yorkers-on-medicaid-has-skyrocketed-in-the-last-decade/" target="_blank" rel="noopener">according to a recent report</a> by Comptroller Tom DiNapoli, and 7 million New Yorkers are receiving Medicaid, the federal program administered by the state with localities. Beyond the rhetoric of health insurance as a right and not a privilege, these Democratic candidates are also insisting the move to a single-payer system would actually save taxpayers and businesses money in the long run. “Shifting to a single-payer system would actually reduce property taxes, because it would reduce the cost of local taxes and government costs from how they pay for their employees' health insurance,” Metzger, a member of the Rosendale Town Council, told Gotham Gazette.</p> <p>This is of course disputed by state Senate Republicans, who have cast the possible change to a single-payer system as a big government takeover of the healthcare sector. “You can’t hold the line on taxes and spending when you’re calling for creation of a new government-run health care system that would double the size of the state budget and cost taxpayers hundreds of billions of dollars more than they already pay,” Senate GOP spokesperson Scott Reif <a href="http://www.nystateofpolitics.com/2018/10/cuomo-with-li-dems-finds-common-ground-with-pledge/" target="_blank" rel="noopener">said in response</a> to a Democratic pledge -- signed by Cuomo and Long Island Democratic Senate candidates -- that included a promise to keep property taxes low, but made no mention of single-payer health care.</p> <p>The RAND Corporation study concluded the change to a single-payer system in New York could (if certain assumptions were made true) save the state money in the long run, as even the bill’s primary sponsor in the Assembly, Gottfried, has said, that <a href="https://www.politico.com/states/new-york/albany/story/2018/08/01/rand-study-finds-single-payer-viable-in-new-york-but-with-big-caveats-536072" target="_blank" rel="noopener">payroll and other taxes would need to increase</a> to pay for the new system. The New York Health Act legislation itself doesn’t provide an exact way to pay for the single-payer system, instead authorizing a commission to figure out how to fund the plan should the bill pass. But Mannion posited that it’s not as if health insurance costs are affordable or helpful at the moment.<br /><br />“I spoke to someone, a small business owner in my district, who said the entire health insurance premium he paid was $300,000 for his employees six years ago, and this year alone it increased by $300,000,” Mannion said, in response to a question on whether he’s prepared to explain tax increases necessary for a single-payer system.</p> <p>Still, some Democrats are wary to discuss their views on the issue, even if they list it as an issue they’re running on. Jim Gaughran, running against Republican Senator Carl Marcellino in Long Island’s 5th District, called healthcare a right and not a privilege <a href="http://gaughran2018.com/issues-page-gaughran#health-act" target="_blank" rel="noopener">on his website</a>, but did not respond to a request for comment, even after he was reached on his cell phone and promised a return call that did not materialize. The same situation came up with candidates Karen Smythe, whose website <a href="https://karen4nysenate.com/issues/" target="_blank" rel="noopener">calls for universal single-payer</a>, and <a href="https://votepatstrong.com/issues/">Pat Strong</a>, who said she would pass the New York Health Act. In the case of Assembly Member James Skoufis, running to represent the 39th Senate District, he’s already voted for the bill <a href="https://www.recordonline.com/news/20180929/control-of-state-senate-could-be-decided-here" target="_blank" rel="noopener">more than once</a> in his time in the Assembly, but doesn’t list is as one of his main issues on his campaign website. Skoufis <a href="https://twitter.com/JamesSkoufis/status/1042066707299397633" target="_blank" rel="noopener">released a campaign ad</a> touting his a fight with insurance companies on behalf of a constituent, but his campaign did not respond to multiple requests for comment on whether or not he would support the New York Health Act in the Senate the way he did in the Assembly.</p> <p>The candidates who spoke to Gotham Gazette did insist that even if they won and Democrats capture a majority in the state Senate, voters shouldn’t expect an immediate passage of the bill in the first budget session.</p> <p>“During the gubernatorial primary, Cynthia Nixon said ‘Oh just pass [the bill] and pay for it,’ but that's not how you pass and craft legislation,” Harckham said, referring to when Nixon <a href="http://www.nydailynews.com/news/politics/ny-pol-nixon-deblasio-nycha-lead-cuomo-20180905-story.html" target="_blank" rel="noopener">told the Daily News editorial board</a> “Pass it and then figure out how to fund it” when its members asked her about the New York Health Act. “My starting point is New York Health, and let's sit down with the experts. The Assembly has passed this version, so it's pretty far along, but that doesn't mean the Senate can't alter it,” she continued. “Let's do our due diligence, with the goal of providing universal single-payer coverage for all New Yorkers.”</p> <p>Harckham did say, though, that he felt “two years of legislative time” is long enough to debate and pass a bill, which he called <a href="http://peteforny.com/issues/" target="_blank" rel="noopener">a first-term priority on his website</a> (state legislative terms are two years long).</p> <p>“The Assembly bill has to be revamped, and we have get it right,” Mannion said. A spokesperson for Mannion later told Gotham Gazette that “getting it right” meant that Mannion believed “a transition from the current system to universal coverage as per the bill would likely require a transitional period in which purchasing into a Medicare-for-all like system would be a possible step, including offering that option on the NY State of Health exchange website.” That website is currently where New Yorkers can purchase health insurance plans under the Affordable Care Act.</p> <p>And even though the governor has said he prefers single-payer on a federal level, Metzger said there might be hope of convincing him to embrace the New York Health Act by playing to <a href="https://www.andrewcuomo.com/issues" target="_blank" rel="noopener">his love of New York being first</a>. “I think we can show that [single-payer] can be done, I think there's a lot of value in demonstration value,” Metzger said. “It's been these academic debates in this country for a long time. If anyone can do it, I think New York can do it.”</p> <p>

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by Dave Colon, Gotham Gazette
     

Read more by this writer.

</p>
State of Latino Health: Dismal, and Invisible 2018-10-10T04:00:00+00:00 2018-10-10T04:00:00+00:00 http://www.gothamgazette.com/130-opinion/7988-state-of-latino-health-dismal-and-invisible Ben Max <p><img src="http://www.gothamgazette.com/images/29786236128_e5251de28d_z.jpg" alt="Gotham Health Center" width="600" height="401" /></p> <p>(photo via NYC Mayor's Office)</p> <hr /> <p>Latinos make up nearly a third of New York City’s eight million residents. But even though we are a large part of New York’s present and a rising population that’s crucial to the city’s future, we are completely invisible. <br /> <br />We are invisible in large part because we are different. And because of those joined factors, our health care is in a state of crisis. Compared to our fellow New York neighbors, we lack access to quality, culturally competent care, and we face a shortage of high-quality family care options. In fact, we sometimes encounter unique barriers that make us even more susceptible to illnesses than our neighbors and tend to experience worse health outcomes.<br /> <br />After decades of efforts to bring health care to underserved Latinos across the city, we set out to answer crucial questions: Why do great disparities in health care remain? And why do our families lack the health care services they need?<br /> <br />Why are Latinos far less healthy than our neighbors? <br /> <br />In <a href="https://stateoflatinohealth.com/#" target="_blank" rel="noopener">a new report</a> put out by my organization, a nonprofit network of over 2,000 providers who treat over 650,000 patients largely from lower income immigrant communities, we talked to hundreds of Latino doctors and patients across New York City to compile a first-ever poll.<br /> <br />We hope it spurs a movement. <br /> <br />We set out to bring to light health disparities and the cultural, economic, and institutional barriers that diminish access to even basic health care services -- leading to devastating health outcomes for many in our communities.<br /> <br />So what did we learn about the state of Latino health in New York City in 2018?<br /> <br />First, we learned that there is a wide gap between Latino patients and their physicians over what constitutes good health. While a majority of Latinos think they are healthy, their doctors disagree by vast margins. And only one-third of Latino patients think they are not receiving the care they need while two-thirds of doctors think Latinos experience persistent barriers to care.<br /> <br />Second, transportation and child care pose major barriers to health care access in Latino communities. Language is another major issue: in the Bronx, home to the city’s largest Latino population, only 10% of doctors speak Spanish, compared to 60% of residents. In fact, immigrants interviewed stated that language barriers kept them from telling their health care providers all of their symptoms – leading to unnecessary emergency room visits, avoidable crises, and uncontrolled chronic conditions.<br /> <br />Finally, too many health problems are going untreated in the Latino community. Smoking, asthma, obesity, diabetes, and hypertension are prevalent problems but health education has not kept up and health education materials are often not available in Spanish. In addition, mental health and substance abuse challenges are stigmatized and remain taboo to discuss, going undertreated or even untreated.<br /> <br />In short, our report showed us that we have much more work to do to lift up and improve health outcomes in the Latino community, but we can make progress if we are willing to put in the work. <br /> <br />Together, by prioritizing community engagement, we can build and scale a sustainable architecture of innovation to confront and solve these problems. We can and must develop and sustain strong community, public health, and health care strategies to improve access to quality, culturally competent, and much needed care. <br /> <br />Additionally, we also need a serious investment in health education on the part of policy-makers to address not only these conditions but also the lack of health education resources offered. And language matters. Understanding these nuanced, culture-specific disparities will help us build a system that combines high quality with more effective care that reduces costs for patients, institutions, cities, states, and the federal government.<br /> <br />The Latino community is growing faster in New York than in Nevada or California. Over the next few years, through intervention, innovation, and integration, we will use the findings of this report to partner with the state and city to better deliver culturally-competent care and build a stronger, healthier Latino community in New York.<br /> <br />The need is urgent, the path forward clear – now it’s time for action.<br /> <br />***<br />Dr. Ramon Tallaj is the founder and chairman of SOMOS Community Care.</p> <p>

