By Penny Mintz
The changes in store for Beth Israel are temporarily on hold. Mt. Sinai is deferring its application to the Department of Health for a certificate of need, which the state must approve before the changes can be made. According to Arthur Schwartz, who is pursuing a lawsuit against Mt. Sinai and the Department of Health (think David v. Goliath), Mt. Sinai still intends to replace the full-service 600-bed Beth Israel with a 72-bed facility on East 13th Street, but for now the megalithic health-care provider is “re-thinking the massing and design” of the new building.
While Beth Israel changes are taking a breather, action on the New York Health Act is heating up.
The New York Health Act proposes to provide healthcare coverage for all New Yorkers, including long-term care for seniors. It would be funded in part by federal payments now going to Medicaid and Medicare and in part by a progressively graduated income tax imposed on all income, including investment income. For 98% of us New Yorkers, the new tax would be more than offset by health-care costs we now incur in the form of insurance premiums, deductibles, co-pays, and co-insurance. Also eliminated would be out-of-network costs. Nothing, except perhaps an elective facelift, would be out of network (too bad for me).
According to Gerald Friedman, chair of economics at the University of Massachusetts at Amherst, New Yorkers will save over $45 billion by eliminating insurance company profits, eliminating providers’ insurance-related administrative costs, and capturing savings from negotiated drug and medical-device prices.
In a report released on August 1, 2018, the Rand Corporation, a conservative think tank, essentially agreed with Friedman. The Koch brothers-funded Mercatus Institute concluded that a single-payer plan on the federal level would reduce health-care spending by $2 trillion over ten years.
We know why it’s currently a nonstarter on the federal level. But why don’t we have single-payer in the state?
The Health Act has passed in the New York State Assembly year after year. It has never come to the floor for a vote in the Republican-controlled state senate. This year, the state senate is controlled by Democrats, several of whom ran on the issue of single-payer health care. Hopes are high that things will change.
On December 6, 2018, a broad coalition of supporters of the Health Act met on the steps of City Hall and then appeared before the Committee on Health to speak in support of a resolution sponsored by our own council member, Speaker Corey Johnson. The resolution calls on the state legislature and governor to enact the New York Health Act.
On December 11, 2018, an overwhelming majority of City Council members—44 out of 51—voted in favor of the resolution. In opposition were Council Members Joseph Borelli (R., Staten Island), Robert Holden (R., Queens), Kalman Yeger (D., Brooklyn), and Minority Leader Steven Matteo (R., Staten Island). Council Members Chaim Deutsch (D., Brooklyn) and Daneek Miller (D., Queens) abstained.
If the Health Act is enacted, New York City can expect to save $9.4 billion in its share of Medicaid costs.
Hospitals will also benefit. According to State Assembly Member Dick Gottfried, who has led a sometimes lonely campaign for the Health Act since 1992, hospitals get most of their revenue from Medicaid, Medicare, and private payments. According to Gottfried, none of these sources fully cover the cost of care, but “the NY Health Act requires full funding for all hospital care.” Gottfried says that it will also save billions in hospital administrative costs.
So maybe, just maybe, the rush to close hospitals will end if the Health Act is passed.
If only Beth Israel could hold out, any alleged financial rationale for the closure would evaporate.