Restructuring Health Care: Right Sizing vs. "Rights" Sizing

An article in the Metro section of yesterday's New York Times paints a deceptively pleasant picture of a deal between the Pataki and Bush administrations to  provide $1.5 billion in funds to bailout New York's ailing health care system.

What the Times fails to report is that those funds are likely to be used for "acute care rightsizing," a euphemistic term for restructuring health services that will  result in the loss of primary care services in medically underserved areas of NYC - particularly low-income neighborhoods and communities of color.

In New York City, these communities already face a shortage of primary care services, and are at greater risk of contracting "Ambulatory Care Sensitive" (ACS) conditions such as diabetes, heart conditions and asthma (see maps below). 

Primary Care and Poverty		Primary Care and ACS

ACS conditions are easily manageable with proper primary care, yet without that care they can develop into dire medical crises with skyrocketing medical costs for patients and taxpayers.  Treating these conditions before they worsen not only saves lives, but it can save hundreds of millions of dollars in medical costs.   

Right sizing measures like those required in exchange for the Bush Administration's $1.5 billion bailout are likely to exacerbate this problem rather than lessen it.  Instead of focusing on right-sizing strategies that leave patients behind, health care reform should focus on rights sizing - or restructuring the health care system based on community needs.  Access to adequate health care is a basic human right.  Protecting that right will not only save the taxpayers' money, it's also the right thing to do.