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<p><img src="http://www.gothamgazette.com/images/29786236128_e5251de28d_z.jpg" alt="Gotham Health Center" width="600" height="401" /></p> <p>(photo via NYC Mayor's Office)</p> <hr /> <p>Latinos make up nearly a third of New York City’s eight million residents. But even though we are a large part of New York’s present and a rising population that’s crucial to the city’s future, we are completely invisible. <br /> <br />We are invisible in large part because we are different. And because of those joined factors, our health care is in a state of crisis. Compared to our fellow New York neighbors, we lack access to quality, culturally competent care, and we face a shortage of high-quality family care options. In fact, we sometimes encounter unique barriers that make us even more susceptible to illnesses than our neighbors and tend to experience worse health outcomes.<br /> <br />After decades of efforts to bring health care to underserved Latinos across the city, we set out to answer crucial questions: Why do great disparities in health care remain? And why do our families lack the health care services they need?<br /> <br />Why are Latinos far less healthy than our neighbors? <br /> <br />In <a href="https://stateoflatinohealth.com/#" target="_blank" rel="noopener">a new report</a> put out by my organization, a nonprofit network of over 2,000 providers who treat over 650,000 patients largely from lower income immigrant communities, we talked to hundreds of Latino doctors and patients across New York City to compile a first-ever poll.<br /> <br />We hope it spurs a movement. <br /> <br />We set out to bring to light health disparities and the cultural, economic, and institutional barriers that diminish access to even basic health care services -- leading to devastating health outcomes for many in our communities.<br /> <br />So what did we learn about the state of Latino health in New York City in 2018?<br /> <br />First, we learned that there is a wide gap between Latino patients and their physicians over what constitutes good health. While a majority of Latinos think they are healthy, their doctors disagree by vast margins. And only one-third of Latino patients think they are not receiving the care they need while two-thirds of doctors think Latinos experience persistent barriers to care.<br /> <br />Second, transportation and child care pose major barriers to health care access in Latino communities. Language is another major issue: in the Bronx, home to the city’s largest Latino population, only 10% of doctors speak Spanish, compared to 60% of residents. In fact, immigrants interviewed stated that language barriers kept them from telling their health care providers all of their symptoms – leading to unnecessary emergency room visits, avoidable crises, and uncontrolled chronic conditions.<br /> <br />Finally, too many health problems are going untreated in the Latino community. Smoking, asthma, obesity, diabetes, and hypertension are prevalent problems but health education has not kept up and health education materials are often not available in Spanish. In addition, mental health and substance abuse challenges are stigmatized and remain taboo to discuss, going undertreated or even untreated.<br /> <br />In short, our report showed us that we have much more work to do to lift up and improve health outcomes in the Latino community, but we can make progress if we are willing to put in the work. <br /> <br />Together, by prioritizing community engagement, we can build and scale a sustainable architecture of innovation to confront and solve these problems. We can and must develop and sustain strong community, public health, and health care strategies to improve access to quality, culturally competent, and much needed care. <br /> <br />Additionally, we also need a serious investment in health education on the part of policy-makers to address not only these conditions but also the lack of health education resources offered. And language matters. Understanding these nuanced, culture-specific disparities will help us build a system that combines high quality with more effective care that reduces costs for patients, institutions, cities, states, and the federal government.<br /> <br />The Latino community is growing faster in New York than in Nevada or California. Over the next few years, through intervention, innovation, and integration, we will use the findings of this report to partner with the state and city to better deliver culturally-competent care and build a stronger, healthier Latino community in New York.<br /> <br />The need is urgent, the path forward clear – now it’s time for action.<br /> <br />***<br />Dr. Ramon Tallaj is the founder and chairman of SOMOS Community Care.</p> <p>

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With Fake Clinics Proliferating, New Yorkers Should Know Their Reproductive Health Care Rights 2018-09-23T04:00:00+00:00 2018-09-23T04:00:00+00:00 http://www.gothamgazette.com/130-opinion/7951-with-fake-clinics-proliferating-new-yorkers-should-know-their-reproductive-health-care-rights Ben Max <p><img src="http://www.gothamgazette.com/images/letitia_james_andrea_miller.jpg.png" alt="letitia james andrea miller" width="600" height="499" /></p> <p>Letitia James and Andrea Miller, the authors</p> <hr /> <p>When visiting a health care provider, most patients trust that they’ll get a reasonably high standard of medical care and assume that their medical providers will keep their information confidential, and are not actively trying to deceive them. But around the country, 2,700 fake women’s health centers – which sometimes call themselves “crisis pregnancy centers” – are lying to women and giving false information in order to prevent women from having abortions. One hundred of them are here in New York State.</p> <p>It is imperative that any New York woman or teen who is pregnant, or thinks she might be, can get accurate health care information and knows her rights, including the right to have an abortion.</p> <p>That’s why the National Institute for Reproductive Health (NIRH) and New York City Public Advocate Letitia James have just released “Know Your Rights,” a public awareness and education brochure, so pregnant New Yorkers, those who might be pregnant, and their families and loved ones, can access accurate information about pregnancy and abortion, regardless of whether a woman chooses to continue her pregnancy or not.</p> <p>Fake clinics actively trick and lure women into their centers. They set up shop near legitimate health care providers and brand themselves with words like “women’s choices” or “pregnancy resources” to suggest they provide all-options counseling and care to help women and teens make fully informed decisions; they advertise free pregnancy tests and ultrasounds. Inside, these clinics can look and feel like a real doctor’s office — staff wear white coats or medical scrubs, and pamphlets about pregnancy and ultrasound machines are located in exam rooms. The staff will often lie to women, either telling them that they are farther along in their pregnancy than they really are, and that it is too late for an abortion or that it is earlier in pregnancy than they really are, and they should wait before making any decisions.</p> <p>Fake clinics are often part of national anti-abortion networks, and they target women from low-income communities, communities of color, and immigrant communities. Alarmingly, fake clinics outnumber real abortion providers by as much as four-to-one nationwide.</p> <p>New York City saw the dangers these fake clinics posed and passed Local Law 17 in 2011, which took effect in 2016, requiring them to disclose that they don’t have a licensed medical provider on site and to keep client information confidential. Unfortunately, many fake clinics fail to comply with this law.</p> <p>In light of the federal government’s continued attempts to undermine access to abortion and the current Supreme Court’s indifference to the harms posed by fake clinics, New York must work twice as hard to protect our residents’ right to accurate medical information and abortion care. We must retain our reputation as a state that protects and supports women and girls.</p> <p>NIRH and Public Advocate James are committed to protecting the reproductive health and rights of all New York women. "Know Your Rights," available&nbsp;at <a href="http://nirhealth.org/knowyourrights" target="_blank" rel="noopener">the NIRH website</a>, <a href="http://pubadvocate.nyc.gov/sites/advocate.nyc.gov/files/know-your-rights.pdf" target="_blank" rel="noopener">the public advocate website</a>, and&nbsp;in hard copy around the city, provides a list of legitimate health care providers that offer prenatal care and abortion, and information regarding privacy rights.</p> <p>New York City residents deserve nothing less.</p> <p>***<br />Letitia James is New York City Public Advocate. Andrea Miller is President of the National Institute for Reproductive Health (NIRH). On Twitter <a href="https://twitter.com/TishJames" target="_blank" rel="noopener">@TishJames</a> and <a href="https://twitter.com/AMillerNIRH" target="_blank" rel="noopener">@AMillerNIRH</a>.</p> <p>

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<p><img src="http://www.gothamgazette.com/images/letitia_james_andrea_miller.jpg.png" alt="letitia james andrea miller" width="600" height="499" /></p> <p>Letitia James and Andrea Miller, the authors</p> <hr /> <p>When visiting a health care provider, most patients trust that they’ll get a reasonably high standard of medical care and assume that their medical providers will keep their information confidential, and are not actively trying to deceive them. But around the country, 2,700 fake women’s health centers – which sometimes call themselves “crisis pregnancy centers” – are lying to women and giving false information in order to prevent women from having abortions. One hundred of them are here in New York State.</p> <p>It is imperative that any New York woman or teen who is pregnant, or thinks she might be, can get accurate health care information and knows her rights, including the right to have an abortion.</p> <p>That’s why the National Institute for Reproductive Health (NIRH) and New York City Public Advocate Letitia James have just released “Know Your Rights,” a public awareness and education brochure, so pregnant New Yorkers, those who might be pregnant, and their families and loved ones, can access accurate information about pregnancy and abortion, regardless of whether a woman chooses to continue her pregnancy or not.</p> <p>Fake clinics actively trick and lure women into their centers. They set up shop near legitimate health care providers and brand themselves with words like “women’s choices” or “pregnancy resources” to suggest they provide all-options counseling and care to help women and teens make fully informed decisions; they advertise free pregnancy tests and ultrasounds. Inside, these clinics can look and feel like a real doctor’s office — staff wear white coats or medical scrubs, and pamphlets about pregnancy and ultrasound machines are located in exam rooms. The staff will often lie to women, either telling them that they are farther along in their pregnancy than they really are, and that it is too late for an abortion or that it is earlier in pregnancy than they really are, and they should wait before making any decisions.</p> <p>Fake clinics are often part of national anti-abortion networks, and they target women from low-income communities, communities of color, and immigrant communities. Alarmingly, fake clinics outnumber real abortion providers by as much as four-to-one nationwide.</p> <p>New York City saw the dangers these fake clinics posed and passed Local Law 17 in 2011, which took effect in 2016, requiring them to disclose that they don’t have a licensed medical provider on site and to keep client information confidential. Unfortunately, many fake clinics fail to comply with this law.</p> <p>In light of the federal government’s continued attempts to undermine access to abortion and the current Supreme Court’s indifference to the harms posed by fake clinics, New York must work twice as hard to protect our residents’ right to accurate medical information and abortion care. We must retain our reputation as a state that protects and supports women and girls.</p> <p>NIRH and Public Advocate James are committed to protecting the reproductive health and rights of all New York women. "Know Your Rights," available&nbsp;at <a href="http://nirhealth.org/knowyourrights" target="_blank" rel="noopener">the NIRH website</a>, <a href="http://pubadvocate.nyc.gov/sites/advocate.nyc.gov/files/know-your-rights.pdf" target="_blank" rel="noopener">the public advocate website</a>, and&nbsp;in hard copy around the city, provides a list of legitimate health care providers that offer prenatal care and abortion, and information regarding privacy rights.</p> <p>New York City residents deserve nothing less.</p> <p>***<br />Letitia James is New York City Public Advocate. Andrea Miller is President of the National Institute for Reproductive Health (NIRH). On Twitter <a href="https://twitter.com/TishJames" target="_blank" rel="noopener">@TishJames</a> and <a href="https://twitter.com/AMillerNIRH" target="_blank" rel="noopener">@AMillerNIRH</a>.</p> <p>

