Dangerous and Unlawful

As some of our readers may know, today is a big day for the New York State Health Care System.  The Commission on Health Care Facilities in the 21st Century (aka the Berger Commission) released their recommendations on "right sizing" the New York State Hospital System.  The commission recommended closing 9 hospitals - 5 of which are in New York City.  While the practical effects of the commission's recommendations must still be determined,  many advocates feared a much worse outcome - particularly for hospitals in underserved neighborhoods in Queens and Brooklyn. 

But that silver lining shouldn't hide the exceedingly gray clouds that surround New York's Health Care System.

In response to today's recommendations by the Berger Commission, The Opportunity Agenda has released the following resources to paint a picture of the state of New York's health care system:

• Listen to our morning press briefing
• Read our report: Dangerous and Unlawful - Why our Health Care System Fails New York Communities and How to Fix It
• Read our Fact Sheets
• Read our Public Opinion Poll

Primary Care

• In 2001, an estimated 1.8 million New York State residents were designated by the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) as living in medically underserved communities.
• Nearly 3.6 million people in New York State lived in Health Professional Shortage Areas in 2001.  Between 2001 and 2005, the number increased by an estimated 13.23 percent.  (The federal government defines a shortage area as less than one primary care physician per 3,500 people, and less then one per 3,000 people in high-need areas.)
• Almost60% of New York City’s zip codes have an inadequate supply of primary care physicians who are willing to see Medicaid patients.
• Nearly one in four New York City residents do not have a regular doctor.  More than half a million New York City residents reported needing but not receiving medical care in a twelve month period in 2002-2003.

Maternal Health Care

• The availability of obstetric and gynecologic (OB/GYN) physicians varies considerably across New York City’s five boroughs.  On average, low-income communities and communities of color have the fewest OB/GYN providers.
• Women in neighborhoods that have the lowest density of OB/GYN providers often have the highest rates of receiving late or no prenatal care.
• New York’s low-income communities and communities of color have a high percentage of babies born with low birth weight.  While low birth weight is caused by many complex factors, access to good prenatal care and hospital-based delivery services can improve health outcomes of low-birth weight children.
• The current state of care jeopardizes the health of New York mothers and their children, and violates the law.  Moreover, any downsizing, closures, or service changes that further diminish prenatal or postnatal care will compound those violations and further threaten New Yorkers’ health.

Equal Opportunity in Health Care

• In New York City, areas with high concentrations of African Americans, Latinos, and Asian Americans are most likely to have serious shortages of primary care physicians.
• Hospital closures and downsizing in New York City have disproportionately affected communities of color.  Two-thirds of the 12 hospitals that closed between 1995 and 2005 in New York City – each time with the approval of New York State’s Department of Health –served predominantly people of color.  In some cases, the patient populations served by those hospitals were more than 90% African American, Latino, and Asian American.

Solutions

Public Opinion polling conducted by The Opportunity Agenda shows that New Yorkers - across the state - reject a health care system that fails to provide for those most in need.  75% of those surveyed held the State responsible for ensuring that racial or ethnic minorities and low-income New Yorkers have an equal chance to access health care as wealthy people. An overwhelming number of New Yorkers believe that all levels of government – local, state, and federal – are responsible for ensuring that everyone in New York gets the health care they need.

New York's health care system may be in crisis, but closing hospitals is not the answer: 

• In New York State alone, federal and state government could save hundreds of millions of tax dollars if it ensured adequate primary care for all New Yorkers.  New York City’s Health and Hospitals Corporation, which runs the city’s public hospitals, has seen the wisdom of this approach.  It has assigned some 240,000 uninsured patients to personal primary care doctors, enabling them to get check-ups and preventative care.  As HHC President Alan Aviles told the New York Times:  “For most preventative efforts there is an upfront expense,” but “over the long term it saves money.”  New York State can and should follow that example.
• A relatively small investment in prenatal care and maternal health can also save the State millions of dollars.  As Ms. Ngozi Moses of the Brooklyn Perinatal Network explains, the average cost of medical and follow up care for a healthy normal weight baby is $6,500.  Ms. Moses stresses that “[i]f you don’t get care and you end up with a premature baby or a low birth-weight baby, or if the mother has risk factors, costs start at about $90,000.  For a very low birth-weight baby, that doubles to $180,000.”  Ms. Moses explains that “[p]reventing the birth of two low birth-weight babies can fund a $180,000 health promotion program that will provide more than 50 at-risk pregnant women with intervention to reduce their risk of bearing low birth-weight babies.”

For more solutions to this problem, and information about Health Care Equity and Health Disparities in New York, check out these resources:

• Read our report: Dangerous and Unlawful - Why our Health Care System Fails New York Communities and How to Fix It
• New York Health Equity Fact Sheets
• New York State Public Opinion Poll - Health Care