Hochul’s agenda mostly ignores health care

Hochul gave health care surprisingly little attention in her state of the state address on Tuesday — a sign that dealing with the dysfunction in a sixth of the state’s economy ranks low on her list of priorities.

I suggested expansion and improvement Services for the mentally illincluding opening thousands of beds in psychiatric hospitals and group homes, as part of a larger effort to reduce homelessness and improve public safety.

But she Annual address He made no mention of issues that seem urgent in the broader health system – eg Understaffing And Work disordersallegations Negligence and fraud in nursing homesrepercussions of a massive pandemic, Unaffordable health premiumsAnd Low quality hospital careAnd Medicaid costs escalate.

In fact, her speech didn’t include the word “Medicaid,” even though it’s one of the state’s largest programs and covers one in three New Yorkers.

Almost all of its healthcare agenda has been neglected book copy of her letter to the legislature, amounting to only 30 of the 276 pages.

Some of those health-related suggestions seemed routine or half-baked. The section titled “Strengthening New York’s Public Health Emergency Preparedness Capacity” consisted of an unspecified promise that “the Department of Health will allocate additional personnel resources” for planning, training and stockpiling.

The section on improving long-term care included a vague proposal to “invest in care teams to provide care for low-income adults in their own homes, helping to ensure that New Yorkers grow old.” This is something New York already spends billions doing – in proportion more than any other country.

Notably absent from the book is any discussion Big changes Coming to Medicaid nationwide. Starting April 1, the federal government will begin phasing out additional aid payments it made to states during the pandemic, which amounted to about $3.5 billion a year in New York.

That date also marks the end of the “continued coverage” requirement, which suspended normal eligibility checks to enroll in Medicaid — leaving millions of people on the list who wouldn’t otherwise qualify. Many are thought to qualify for employer-sponsored health benefits — and may be enrolled in those plans — even as the state pays monthly premiums for Medicaid coverage they don’t need.

Federal policy calls for states to gradually reduce these enrollees from their Medicaid plans over the next year, which would be a big undertaking. In New York alone, Medicaid listings are expected to shrink by a million or more.

Neither the loss of assistance nor the looming pressures on the health department’s registration infrastructure are discussed in the governor’s letter.

Here is a summary of some of Hochul’s most important proposals:

organizational reform. Hochul has advocated easing or reforming various regulatory constraints on the health care system that tend to restrict the availability of services, reduce consumer choice and increase costs.

One such proposal would relax “scope of practice” limits on professional licensing, allowing nurses, pharmacists, and other trained professionals to take on certain tasks currently handled only by physicians. Hochul has also advocated joining interstate licensing agreements so that professionals who relocate can play sports more easily in New York.

The second proposal would streamline the process of reviewing the Certificate of Need at the Ministry of Health, facilitating the establishment or expansion of health facilities such as hospitals, nursing homes and clinics.

Cigarette tax hike. Hochul wants to increase the state tax on cigarettes by $1 per pack, to $5.35, which she said would discourage young people from smoking.

How much difference this will make is debatable. New york already charges one of The highest fees of this state In the country – second only to the District of Columbia.

The amount of money this tax collected steadily declining, from $1.5 billion in 2010 — when the tax was raised to its current rate of $4.35 per can — to $900 million last year. This is partly due to Low rates of smokingbut also because widespread tax evasion. New York is estimated to be the largest importer of black market cigarettes, which generates significant profits for organized crime and street gangs. Increasing other taxes would further fuel this illegal activity.

Data collection. The nation’s response to the coronavirus pandemic has often been hampered by a lack of timely, accurate data. In New York, officials effectively designed a collection system from scratch after the outbreak began, imposing additional paperwork on hospitals and nursing homes that were in the midst of a crisis.

Hochul proposes a modern data collection system that would integrate with service providers’ existing information technology. This would theoretically simplify the reporting process and potentially allow officials to detect early signs of a new outbreak.

Such a system would require the adoption of standardized electronic medical records, which could be useful in other ways. If privacy can be guaranteed, this is worth exploring as an important upgrade to New York’s public health defences.

Capital financing. Hochul proposed that additional funds be allocated from the state for construction projects, equipment upgrades, and other capital purposes for state hospitals, nursing homes, and other service providers.

It is not clear if this is necessary. Since 2014, lawmakers have agreed $5.4 billion in health capital funding, including $1.6 billion in last year’s budget. As of April 2022, nearly two-thirds of that money has not been spent.

Lawmakers also failed to properly identify who qualifies for funding, resulting in apparent waste and corruption. in One notorious caseInc., a company that gave to Governor Cuomo’s campaign account received $25 million in state money to support medical office buildings that could easily have been built with private money.

Reform Committee. Acknowledging the many shortcomings of the state’s health care system — including some of the lowest quality scores in the country for hospitals and the longest waiting times in emergency rooms — Hochul said she intends to create a commission that would “change how care is paid for and delivered.”

One of its goals will be to “establish a nation-wide public health disease response and surveillance system” – an urgent need for this Hochul was slow to process.

However, as described, the description of the commission’s mandate consists of platitudes and buzzwords, such as “to lead a comprehensive, data-driven view of the state’s healthcare delivery system” and “to develop and develop a comprehensive, evidence-based strategy and roadmap for system change.”

Given this ambiguous language—and the fact that Hochul did not see fit to mention the committee in her speech—it is difficult to know how seriously this idea should be taken.

Hochul is due to present an official budget proposal in the coming weeks. In that document, she has no choice but to address Medicaid clearlyIt represents nearly $30 billion in government spending. She must also provide specific details of any other proposals she intends to be approved by the legislature as part of the budget process.

That will give New Yorkers a clearer view of whether their governor has a real agenda for the healthcare system, or just intends to continue with the status quo.

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