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As Broader Debate Intensifies, New York Nonprofits Consider Throwing Weight Behind Single-Payer 2018-09-20T04:00:00+00:00 2018-09-20T04:00:00+00:00 http://www.gothamgazette.com/state/7944-as-broader-debate-intensifies-new-york-nonprofits-consider-throwing-weight-behind-single-payer Ben Max <p><img src="http://www.gothamgazette.com/images/graphics/2018/gottfried-org-2.jpg" alt="gottfried org 2" width="600" height="400" /></p> <p>Assemblymember Gottfried (photo: Dickgottfried.org)</p> <hr /> <p>Wendy Stark is ready to press the reset button on health care. The executive director of Callen-Lorde Community Health Center, based in Lower Manhattan, Stark is hopeful that an overhaul may be on the horizon in New York through controversial legislation gaining increasing attention as this fall’s elections determine the upcoming balance of power in state government, from the governor’s office through the state Legislature.</p> <p>The New York Health Act -- which has increasingly strong chances of passing the state Legislature but does not have the support of Democratic Governor Andrew Cuomo, who is favored to win a third term -- would set the stage for New York to toss out the current health insurance system in favor of a single taxpayer-funded, government-administered health care program for everyone.</p> <p>As the bill has been the subject of more debate in recent months, partially stemming from gubernatorial candidate Cynthia Nixon’s support for it, powerful lobbyist groups representing insurers, hospitals, and businesses have been vocal about their opposition. The Business Council of New York State <a href="http://video.foxnews.com/v/5832013647001/?#sp=show-clips" target="_blank" rel="noopener">took to Fox &amp; Friends</a> to denounce the legislation, while others have written op-eds in local publications. Republicans running for office, including gubernatorial nominee Marc Molinaro, are warning New Yorkers about a potential government takeover of health care.</p> <p>But as the leader of a health care provider that serves mostly low-income members of the LGBT community through its clinics in Manhattan and the Bronx and employs more than 350 people, Stark has a very different take. She says in addition to allowing her organization to save on employee benefits and administrative costs -- a projection generally backed up by <a href="https://www.rand.org/pubs/research_reports/RR2424.html" target="_blank" rel="noopener">the RAND Corp.’s recently-published analysis</a> of the New York Health Act -- a single-payer system would cut down on the red tape patients have to deal with.</p> <p>“So many of the barriers to care people experience are rooted in the economics of health care,” Stark said. “We don’t believe health care can make adequate improvements without changing the foundational economics of how it works and is paid for.”</p> <p>Under the proposed single-payer system, insurance premiums, deductibles and copays would all go out the window, and patients could visit any health care provider without having to worry about whether they were in their insurance network. Meanwhile, taxes would go up, with the wealthiest New Yorkers paying a greater portion of their income and employers paying a certain amount per employee. Under the sample tax model proposed by the RAND Corp., the state would have to collect an estimated $139 billion in new taxes in 2022 to pay for the single-payer system. Still, RAND projected that overall spending on health care would go down -- barring a few caveats that <a href="http://gothamist.com/2018/08/22/nyc_universal_healthcare.php" target="_blank" rel="noopener">that could stand in the way</a> of the system being successful.</p> <p>Callen-Lorde is one of 10 community-based health centers and 183 total nonprofit groups statewide that have <a href="https://www.nyhcampaign.org/endorsers" target="_blank" rel="noopener">publicly endorsed</a> the campaign supporting the New York Health Act (in addition to a variety of mostly small for-profit businesses). But while it may seem like a natural fit, the bill still has a ways to go to become a widespread legislative priority for the large contingent of community-based organizations that help connect immigrants, people with behavioral health problems and housing insecurity, formerly incarcerated individuals, and members of other marginalized groups to needed health care and social services.</p> <p>Many nonprofit health centers and other organizations, including those in the human services sector -- which <a href="http://humanservicescouncil.org/wp-content/uploads/Initiatives/RestoreOpportunityNow/RONreport.pdf" target="_blank" rel="noopener">employ a growing workforce</a> and have formed coalitions to represent their interests in Albany and Washington, D.C. -- are still examining the implications of the New York Health Act before issuing full-throated endorsements. Others are directing their limited resources to what they see as more pressing policy and funding concerns.</p> <p>But that may change as the policy conversation develops. Groups like the Federation of Protestant Welfare Agencies, FPWA, which represents 170 human-services and faith-based organizations, are hoping to help move things along.</p> <p>“We believe the New York Health Act would strengthen nonprofits both for the communities they serve as well as their employees, and make the system more tenable long-term,” said Winn Periyasamy, policy analyst at FPWA.</p> <p>FPWA, along with the Coalition for Asian American Children and Families and the New York Immigration Coalition, hosted a forum on single-payer for nonprofit representatives on the Lower East Side last month, where they heard about the New York Health Act directly from its lead sponsors in the Legislature, Assemblymember Richard Gottfried and Senator Gustavo Rivera, both Democrats who represent parts of New York City in their respective legislative houses.</p> <p>New Yorkers in favor of a single-payer health system will know they’re winning, Rivera told the audience, when sinister images of him and Gottfried start appearing in insurance-industry funded attack ads.</p> <p>“I can’t wait for that gritty video, I can’t wait for it!” said Rivera, of the Bronx, exuding confidence that the debate over the state’s single-payer bill is on its way to reaching a fever pitch.</p> <p>The New York Health Act passed the Assembly the last four years in a row, but was thwarted each time by the Republican-controlled Senate. Now the bill--which was already only one sponsor short of a majority in the Senate in the last session--is among a slew of progressive measures that have been infused with new hope following the dissolution of the Independent Democratic Conference, which allowed Senate Democrats to caucus with Republicans.</p> <p>“This is real,” Gottfried insisted at the forum. “This is not a dream. And you and your people are really crucial to making sure it gets done.”</p> <p>Those in attendance were particularly interested in how the bill would affect undocumented New Yorkers, who are generally not eligible for health insurance now but would be under the single-payer system. Undocumented New Yorkers currently often use public hospitals at great expense, having eschewed preventative care due to their documentation status and lack of insurance. Dr. Mitchell Katz, chief executive of the cash-strapped NYC Health + Hospitals system, <a href="https://twitter.com/DrKatzNYCHH/status/1007736953008246784" target="_blank" rel="noopener">praised the Assembly</a> on Twitter for passing the New York Health Act in June.</p> <p>Attendees at the event also talked about the need to properly translate materials on single-payer into the languages of the communities they serve.</p> <p>“We’re reaching into our Asian-American communities,” said Anita Gundanna, co-executive director of the Coalition for Asian American Children and Families. “A lot of people had never heard of the [single-payer] proposal before or thought through the impact of it, so for us the very beginning step is to expose our communities to what’s going on and how it might impact them.”</p> <p>CACF and other groups serving Asian-Pacific Americans advocate for health care initiatives through Project CHARGE, the Coalition for Health Access to Reach Greater Equity. Gundanna said there’s a need to get more buy-in from individual organizations before single-payer can become an official part of the coalition’s policy agenda.</p> <p>“We have to be strategic and patient,” she said. “We can’t move without having our coalition behind us.”</p> <p>On the bright side, Gundanna pointed out, the nonprofit sector had to increase its capacity to share information about health policy a few years ago in order to help people understand and get insured through the federal Affordable Care Act, also known as Obamacare.</p> <p>But more recently everyone has been on the defensive, using their resources to try to preserve the ACA and prevent a wide array of federal policies from taking effect. Lately, many organizations are preoccupied with changes the Trump administration is considering to <a href="https://www.nejm.org/doi/full/10.1056/NEJMp1808020" target="_blank" rel="noopener">the Public Charge Rule</a>, which people in the social-services sector say are already discouraging some immigrants from using public benefits, including subsidized health insurance, for fear it could be used as a strike against them later.</p> <p>Gundanna said she wants to present nonprofits with proactive solutions like single-payer but acknowledges that everyone must consider, “How many resources are there to explore these quote-unquote ideal options in this quote-unquote ideal world?”</p> <p>Asked about the New York Health Act, the Community Healthcare Association of New York State, which spent much of 2017 and early 2018 consumed by a battle to secure endangered federal funding for its members, said in a statement, “CHCANYS supports innovations in health policy that improve access to high-quality health care for everyone. We continue to study the options for expanding coverage to all New Yorkers and are closely monitoring the current political discourse.”</p> <p>Meanwhile, the Human Services Council, whose advocacy focuses on improving the government contracts its member organizations rely on for funding, is not likely to take a position on the New York Health Act, said Allison Sesso, the coalition’s executive director.</p> <p>“Doing stuff on this is not why we exist and could eat up resources,” said Sesso, although she added, “I think this conversation is really important and I’m glad it’s being elevated.”</p> <p>As advocates for the New York Health Act work to make the case that it’s worth the time and effort for would-be proponents to support the bill, they are also faced with the uphill battle of getting the governor on their side. A year ago, before the bill stood much of a chance of passing both houses of the state Legislature, Cuomo <a href="https://www.timesunion.com/7day-state/article/Cuomo-signals-support-for-single-payer-health-care-12206177.php" target="_blank" rel="noopener">signaled some slight openness</a> to the idea of implementing a single-payer system in New York. Asked about it again during his debate with Nixon, before he beat her in the gubernatorial primary this month, Cuomo came out against the idea. He said he thought it could work at the federal level but would be too costly an endeavor for the state to embark on alone.</p> <p>***<br /> by Caroline Lewis for Gotham Gazette. On Twitter <a href="https://twitter.com/clewisreports" target="_blank" rel="noopener">@clewisreports</a> and <a href="https://twitter.com/gothamgazette" target="_blank" rel="noopener">@GothamGazette</a>.</p> <p><img src="http://www.gothamgazette.com/images/graphics/2018/gottfried-org-2.jpg" alt="gottfried org 2" width="600" height="400" /></p> <p>Assemblymember Gottfried (photo: Dickgottfried.org)</p> <hr /> <p>Wendy Stark is ready to press the reset button on health care. The executive director of Callen-Lorde Community Health Center, based in Lower Manhattan, Stark is hopeful that an overhaul may be on the horizon in New York through controversial legislation gaining increasing attention as this fall’s elections determine the upcoming balance of power in state government, from the governor’s office through the state Legislature.</p> <p>The New York Health Act -- which has increasingly strong chances of passing the state Legislature but does not have the support of Democratic Governor Andrew Cuomo, who is favored to win a third term -- would set the stage for New York to toss out the current health insurance system in favor of a single taxpayer-funded, government-administered health care program for everyone.</p> <p>As the bill has been the subject of more debate in recent months, partially stemming from gubernatorial candidate Cynthia Nixon’s support for it, powerful lobbyist groups representing insurers, hospitals, and businesses have been vocal about their opposition. The Business Council of New York State <a href="http://video.foxnews.com/v/5832013647001/?#sp=show-clips" target="_blank" rel="noopener">took to Fox &amp; Friends</a> to denounce the legislation, while others have written op-eds in local publications. Republicans running for office, including gubernatorial nominee Marc Molinaro, are warning New Yorkers about a potential government takeover of health care.</p> <p>But as the leader of a health care provider that serves mostly low-income members of the LGBT community through its clinics in Manhattan and the Bronx and employs more than 350 people, Stark has a very different take. She says in addition to allowing her organization to save on employee benefits and administrative costs -- a projection generally backed up by <a href="https://www.rand.org/pubs/research_reports/RR2424.html" target="_blank" rel="noopener">the RAND Corp.’s recently-published analysis</a> of the New York Health Act -- a single-payer system would cut down on the red tape patients have to deal with.</p> <p>“So many of the barriers to care people experience are rooted in the economics of health care,” Stark said. “We don’t believe health care can make adequate improvements without changing the foundational economics of how it works and is paid for.”</p> <p>Under the proposed single-payer system, insurance premiums, deductibles and copays would all go out the window, and patients could visit any health care provider without having to worry about whether they were in their insurance network. Meanwhile, taxes would go up, with the wealthiest New Yorkers paying a greater portion of their income and employers paying a certain amount per employee. Under the sample tax model proposed by the RAND Corp., the state would have to collect an estimated $139 billion in new taxes in 2022 to pay for the single-payer system. Still, RAND projected that overall spending on health care would go down -- barring a few caveats that <a href="http://gothamist.com/2018/08/22/nyc_universal_healthcare.php" target="_blank" rel="noopener">that could stand in the way</a> of the system being successful.</p> <p>Callen-Lorde is one of 10 community-based health centers and 183 total nonprofit groups statewide that have <a href="https://www.nyhcampaign.org/endorsers" target="_blank" rel="noopener">publicly endorsed</a> the campaign supporting the New York Health Act (in addition to a variety of mostly small for-profit businesses). But while it may seem like a natural fit, the bill still has a ways to go to become a widespread legislative priority for the large contingent of community-based organizations that help connect immigrants, people with behavioral health problems and housing insecurity, formerly incarcerated individuals, and members of other marginalized groups to needed health care and social services.</p> <p>Many nonprofit health centers and other organizations, including those in the human services sector -- which <a href="http://humanservicescouncil.org/wp-content/uploads/Initiatives/RestoreOpportunityNow/RONreport.pdf" target="_blank" rel="noopener">employ a growing workforce</a> and have formed coalitions to represent their interests in Albany and Washington, D.C. -- are still examining the implications of the New York Health Act before issuing full-throated endorsements. Others are directing their limited resources to what they see as more pressing policy and funding concerns.</p> <p>But that may change as the policy conversation develops. Groups like the Federation of Protestant Welfare Agencies, FPWA, which represents 170 human-services and faith-based organizations, are hoping to help move things along.</p> <p>“We believe the New York Health Act would strengthen nonprofits both for the communities they serve as well as their employees, and make the system more tenable long-term,” said Winn Periyasamy, policy analyst at FPWA.</p> <p>FPWA, along with the Coalition for Asian American Children and Families and the New York Immigration Coalition, hosted a forum on single-payer for nonprofit representatives on the Lower East Side last month, where they heard about the New York Health Act directly from its lead sponsors in the Legislature, Assemblymember Richard Gottfried and Senator Gustavo Rivera, both Democrats who represent parts of New York City in their respective legislative houses.</p> <p>New Yorkers in favor of a single-payer health system will know they’re winning, Rivera told the audience, when sinister images of him and Gottfried start appearing in insurance-industry funded attack ads.</p> <p>“I can’t wait for that gritty video, I can’t wait for it!” said Rivera, of the Bronx, exuding confidence that the debate over the state’s single-payer bill is on its way to reaching a fever pitch.</p> <p>The New York Health Act passed the Assembly the last four years in a row, but was thwarted each time by the Republican-controlled Senate. Now the bill--which was already only one sponsor short of a majority in the Senate in the last session--is among a slew of progressive measures that have been infused with new hope following the dissolution of the Independent Democratic Conference, which allowed Senate Democrats to caucus with Republicans.</p> <p>“This is real,” Gottfried insisted at the forum. “This is not a dream. And you and your people are really crucial to making sure it gets done.”</p> <p>Those in attendance were particularly interested in how the bill would affect undocumented New Yorkers, who are generally not eligible for health insurance now but would be under the single-payer system. Undocumented New Yorkers currently often use public hospitals at great expense, having eschewed preventative care due to their documentation status and lack of insurance. Dr. Mitchell Katz, chief executive of the cash-strapped NYC Health + Hospitals system, <a href="https://twitter.com/DrKatzNYCHH/status/1007736953008246784" target="_blank" rel="noopener">praised the Assembly</a> on Twitter for passing the New York Health Act in June.</p> <p>Attendees at the event also talked about the need to properly translate materials on single-payer into the languages of the communities they serve.</p> <p>“We’re reaching into our Asian-American communities,” said Anita Gundanna, co-executive director of the Coalition for Asian American Children and Families. “A lot of people had never heard of the [single-payer] proposal before or thought through the impact of it, so for us the very beginning step is to expose our communities to what’s going on and how it might impact them.”</p> <p>CACF and other groups serving Asian-Pacific Americans advocate for health care initiatives through Project CHARGE, the Coalition for Health Access to Reach Greater Equity. Gundanna said there’s a need to get more buy-in from individual organizations before single-payer can become an official part of the coalition’s policy agenda.</p> <p>“We have to be strategic and patient,” she said. “We can’t move without having our coalition behind us.”</p> <p>On the bright side, Gundanna pointed out, the nonprofit sector had to increase its capacity to share information about health policy a few years ago in order to help people understand and get insured through the federal Affordable Care Act, also known as Obamacare.</p> <p>But more recently everyone has been on the defensive, using their resources to try to preserve the ACA and prevent a wide array of federal policies from taking effect. Lately, many organizations are preoccupied with changes the Trump administration is considering to <a href="https://www.nejm.org/doi/full/10.1056/NEJMp1808020" target="_blank" rel="noopener">the Public Charge Rule</a>, which people in the social-services sector say are already discouraging some immigrants from using public benefits, including subsidized health insurance, for fear it could be used as a strike against them later.</p> <p>Gundanna said she wants to present nonprofits with proactive solutions like single-payer but acknowledges that everyone must consider, “How many resources are there to explore these quote-unquote ideal options in this quote-unquote ideal world?”</p> <p>Asked about the New York Health Act, the Community Healthcare Association of New York State, which spent much of 2017 and early 2018 consumed by a battle to secure endangered federal funding for its members, said in a statement, “CHCANYS supports innovations in health policy that improve access to high-quality health care for everyone. We continue to study the options for expanding coverage to all New Yorkers and are closely monitoring the current political discourse.”</p> <p>Meanwhile, the Human Services Council, whose advocacy focuses on improving the government contracts its member organizations rely on for funding, is not likely to take a position on the New York Health Act, said Allison Sesso, the coalition’s executive director.</p> <p>“Doing stuff on this is not why we exist and could eat up resources,” said Sesso, although she added, “I think this conversation is really important and I’m glad it’s being elevated.”</p> <p>As advocates for the New York Health Act work to make the case that it’s worth the time and effort for would-be proponents to support the bill, they are also faced with the uphill battle of getting the governor on their side. A year ago, before the bill stood much of a chance of passing both houses of the state Legislature, Cuomo <a href="https://www.timesunion.com/7day-state/article/Cuomo-signals-support-for-single-payer-health-care-12206177.php" target="_blank" rel="noopener">signaled some slight openness</a> to the idea of implementing a single-payer system in New York. Asked about it again during his debate with Nixon, before he beat her in the gubernatorial primary this month, Cuomo came out against the idea. He said he thought it could work at the federal level but would be too costly an endeavor for the state to embark on alone.</p> <p>***<br /> by Caroline Lewis for Gotham Gazette. On Twitter <a href="https://twitter.com/clewisreports" target="_blank" rel="noopener">@clewisreports</a> and <a href="https://twitter.com/gothamgazette" target="_blank" rel="noopener">@GothamGazette</a>.</p> Extending the Human Right of Health Care to All New Yorkers 2018-08-08T04:00:00+00:00 2018-08-08T04:00:00+00:00 http://www.gothamgazette.com/130-opinion/7853-extending-the-human-right-of-health-care-to-all-new-yorkers Ben Max <p><img src="http://www.gothamgazette.com/images/graphics/2018/c-johnson-brooklyn-credit.jpg" alt="c johnson brooklyn credit" width="600" height="400" /></p> <p>Speaker Johnson, the author, visits a health care facility (photo via John McCarten)</p> <hr /> <p>Health care for all is a human right. This means no one should be denied care based on their ability to pay.</p> <p>The World Health Organization recognized this fundamental truth 70 years ago, most countries around the world have been putting it into action for decades now, and doctors and nurses live it out professionally every day.</p> <p>Truly achieving this moral imperative means we need a universal health care system supported by taxes and administered by one provider. Not only is this the right thing to do, it’s also more practical and less expensive than the status quo.</p> <p><a href="https://www.rand.org/pubs/research_reports/RR2424.html" target="_blank" rel="noopener">A recent study</a> conducted by the RAND Corporation shows that single-payer is likely to save our state health care system $15 billion by 2031 compared to our current system. Other estimates project savings of up to $45 billion.</p> <p>For these reasons I introduced a resolution Wednesday urging our state government to approve a law that would lay the foundation for single-payer healthcare in the Empire State. The proposal would create the New York Health program, which, if fully implemented, would result in 90 percent of New Yorkers spending less on health care than they currently do.</p> <p>The plan would help save New Yorkers money by cutting administrative costs and simplifying the present system. Approximately one million New Yorkers are without any health insurance and have essentially been priced out of the market, which is another practical reason why I support this legislation. Also, you, the patient, would pay no premiums, deductibles or co-payments when visiting a doctor under the new system.</p> <p>According to the RAND study, New Yorkers could spend half as much money out of their own pockets under the New York Health program than they do within the current system. In fact, according to a relatively conservative scenario, New Yorkers with an annual household compensation of less than $105,300 would save about $2,800 per person every year. Other estimates project even greater savings.</p> <p>Single-payer is traditionally viewed as a progressive cause, but it has earned support from conservative quarters too. RAND, which was originally founded to provide research to the armed forces, isn’t exactly a progressive endeavor.</p> <p>It is also worth noting that New York is a relatively wealthy state. Our economy is the third largest in the nation, behind California and Texas. And with a gross domestic product of $1.56 trillion, our economy is comparable to Canada’s, which has a $1.65 trillion GDP.</p> <p>That kind of prosperity is an advantage few states – and few countries, for that matter – enjoy, and it’s one we should leverage so as many New Yorkers as possible have access to good health care. Failing to do so would be an abdication of our responsibility as elected representatives.</p> <p>The current landscape is complicated and there are a lot of moving parts, but complexity shouldn’t be the enemy of what is right.</p> <p>President Trump’s administration has signaled it would oppose single-payer plans from state governments seeking to bring sanity to their respective health care landscapes, so it is unlikely his administration will grant New York the federal waivers needed for a single-payer system to be fully implemented here.</p> <p>However, even without a waiver, the state could still ramp up the program on a partial basis and, in the process, save money for current Medicare and Medicaid recipients through improved, wrap-around coverage. It would also lay the framework for full implementation of the plan under a new president.</p> <p>Critics on the other side of this debate have also argued that adequate health care shouldn’t be considered a right – that it is a finite resource and can’t be placed in the same category as voting or free speech.</p> <p>I disagree.</p> <p>Many human rights we now take for granted in the United States weren’t considered rights at all during various periods of history. But eventually we evolved to see them as such.</p> <p>The right to vote, freedom of speech, the right to assemble – these are now encoded into our nation’s DNA, but over the course of world history this wasn’t always the case.</p> <p>Even today, not everyone on earth has the right to vote. Many Americans didn’t have that right immediately after our nation was founded.</p> <p>But we’ve made progress – often that progress comes too slowly, but there is no progress until we take the first steps forward.</p> <p>Adopting single-payer healthcare in New York State would be an enormous step in the right direction. This is why I am standing with my colleagues in state government who support it, and I hope you will too.</p> <p>***<br /> Corey Johnson is the Speaker of the New York City Council and represents the Council’s 3rd District, in Manhattan. On Twitter <a href="https://twitter.com/NYCSpeakerCoJo" target="_blank" rel="noopener">@NYCSpeakerCoJo</a>.</p> <p>

