MAYOR DE BLASIO

MAYOR DE BLASIO: Can do it cheaper and better.

The municipal hospital system has prided itself on providing health care to anyone who was sick, regardless of their immigration status or ability to pay. Now, Mayor de Blasio has pledged to expand that commitment to give everyone in the city access to a primary care physician before they become ill.

The program will also provide mental-health services.

Who’s Covered

Mr. de Blasio is committing $100 million to the initial rollout of the NYC Care initiative, which aims to eventually offer primary-care access to an estimated 600,000 New Yorkers who are either not enrolled currently in any health-care plan or are ineligible for insurance coverage because of their immigration status. (Undocumented adults were expressly prohibited by Congress from coverage under President Obama’s Affordable Care Act.)

The Mayor, who has been widely reported as having a desire to be a national public-policy player, used an appearance on MSNBC’s “Morning Joe” to announce the new health-care initiative.

“We’re already paying an exorbitant amount to provide health care the wrong way and to wait until people are really sick, you know, to wait until kids, to wait until seniors are really sick and end up in that emergency room when what we should be doing is helping them get the primary care,” Mr. de Blasio told the national audience. “This plan will literally say, here’s a primary care doctor, here’s a person you can see is now going to be your doctor on a regular basis, and if you need something else, especially service, here’s how you get it.”

Later at Lincoln Hospital for the formal announcement of the initiative, the Mayor called health care “a right, not a privilege reserved for those who can afford it.” He said that “while the Federal Government works to gut health care for millions of Americans, New York City is leading the way by guaranteeing that every New Yorker has access to quality, comprehensive access to care, regardless of immigration status or their ability to pay.”

DC 37 Applauds

Henry Garrido, executive director of Council District 37, which represents most of the H+H workforce, praised the initiative.

“At a time when hundreds of thousands of city residents cannot access the care they need because of underfunding and uncertainty in Washington, D.C., the Mayor’s plan puts NYC Health + Hospitals and its tens of thousands of dedicated public health workers, including over 18,000 DC 37 members, on the cutting edge of comprehensive health-care delivery,” he said in a statement.

The de Blasio administration’s commitment to expand primary care to the uninsured comes at a time when, under the leadership of Dr. Mitchell Katz, H+H has significantly improved its financial position from just over a year ago when the system, with an annual $8-billion budget, was struggling to make payroll.

Last October NYC H+H reported that its decision to be more aggressive in challenging health-insurance companies’ rejections of patient claims resulted in the municipal system closing Fiscal Year 2018 $150 million ahead of its projections for patient-generated revenue, according to Dr. Katz.

Major Turnaround

On a follow-up press call on the NYC Cares rollout on Jan. 8, city Budget Director Melanie Hartzog told reporters that the hospital system’s finances had markedly improved. As a consequence, she said H+H was ending the year with a $736-million cash balance, after averaging a balance of $120 million in the recent past. The improvement stemmed partly from $350 million in savings produced first by ex-Interim CEO Stanley Brezenoff and expanded upon by Dr. Katz.

James Parrott, director of economic and fiscal policy for the Center for New York City Affairs at the New School, said in a phone interview that the Mayor’s announcement was a “positive and worthwhile aspiration” but that he was concerned the $100 million initially committed by Mr. de Blasio, when divided over 600,000 potential participants, would come up short.

“Granted, that includes a lot of young people” for whom primary care is unlikely to be expensive, but it could be insufficient to cover the needs of older patients with chronic health issues, he said.

The Mayor’s announcement did not come in a vacuum.

Many of the newly elected Democrats in Congress from across the country ran on a platform that included “Medicare For All.” In Albany, longtime advocates for a single-payer system, who for years hit a roadblock with the Republican-controlled Senate, are optimistic that Democrats gaining a large majority in the upper house bodes well for their proposal.

George Arzt, a veteran political consultant who served as Mayor Ed Koch’s press secretary, said that he didn’t see much difference between the Mayor’s NYC Care plan and the city’s long tradition of extending free medical care to anyone who needed it.

“This is going to get play on the wires, the broadcast outlets and the newspapers,” he said. “We have to wait for the health-care experts to see whether or not this is a solid program.”


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