ES2 Economic Security Campaign

AFFORDABLE AND COMPREHENSIVE UNIVERSAL HEALTH CARE COVERAGE
Empire State Economic Security Campaign

The Challenge
The rising cost of health care is a major concern for all segments of New York. Inadequate coverage, even among persons who are insured, has become a major cause of personal bankruptcies. Medicaid expenditures now represent (if we include the federal share) almost half of the state budget.

The huge numbers of New Yorkers without health insurance—almost one in three in a twelve-month period—are a major factor in our health care costs and in the financial problems facing many hospitals. High health care costs are a major reason in why we have such high auto insurance and worker comp rates in our state. Rising health care costs are a major burden on all employers and are increasingly the main reason for labor-management disputes.

While the United States has very skilled health providers, our health care system performs poorly, with its overall quality only ranked 37th by the World Health Organization. The US spends an annual $6,102 per person -- more than any other country and more than twice the average of $2,571. This amounts to a whopping 15.5% of our GNP on health care – far more than any other country – which puts our businesses at a competitive disadvantage in the international marketplace. Increases in health care costs thwart job growth, suppress increases for current workers, weaken the viability of pension funds, and depress the quality of jobs. Rising health care costs are also causing budgetary problems for federal and state governments, who are currently paying over 50% of the U.S. health care bill.

Despite having some of the best medical professionals, hospitals and equipment in the world, the U.S lags behind many other countries on basic public health indicators such as life expectancy and infant mortality rates.

In 2007, state lawmakers agreed to our proposal to fund a series of cost-benefit studies on the various ways New York could provide health care to all. A single payer system will be one of the approaches studied. Governor Spitzer subsequently appointed a Task Force to oversee the studies, hold public hearings and develop a recommendation for a universal health care system by May 2008. Assemblymember Gottfried has also developed a proposal to expand Family Health Plus into a universal health care system that is worthy of support and study.

What the Public Thinks
Public opinion polls have consistently shown strong public support for a universal health care system. For instance, a March 2007 poll by CBS/ NY Times found that 64 percent of the respondents said the government should guarantee health insurance for all; 27 percent said it should not. An overwhelming majority in the poll said the health care system needed fundamental change or total reorganization.

ES2 Policy Recommendations
ES2 supports a universal health care system to provide quality, comprehensive health care service to all New Yorkers. The most common sense solution is a single payer financing system, similar to Medicare for All. (A7354/S3107) This system, used by almost all of the other industrial countries, eliminates the huge waste and paperwork of the private health insurance system. Private insurance uses up as much as thirty cents per dollar; Medicare’s administrative costs in comparison are 3%. The thousands of insurance companies and their dueling forms and coverage criteria force doctors on average to hire 2.5 staff people just to deal with the paperwork, further driving up costs. Nationally, it is estimated that a single payer system would save over $200 billion annually. A recent study found that a state single payer system just in California would save $30 billion annually.

We applaud the State Legislature for agreeing last year to add $200,000 to fund a series of health care studies on how New York can most cost-effectively provide quality health care to all New Yorkers. It is important that the Legislature ensures that the study process is open and transparent. Whatever universal health care system that is adopted by New York should lower rather than increase costs; this starts with reducing administrative overhead to less than 10%. Patients’ care, not profits, should be the focus of our health care system. The health care system should be paid for in an equitable way: those with higher incomes should pay a higher proportion of their incomes than those with less. We define universal health care coverage to mean that 100% of residents are covered; requiring even modest premiums and co-pays will prevent many moderate income families from accessing health care.

The 2008-2009 Session

We support the Governor’s efforts to make the delivery of health care to patients the primary focus of state spending. We support the Governor’s efforts to place greater priority – and funding – into primary care, including the Doctors Across New York initiative, to attract more doctors and other health care providers to underserved areas. We support the Governor’s proposal for the state to pick up the federal share for expanding Child Health Plus coverage to 400% of poverty

ES2 endorses the positions of Medicaid Matters NY

We support the Governor’s proposal to establish a new enrollment portal permitting the State to directly enroll and renew individuals in Medicaid. We support the proposal to “modernize” the Medicaid utilization threshold program, which presently places an undue limit on the number of services a Medicaid recipient may receive in a year. We support the Governor’s proposal to it easier for consumers to access the Medicaid program, including:

eliminating the asset test for those eligible for the Medicare Savings Program, contingent on Federal approval;
aligning the Medicaid and Family Health Plus resource tests;
eliminating drug and alcohol screening as a condition of eligibility;
aligning Medicaid eligibility levels for single adults and childless couples, and eliminating varying county-by-county standards;
expanding Medicaid coverage for children formerly in foster care from age 18 to age 21; and,
eliminating the need for reapplication for Medicaid or Family Health Plus when moving from one county to another.

There are further reforms that we hope the legislature will adopt. We support the establishment of a state-wide network of consumer assistance/navigation so that people are not only provided a Medicaid card, but are also provided with consumer-friendly assistance so they can actually figure out how to use the services they need. We support eliminating the requirement of a face-to-face interview as part of the Medicaid application process. The state should allow “passive” renewal on a biannual basis where individuals simply have to sign a postcard that indicates that nothing has materially changed in their conditions regarding eligibility for Medicaid. A full renewal review would be conducted on the alternate years.

Reduce Insurance Administrative Costs and Profits. Private insurance has an extremely negative impact upon health care costs and delivery of services. As a short-term step, New York should require prior approval of insurance premium increases. State laws and regulations governing care-share (hitherto called “medical loss ratio” in statute and regulations) need to be strengthened and enforced.

Ban Gifts to Physicians by Drug Companies. Gifts by the pharmaceutical industry are distorting medical decision making and raising costs by giving preference to medicines that may be quite expensive. State legislation in Minnesota has prohibited such gifts over the value of $50.

Expand Bulk Purchasing of Prescription drugs. We support the Governor’s efforts to reduce the cost of prescription drugs, including giving the DOH Commissioner authority to negotiate with other states on bulk purchasing. We support the proposed initiative to create new EPIC Discount Card Program for financially vulnerable persons of any age. We are disappointed however that the Governor failed to change the rules for the state’s elderly pharmaceutical assistance program (EPIC) to allow New Yorkers with severe disabilities that receive SSI and meet the program’s income requirements to participate.

Children Environmental Health Centers. $2.05 Million in funding is needed for the Centers. To stem the tide of the chronic disease epidemic in our children, New York should establish a statewide, regionalized children’s environmental health system of four to six centers of excellence. While childhood diseases of environmental origin cost Americans $54.9 billion annually, the startup cost for the centers is less than .01% of the environmentally attributable costs. Chronic diseases among children include asthma, lead poisoning, obesity, cancer, birth defects, injury, mental disability, autism and ADHD, behavioral, learning and psychiatric disorders. At least 28% of developmental disabilities in children are due at least in part to environmental causes. The Centers would help health care providers reduce children’s exposures to environmental hazards through education of parents, identification of hazardous exposures, diagnosis and treatment of children, and advocating for prevention.