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<p><img src="http://www.gothamgazette.com/images/graphics/2018/c-johnson-brooklyn-credit.jpg" alt="c johnson brooklyn credit" width="600" height="400" /></p> <p>Speaker Johnson, the author, visits a health care facility (photo via John McCarten)</p> <hr /> <p>Health care for all is a human right. This means no one should be denied care based on their ability to pay.</p> <p>The World Health Organization recognized this fundamental truth 70 years ago, most countries around the world have been putting it into action for decades now, and doctors and nurses live it out professionally every day.</p> <p>Truly achieving this moral imperative means we need a universal health care system supported by taxes and administered by one provider. Not only is this the right thing to do, it’s also more practical and less expensive than the status quo.</p> <p><a href="https://www.rand.org/pubs/research_reports/RR2424.html" target="_blank" rel="noopener">A recent study</a> conducted by the RAND Corporation shows that single-payer is likely to save our state health care system $15 billion by 2031 compared to our current system. Other estimates project savings of up to $45 billion.</p> <p>For these reasons I introduced a resolution Wednesday urging our state government to approve a law that would lay the foundation for single-payer healthcare in the Empire State. The proposal would create the New York Health program, which, if fully implemented, would result in 90 percent of New Yorkers spending less on health care than they currently do.</p> <p>The plan would help save New Yorkers money by cutting administrative costs and simplifying the present system. Approximately one million New Yorkers are without any health insurance and have essentially been priced out of the market, which is another practical reason why I support this legislation. Also, you, the patient, would pay no premiums, deductibles or co-payments when visiting a doctor under the new system.</p> <p>According to the RAND study, New Yorkers could spend half as much money out of their own pockets under the New York Health program than they do within the current system. In fact, according to a relatively conservative scenario, New Yorkers with an annual household compensation of less than $105,300 would save about $2,800 per person every year. Other estimates project even greater savings.</p> <p>Single-payer is traditionally viewed as a progressive cause, but it has earned support from conservative quarters too. RAND, which was originally founded to provide research to the armed forces, isn’t exactly a progressive endeavor.</p> <p>It is also worth noting that New York is a relatively wealthy state. Our economy is the third largest in the nation, behind California and Texas. And with a gross domestic product of $1.56 trillion, our economy is comparable to Canada’s, which has a $1.65 trillion GDP.</p> <p>That kind of prosperity is an advantage few states – and few countries, for that matter – enjoy, and it’s one we should leverage so as many New Yorkers as possible have access to good health care. Failing to do so would be an abdication of our responsibility as elected representatives.</p> <p>The current landscape is complicated and there are a lot of moving parts, but complexity shouldn’t be the enemy of what is right.</p> <p>President Trump’s administration has signaled it would oppose single-payer plans from state governments seeking to bring sanity to their respective health care landscapes, so it is unlikely his administration will grant New York the federal waivers needed for a single-payer system to be fully implemented here.</p> <p>However, even without a waiver, the state could still ramp up the program on a partial basis and, in the process, save money for current Medicare and Medicaid recipients through improved, wrap-around coverage. It would also lay the framework for full implementation of the plan under a new president.</p> <p>Critics on the other side of this debate have also argued that adequate health care shouldn’t be considered a right – that it is a finite resource and can’t be placed in the same category as voting or free speech.</p> <p>I disagree.</p> <p>Many human rights we now take for granted in the United States weren’t considered rights at all during various periods of history. But eventually we evolved to see them as such.</p> <p>The right to vote, freedom of speech, the right to assemble – these are now encoded into our nation’s DNA, but over the course of world history this wasn’t always the case.</p> <p>Even today, not everyone on earth has the right to vote. Many Americans didn’t have that right immediately after our nation was founded.</p> <p>But we’ve made progress – often that progress comes too slowly, but there is no progress until we take the first steps forward.</p> <p>Adopting single-payer healthcare in New York State would be an enormous step in the right direction. This is why I am standing with my colleagues in state government who support it, and I hope you will too.</p> <p>***<br /> Corey Johnson is the Speaker of the New York City Council and represents the Council’s 3rd District, in Manhattan. On Twitter <a href="https://twitter.com/NYCSpeakerCoJo" target="_blank" rel="noopener">@NYCSpeakerCoJo</a>.</p> <p>

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28 Years Later, ADA Non-Compliance Leaves Deaf Patients At Risk 2018-07-31T04:00:00+00:00 2018-07-31T04:00:00+00:00 http://www.gothamgazette.com/130-opinion/7837-28-years-later-ada-non-compliance-is-leaving-deaf-people-at-risk Ben Max <p><img src="http://www.gothamgazette.com/images/graphics/2018/unique-uconn-today.jpg" alt="unique uconn today" width="600" /></p> <p>(photo via UCONN)</p> <hr /> <p>Imagine being in so much pain that you call 911. Imagine being transported a great distance by an ambulance, all the while in excruciating pain and scared about what might be going on inside your body. Imagine that when you arrive in the hospital, multiple people poke and prod you without telling you what they are doing and without your being able to tell them what you need.</p> <p>All too frequently, this is the experience of people who are deaf within the United States medical system, because of a complete disregard for the regulations and guidelines set forth in the Americans with Disabilities Act (ADA), which mandate sign language interpreter services.</p> <p>When former President George H. W. Bush signed the ADA 28 years ago last week, he said, “Let the shameful wall of exclusion finally come tumbling down.” The ADA requires systemic change in how America accommodates people with disabilities, yet more than a quarter of a century after the law’s enactment, pervasive “walls of exclusion” still exist.</p> <p>New York Lawyers for the Public Interest (NYLPI) recently settled a complaint on behalf of a deaf person in New York City who was denied access to interpreter services at a hospital. It took over six years to resolve the matter, and the client continued to encounter countless similar experiences virtually every time she attempted to schedule an appointment with and visit a medical professional.</p> <p>This individual is not alone – primary care doctors, specialists, dentists, mental health providers, nursing homes, rehabilitation facilities, and labs routinely deny interpreter services to people who are deaf. This systemic discrimination in the health care setting is illegal under the ADA and has been illegal for even longer in places like New York City, where there are strong state and city non-discrimination laws at play.</p> <p>The lack of effective communication access is not unique to New York City. The Syracuse University College of Law Disability Rights Clinic also regularly litigates cases of healthcare providers refusing to offer sign language interpreters in upstate New York.</p> <p>Although there are resources available in New York to hold medical professionals and other agencies accountable if they do not provide effective communication, these problems remain. The New York City Commission on Human Rights and the New York State Division of Human Rights have the ability to investigate and redress such discrimination, even where the individual wants to proceed anonymously. However, these mechanisms are not enough to prevent countless instances of discrimination against members of the deaf community who seek health care.</p> <p>So if it is illegal, and there are mechanisms for redress, why does the problem persist?</p> <p>It’s all about money and attitude. There’s a pervasive disregard in the health care profession for the importance of effective communication access for both provider and patient. As an anti-discrimination law, the ADA was intended to enact societal change. However, laws are often not enough – we need a shift in culture.</p> <p>When deaf individuals speak out about not receiving interpreter services at medical offices, they are often told it is too expensive and providers are reluctant to pay for communication access. The problem is even more acute for solo practitioners than it is for large hospitals and medical practices with deep pockets. The medical community’s failure to budget and plan for this easily anticipated and legally required expense is unacceptable.</p> <p>Those who speak out are also told they do not really need an interpreter as they can communicate through other means. This is unacceptable.</p> <p>To require a person who is deaf and deprived effective communication access to seek change, continue to advocate until the change is made, file a lawsuit if the change is not made, and continue to prosecute the lawsuit until it is resolved, is not a realistic solution for creating a more accessible world. It unfairly places the onus on the deaf individual.</p> <p>There are already models for how to pay for these services. A few years ago, the Monroe County Bar Association established a fund to help defray up to 50 percent of a member’s interpreter bill. Likewise, Title IV of the ADA, which mandates the establishment of a national telephone relay system enabling deaf people to communicate, is funded through a tiny fee collected from everyone’s telephone bill. For health care providers not affiliated with a large institution, a similar fund should be created.</p> <p>Access delayed is access denied for members of the deaf community when they seek health care. We need creative funding, changes in attitude, and adherence to the law immediately to address this abhorrent situation.</p> <p>***<br /> Michael Schwartz, Associate Professor of Law at the Syracuse University College of Law, Director of its Disability Rights Clinic,&nbsp;board member at Tangata Group, and a long-time deaf rights advocate; and Maureen Belluscio, Senior Staff Attorney, Disability Justice Program of New York Lawyers for the Public Interest. On Twitter <a href="https://twitter.com/nylpi" target="_blank" rel="noopener">@NYLPI</a>.</p> <p>

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<p><img src="http://www.gothamgazette.com/images/graphics/2018/unique-uconn-today.jpg" alt="unique uconn today" width="600" /></p> <p>(photo via UCONN)</p> <hr /> <p>Imagine being in so much pain that you call 911. Imagine being transported a great distance by an ambulance, all the while in excruciating pain and scared about what might be going on inside your body. Imagine that when you arrive in the hospital, multiple people poke and prod you without telling you what they are doing and without your being able to tell them what you need.</p> <p>All too frequently, this is the experience of people who are deaf within the United States medical system, because of a complete disregard for the regulations and guidelines set forth in the Americans with Disabilities Act (ADA), which mandate sign language interpreter services.</p> <p>When former President George H. W. Bush signed the ADA 28 years ago last week, he said, “Let the shameful wall of exclusion finally come tumbling down.” The ADA requires systemic change in how America accommodates people with disabilities, yet more than a quarter of a century after the law’s enactment, pervasive “walls of exclusion” still exist.</p> <p>New York Lawyers for the Public Interest (NYLPI) recently settled a complaint on behalf of a deaf person in New York City who was denied access to interpreter services at a hospital. It took over six years to resolve the matter, and the client continued to encounter countless similar experiences virtually every time she attempted to schedule an appointment with and visit a medical professional.</p> <p>This individual is not alone – primary care doctors, specialists, dentists, mental health providers, nursing homes, rehabilitation facilities, and labs routinely deny interpreter services to people who are deaf. This systemic discrimination in the health care setting is illegal under the ADA and has been illegal for even longer in places like New York City, where there are strong state and city non-discrimination laws at play.</p> <p>The lack of effective communication access is not unique to New York City. The Syracuse University College of Law Disability Rights Clinic also regularly litigates cases of healthcare providers refusing to offer sign language interpreters in upstate New York.</p> <p>Although there are resources available in New York to hold medical professionals and other agencies accountable if they do not provide effective communication, these problems remain. The New York City Commission on Human Rights and the New York State Division of Human Rights have the ability to investigate and redress such discrimination, even where the individual wants to proceed anonymously. However, these mechanisms are not enough to prevent countless instances of discrimination against members of the deaf community who seek health care.</p> <p>So if it is illegal, and there are mechanisms for redress, why does the problem persist?</p> <p>It’s all about money and attitude. There’s a pervasive disregard in the health care profession for the importance of effective communication access for both provider and patient. As an anti-discrimination law, the ADA was intended to enact societal change. However, laws are often not enough – we need a shift in culture.</p> <p>When deaf individuals speak out about not receiving interpreter services at medical offices, they are often told it is too expensive and providers are reluctant to pay for communication access. The problem is even more acute for solo practitioners than it is for large hospitals and medical practices with deep pockets. The medical community’s failure to budget and plan for this easily anticipated and legally required expense is unacceptable.</p> <p>Those who speak out are also told they do not really need an interpreter as they can communicate through other means. This is unacceptable.</p> <p>To require a person who is deaf and deprived effective communication access to seek change, continue to advocate until the change is made, file a lawsuit if the change is not made, and continue to prosecute the lawsuit until it is resolved, is not a realistic solution for creating a more accessible world. It unfairly places the onus on the deaf individual.</p> <p>There are already models for how to pay for these services. A few years ago, the Monroe County Bar Association established a fund to help defray up to 50 percent of a member’s interpreter bill. Likewise, Title IV of the ADA, which mandates the establishment of a national telephone relay system enabling deaf people to communicate, is funded through a tiny fee collected from everyone’s telephone bill. For health care providers not affiliated with a large institution, a similar fund should be created.</p> <p>Access delayed is access denied for members of the deaf community when they seek health care. We need creative funding, changes in attitude, and adherence to the law immediately to address this abhorrent situation.</p> <p>***<br /> Michael Schwartz, Associate Professor of Law at the Syracuse University College of Law, Director of its Disability Rights Clinic,&nbsp;board member at Tangata Group, and a long-time deaf rights advocate; and Maureen Belluscio, Senior Staff Attorney, Disability Justice Program of New York Lawyers for the Public Interest. On Twitter <a href="https://twitter.com/nylpi" target="_blank" rel="noopener">@NYLPI</a>.</p> <p>

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To Help New Yorkers Quit Opioids, Expand Access to Medical Marijuana Now 2018-06-15T04:00:00+00:00 2018-06-15T04:00:00+00:00 http://www.gothamgazette.com/130-opinion/7742-to-help-new-yorkers-quit-opioids-expand-access-to-medical-marijuana-now Ben Max <p><img src="http://www.gothamgazette.com/images/graphics/2018/podcast18/cuomo-medical-maryjane.jpg" alt="cuomo medical maryjane" width="600" height="399" /></p> <p>Gov. Cuomo at a med mar announcement (photo via the Governor's Office)</p> <hr /> <p>As a 67-year-old cancer survivor who suffers from chronic pain as a result of cancer treatments, medical marijuana has allowed me to resume a more normal life free of addictive opioid medications. I hope that lawmakers will now consider expanding the state’s medical marijuana program so that more New Yorkers will have the same access to these important treatments as an alternative to the powerful prescription painkillers that sparked the opioid crisis in our state.</p> <p>My experience is all too typical of how so many people can easily find themselves reliant on prescription painkillers. Following my retirement from the U.S. Navy and a career in retail management, I was diagnosed with colorectal cancer in December 2015 and underwent chemotherapy, radiation therapy, and abdominal perineal resection surgery the following year. As a result of these treatments, I developed debilitating peripheral neuropathy and chronic lower spine pain and was unable to function normally.</p> <p>The pain was constant and excruciating. My doctors prescribed oxycodone to manage my pain, and with no other options seemingly available, I was eventually taking Percocet pills every four hours or less.</p> <p>But after researching New York State’s medical marijuana program, I finally had hope that an alternative to opiates was available to help treat my pain. I contacted my doctor and obtained my medical marijuana card in December 2017. Working closely with my doctor and the pharmacist at the dispensary in my community, we found the medical marijuana products that work best for me.</p> <p>In just a few months, I was able to quit my oxycodone prescription and now live a more normal life — once again able to enjoy my retirement, children, and grandchildren. While my pain will never completely vanish, medical marijuana helps me manage the symptoms without fear of an opioid addiction that has claimed thousands of lives in New York in recent years. It has also been critical in helping to manage my Post Traumatic Stress Disorder (PTSD), which I developed following service in the Vietnam War.</p> <p>But while I had a condition that made me eligible for the state’s medical marijuana program — and am fortunate to have a dispensary in my community that could help me quit oxycodone — thousands of New Yorkers still lack adequate access to medical marijuana and remain at the mercy of opioid-based prescriptions to manage their conditions.</p> <p>Fortunately, there is hope for these patients in need of care. Recently proposed bills in the state Senate and Assembly would greatly expand access to medical marijuana for New Yorkers. &nbsp;</p> <p>Senator George Amedore and Assembly Member Richard Gottfried have each introduced bills in their respective chambers that would allow doctors to prescribe medical marijuana to treat opioid addiction or as an alternative for those currently using prescription opiates — which could help prevent an addiction before it starts.</p> <p>Separately, Assembly Member Gottfried and Senator Diane Savino have both proposed bills that would increase the number of potential dispensaries in New York from 40 to 250 by allowing medical marijuana companies to open up to 25 dispensaries each, bringing access to care for the many communities still in need throughout the state.</p> <p>While these bills would undoubtedly help thousands of New Yorkers, they remain stuck in their respective committees with just days remaining in the current legislative session. Without action by lawmakers now, patients in need of medical marijuana care will be forced to wait even longer.</p> <p>My experience is proof that medical marijuana is an important and meaningful alternative to prescription drugs for those suffering from chronic and painful conditions. I hope state lawmakers will support patients like myself by taking immediate action to pass these bills and give more New Yorkers hope for a life free of powerful and addictive opioid-based drugs.</p> <p>***<br />Garry Croney is a resident of Newburgh.</p> <p>

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<p><img src="http://www.gothamgazette.com/images/graphics/2018/podcast18/cuomo-medical-maryjane.jpg" alt="cuomo medical maryjane" width="600" height="399" /></p> <p>Gov. Cuomo at a med mar announcement (photo via the Governor's Office)</p> <hr /> <p>As a 67-year-old cancer survivor who suffers from chronic pain as a result of cancer treatments, medical marijuana has allowed me to resume a more normal life free of addictive opioid medications. I hope that lawmakers will now consider expanding the state’s medical marijuana program so that more New Yorkers will have the same access to these important treatments as an alternative to the powerful prescription painkillers that sparked the opioid crisis in our state.</p> <p>My experience is all too typical of how so many people can easily find themselves reliant on prescription painkillers. Following my retirement from the U.S. Navy and a career in retail management, I was diagnosed with colorectal cancer in December 2015 and underwent chemotherapy, radiation therapy, and abdominal perineal resection surgery the following year. As a result of these treatments, I developed debilitating peripheral neuropathy and chronic lower spine pain and was unable to function normally.</p> <p>The pain was constant and excruciating. My doctors prescribed oxycodone to manage my pain, and with no other options seemingly available, I was eventually taking Percocet pills every four hours or less.</p> <p>But after researching New York State’s medical marijuana program, I finally had hope that an alternative to opiates was available to help treat my pain. I contacted my doctor and obtained my medical marijuana card in December 2017. Working closely with my doctor and the pharmacist at the dispensary in my community, we found the medical marijuana products that work best for me.</p> <p>In just a few months, I was able to quit my oxycodone prescription and now live a more normal life — once again able to enjoy my retirement, children, and grandchildren. While my pain will never completely vanish, medical marijuana helps me manage the symptoms without fear of an opioid addiction that has claimed thousands of lives in New York in recent years. It has also been critical in helping to manage my Post Traumatic Stress Disorder (PTSD), which I developed following service in the Vietnam War.</p> <p>But while I had a condition that made me eligible for the state’s medical marijuana program — and am fortunate to have a dispensary in my community that could help me quit oxycodone — thousands of New Yorkers still lack adequate access to medical marijuana and remain at the mercy of opioid-based prescriptions to manage their conditions.</p> <p>Fortunately, there is hope for these patients in need of care. Recently proposed bills in the state Senate and Assembly would greatly expand access to medical marijuana for New Yorkers. &nbsp;</p> <p>Senator George Amedore and Assembly Member Richard Gottfried have each introduced bills in their respective chambers that would allow doctors to prescribe medical marijuana to treat opioid addiction or as an alternative for those currently using prescription opiates — which could help prevent an addiction before it starts.</p> <p>Separately, Assembly Member Gottfried and Senator Diane Savino have both proposed bills that would increase the number of potential dispensaries in New York from 40 to 250 by allowing medical marijuana companies to open up to 25 dispensaries each, bringing access to care for the many communities still in need throughout the state.</p> <p>While these bills would undoubtedly help thousands of New Yorkers, they remain stuck in their respective committees with just days remaining in the current legislative session. Without action by lawmakers now, patients in need of medical marijuana care will be forced to wait even longer.</p> <p>My experience is proof that medical marijuana is an important and meaningful alternative to prescription drugs for those suffering from chronic and painful conditions. I hope state lawmakers will support patients like myself by taking immediate action to pass these bills and give more New Yorkers hope for a life free of powerful and addictive opioid-based drugs.</p> <p>***<br />Garry Croney is a resident of Newburgh.</p> <p>

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</p>
Expanding Health Insurance Enrollment Will Help Heal New Yorkers and Our Public Hospitals 2018-05-14T04:00:00+00:00 2018-05-14T04:00:00+00:00 http://www.gothamgazette.com/130-opinion/7672-expanding-health-insurance-enrollment-will-help-heal-new-yorkers-and-our-public-hospitals Ben Max <p><img src="http://www.gothamgazette.com/images/graphics/2018/40780493555_35de91db02_z.jpg" alt="Carlina Rivera City Council" width="600" height="404" /></p> <p>Council Member Rivera, one of the authors (photo: John McCarten/City Council)</p> <hr /> <p>Even in an era of relentless attack on health care by the Trump administration and its allies in Congress, New York City is continuing to reap enormous benefits from the Affordable Care Act. This year alone another 80,000 city residents enrolled in health coverage through our state’s Obamacare exchange.<br /> <br />But a huge number are still being left behind: an estimated 962,000 adults in the five boroughs remain uninsured. These New Yorkers -- many of whom are living in poverty -- often receive no health care until their conditions are severe enough to land them in the emergency room.<br /> <br />The trend is not good for those New Yorkers’ health, as they should have access to preventive care, regular check-ups, and other aspects of quality health care. What’s more, the current situation is also dealing a serious financial blow to our struggling public hospital system (known as Health + Hospitals), whose vital mission it is to serve those in need, including the uninsured. For H+H to avoid financial disaster we need to close the health insurance gap in New York City.<br /> <br />H+H serves over a million patients per year in a network of 11 acute care hospitals and dozens of other facilities throughout the five boroughs. These institutions are by far our city’s largest provider of care to Medicaid recipients, mental health patients, and -- critically -- those who are uninsured.<br /> <br />For decades our public hospitals -- Bellevue, Kings County, Harlem, Elmhurst and others -- have been the ultimate safety net for New Yorkers with nowhere else to turn. H+H’s diverse and committed staff, its proximity to low-income communities, and its sliding-scale fees have helped establish it as second-to-none in serving the neediest New Yorkers.<br /> <br />But balancing the books at our public hospitals has never been easy, in part because Medicaid reimbursement rates are so low. The system’s challenges have only gotten worse in recent years as federal and state safety-net funding has shrunk. And now tectonic changes in the health sector have dealt further blows, as care rapidly moves from inpatient to outpatient services. <br /> <br />The result: H+H is confronting a $1.3 billion deficit this year, projected to balloon to $2.1 billion next year.<br /> <br />This financial strain has real implications for patients, compounding long-running problems in the system. The wait time for appointments at H+H can stretch into the months. Many of the system’s buildings are crumbling, with leaking roofs at Harlem Hospital, deteriorated plumbing at Lincoln, obsolete electric systems at Metropolitan, and elevators throughout the system that are so outdated that their replacement parts are no longer sold.<br /> <br />H+H’s new CEO, Dr. Mitchel Katz, has laid out a multi-pronged plan to address this crisis. He has set out to reduce administrative expenses, more effectively bill insurance companies, and retain more paying patients, among other efforts.<br /> <br />But there is another critical strategy needed to save H+H: New York City urgently needs to enroll more people in health insurance.<br /> <br />Our public hospitals treat over 400,000 uninsured patients each year. That represents hundreds of millions of dollars of lost insurance billing for those eligible for coverage. Providing this health care regardless of ability to pay is the moral thing to do. It also affects the health of all New Yorkers by helping us prevent the spread of communicable diseases.<br /> <br />We need to tap health insurance as a way to make this important work financially sustainable. That’s why it’s critical that we dramatically ramp up our outreach and enrollment efforts.<br /> <br />Today, most funding for ACA enrollment is provided by the State, which spends about $12 million per year on a network of community-based organizations in the five boroughs offering health insurance navigation assistance.<br /> <br />Several City agencies also have dedicated teams doing enrollment, but the numbers are small: only about 50 staff at Human Resources Administration (HRA) and 70 at Department of Health and Mental Hygiene (DOHMH).<br /> <br />We need an aggressive, coordinated plan to take this work to the next level. And we need to be on the ground in neighborhoods. Community-based non-profits make ideal partners for this work, because of their cultural competence and because of the trust they so often have earned in low-income communities.<br /> <br />One group of New Yorkers can’t get enrolled no matter how much we spend on outreach: undocumented immigrants. But there’s a win-win possibility for them as well. By investing in a program to provide them access to primary care we can improve health outcomes and prevent the more costly H+H emergency room admissions that would otherwise occur. <br /> <br />A twin effort to enroll more New Yorkers who are eligible for insurance and to fund access to primary care for those who are undocumented would improve the health of our people while going a long way to shore up the finances of our public hospital system.<br /> <br />That would be a giant step forward to the goal of ensuring that each and every New Yorker, regardless of income or immigration status, has access to the affordable, high-quality care they need.</p> <p>***<br />Mark Levine and Carlina Rivera are members of the New York City Council. Levine chairs the Council’s health committee, Rivera chairs its hospitals committee. On Twitter <a href="https://twitter.com/MarkLevineNYC" target="_blank" rel="noopener">@MarkLevineNYC</a> and <a href="https://twitter.com/CarlinaRivera" target="_blank" rel="noopener">@CarlinaRivera</a>.</p> <p>

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Have an op-ed idea or submission for Gotham Gazette? Email opinion@gothamgazette.com

</p>
<p><img src="http://www.gothamgazette.com/images/graphics/2018/40780493555_35de91db02_z.jpg" alt="Carlina Rivera City Council" width="600" height="404" /></p> <p>Council Member Rivera, one of the authors (photo: John McCarten/City Council)</p> <hr /> <p>Even in an era of relentless attack on health care by the Trump administration and its allies in Congress, New York City is continuing to reap enormous benefits from the Affordable Care Act. This year alone another 80,000 city residents enrolled in health coverage through our state’s Obamacare exchange.<br /> <br />But a huge number are still being left behind: an estimated 962,000 adults in the five boroughs remain uninsured. These New Yorkers -- many of whom are living in poverty -- often receive no health care until their conditions are severe enough to land them in the emergency room.<br /> <br />The trend is not good for those New Yorkers’ health, as they should have access to preventive care, regular check-ups, and other aspects of quality health care. What’s more, the current situation is also dealing a serious financial blow to our struggling public hospital system (known as Health + Hospitals), whose vital mission it is to serve those in need, including the uninsured. For H+H to avoid financial disaster we need to close the health insurance gap in New York City.<br /> <br />H+H serves over a million patients per year in a network of 11 acute care hospitals and dozens of other facilities throughout the five boroughs. These institutions are by far our city’s largest provider of care to Medicaid recipients, mental health patients, and -- critically -- those who are uninsured.<br /> <br />For decades our public hospitals -- Bellevue, Kings County, Harlem, Elmhurst and others -- have been the ultimate safety net for New Yorkers with nowhere else to turn. H+H’s diverse and committed staff, its proximity to low-income communities, and its sliding-scale fees have helped establish it as second-to-none in serving the neediest New Yorkers.<br /> <br />But balancing the books at our public hospitals has never been easy, in part because Medicaid reimbursement rates are so low. The system’s challenges have only gotten worse in recent years as federal and state safety-net funding has shrunk. And now tectonic changes in the health sector have dealt further blows, as care rapidly moves from inpatient to outpatient services. <br /> <br />The result: H+H is confronting a $1.3 billion deficit this year, projected to balloon to $2.1 billion next year.<br /> <br />This financial strain has real implications for patients, compounding long-running problems in the system. The wait time for appointments at H+H can stretch into the months. Many of the system’s buildings are crumbling, with leaking roofs at Harlem Hospital, deteriorated plumbing at Lincoln, obsolete electric systems at Metropolitan, and elevators throughout the system that are so outdated that their replacement parts are no longer sold.<br /> <br />H+H’s new CEO, Dr. Mitchel Katz, has laid out a multi-pronged plan to address this crisis. He has set out to reduce administrative expenses, more effectively bill insurance companies, and retain more paying patients, among other efforts.<br /> <br />But there is another critical strategy needed to save H+H: New York City urgently needs to enroll more people in health insurance.<br /> <br />Our public hospitals treat over 400,000 uninsured patients each year. That represents hundreds of millions of dollars of lost insurance billing for those eligible for coverage. Providing this health care regardless of ability to pay is the moral thing to do. It also affects the health of all New Yorkers by helping us prevent the spread of communicable diseases.<br /> <br />We need to tap health insurance as a way to make this important work financially sustainable. That’s why it’s critical that we dramatically ramp up our outreach and enrollment efforts.<br /> <br />Today, most funding for ACA enrollment is provided by the State, which spends about $12 million per year on a network of community-based organizations in the five boroughs offering health insurance navigation assistance.<br /> <br />Several City agencies also have dedicated teams doing enrollment, but the numbers are small: only about 50 staff at Human Resources Administration (HRA) and 70 at Department of Health and Mental Hygiene (DOHMH).<br /> <br />We need an aggressive, coordinated plan to take this work to the next level. And we need to be on the ground in neighborhoods. Community-based non-profits make ideal partners for this work, because of their cultural competence and because of the trust they so often have earned in low-income communities.<br /> <br />One group of New Yorkers can’t get enrolled no matter how much we spend on outreach: undocumented immigrants. But there’s a win-win possibility for them as well. By investing in a program to provide them access to primary care we can improve health outcomes and prevent the more costly H+H emergency room admissions that would otherwise occur. <br /> <br />A twin effort to enroll more New Yorkers who are eligible for insurance and to fund access to primary care for those who are undocumented would improve the health of our people while going a long way to shore up the finances of our public hospital system.<br /> <br />That would be a giant step forward to the goal of ensuring that each and every New Yorker, regardless of income or immigration status, has access to the affordable, high-quality care they need.</p> <p>***<br />Mark Levine and Carlina Rivera are members of the New York City Council. Levine chairs the Council’s health committee, Rivera chairs its hospitals committee. On Twitter <a href="https://twitter.com/MarkLevineNYC" target="_blank" rel="noopener">@MarkLevineNYC</a> and <a href="https://twitter.com/CarlinaRivera" target="_blank" rel="noopener">@CarlinaRivera</a>.</p> <p>

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Have an op-ed idea or submission for Gotham Gazette? Email opinion@gothamgazette.com

</p>
What's The [Data] Point? 176,000, with Patrick Orecki 2018-05-11T04:00:00+00:00 2018-05-11T04:00:00+00:00 http://www.gothamgazette.com/state/7668-whats-the-data-point-176-000-with-patrick-orecki Ben Max <p><img src="http://www.gothamgazette.com/images/graphics/2017/whats-the-data-point.jpg" alt="whats the data point" width="600" height="600" /></p> <hr /> <p><strong>What's The [Data] Point? Episode 40</strong><strong> -- 176,000,&nbsp;with Patrick Orecki [You can download What's The [Data] Point? wherever you get your podcasts, including on iTunes]</strong></p> <!--<p><img src="http://www.gothamgazette.com/images/graphics/2018/podcast18/wtdp-w-cbrecher-120.jpg" alt="wtdp w cbrecher 120" width="440" height="120" style="display: block; margin: 10px auto;" /></p>--> <p><img src="http://www.gothamgazette.com/images/graphics/2018/podcast18/patrick-orecki-wtpd.jpg" alt="patrick orecki wtpd" width="158" height="160" style="margin-right: 10px; float: left;" /></p> <p>176,000 is the number of New Yorkers statewide currently enrolled in Medicaid health homes, a key component of the Cuomo administration's Medicaid redesign efforts that have helped rein in costs and a program that provides care coordination services for Medicaid enrollees with complex health care needs to link these individuals to a full spectrum of health care providers and other social supports.</p> <p>Patrick Orecki, CBC’s research associate specializing in the state budget and health policy issues, joins the podcast to break down the significance of health homes, what the program is doing well, challenges it has faced, and where it should go next.</p> <p>Listen to the conversation and let us know what you think: Ben Max of GG (<a href="https://twitter.com/TweetBenMax" target="_blank" rel="noopener noreferrer">@TweetBenMax</a>), Maria Doulis of CBC (<a href="https://twitter.com/MariaDoulis" target="_blank" rel="noopener">@MariaDoulis</a>). Listen below or download wherever you get your podcasts!</p> <p><iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/442666578&amp;color=%23ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false&amp;show_teaser=true" width="100%" height="170" frameborder="no" scrolling="no"></iframe></p> <p>

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by Ben Max, Gotham Gazette
     

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</p>
<p><img src="http://www.gothamgazette.com/images/graphics/2017/whats-the-data-point.jpg" alt="whats the data point" width="600" height="600" /></p> <hr /> <p><strong>What's The [Data] Point? Episode 40</strong><strong> -- 176,000,&nbsp;with Patrick Orecki [You can download What's The [Data] Point? wherever you get your podcasts, including on iTunes]</strong></p> <!--<p><img src="http://www.gothamgazette.com/images/graphics/2018/podcast18/wtdp-w-cbrecher-120.jpg" alt="wtdp w cbrecher 120" width="440" height="120" style="display: block; margin: 10px auto;" /></p>--> <p><img src="http://www.gothamgazette.com/images/graphics/2018/podcast18/patrick-orecki-wtpd.jpg" alt="patrick orecki wtpd" width="158" height="160" style="margin-right: 10px; float: left;" /></p> <p>176,000 is the number of New Yorkers statewide currently enrolled in Medicaid health homes, a key component of the Cuomo administration's Medicaid redesign efforts that have helped rein in costs and a program that provides care coordination services for Medicaid enrollees with complex health care needs to link these individuals to a full spectrum of health care providers and other social supports.</p> <p>Patrick Orecki, CBC’s research associate specializing in the state budget and health policy issues, joins the podcast to break down the significance of health homes, what the program is doing well, challenges it has faced, and where it should go next.</p> <p>Listen to the conversation and let us know what you think: Ben Max of GG (<a href="https://twitter.com/TweetBenMax" target="_blank" rel="noopener noreferrer">@TweetBenMax</a>), Maria Doulis of CBC (<a href="https://twitter.com/MariaDoulis" target="_blank" rel="noopener">@MariaDoulis</a>). Listen below or download wherever you get your podcasts!</p> <p><iframe src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/442666578&amp;color=%23ff5500&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false&amp;show_teaser=true" width="100%" height="170" frameborder="no" scrolling="no"></iframe></p> <p>

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by Ben Max, Gotham Gazette
     

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</p>