Inspired by Massachusetts groundbreaking universal health insurance plan, key organizations in New York have begun to separately conceptualize their own plans.
Both the Blueprint for Universal Health Insurance Coverage in New York, a project conducted jointly by the United Hospital Fund and the Commonwealth Fund, and the Cover New York proposal submitted by the Greater New York Hospital Association to the state Legislature last month arrived as sweeping recommendations for revamping the states fragile hospital system were to become law on Jan. 1 (Dec. 4, 2006, p. 6). But while the Blueprint calls for a shared commitment from the state and federal governments, employers and individuals, the GNYHA proposal insists that the states health insurers also contribute to the costs.
GNYHA strongly believes that hospitals and nursing homes have contributed heavily (and painfully) to the effort to reform healthcare in New York, said Brian Conway, a GNYHA spokesman, in an e-mail. It is now time for the health plans, which have over $4 billion in unnecessary, built-up reserves, to step up to the plate and contribute to the reform effort.
The health plans argue, however, that they already pay more than $2.5 billion annually in health insurance premium taxes. The money supports bad debt and charity, graduate medical education, and a huge slush fund that pays for everything from lead poisoning prevention to healthcare restructuring to discretionary grants, said Paul Macielak, president and chief executive officer of the New York Health Plan Association. That money could be better directed to health insurance coverage instead of all these extraneous purposes, Macielak said.
The Blueprintthe result of months of research, including a modeling of estimated costs and the coverage impacts of a range of scenariosestimated that the cost of expanded coverage for the 2.8 million uninsured New Yorkers, or 15% of the states population, at $4.1 billion, representing only 2.5% of the $156 billion spent annually on healthcare in New York, said Robert de Luna, a United Hospital Fund spokesman. The Blueprint also found that simplifying and expanding public health programs would produce a one-third cut, leaving 2 million uninsured New Yorkers.
The Blueprint in fact borrowed many of the concepts from Cover New York, which was originally proposed in early 2006 and developed by the GNYHA and 1199 Service Employees International Union United Healthcare Workers East, Conway noted. Like the Cover New York proposal, the Blueprint calls for an expansion of public programs, the need for corporate responsibility, and also individual responsibilityonce, of course, insurance is affordable, he said. But the hospital association departs from the Blueprint on the issue of uncompensated care, voicing concern that the Blueprint appears to imply that hospital funding for uncompensated care could be withdrawn as the uninsured rates decline.
De Luna noted that the Blueprint was meant only as a starting point for a discussion. There has been so much talk that Massachusetts can (implement universal health insurance) but New York cannot because of all the factors that make New York more complicated, he said. This modeling can get us beyond that initial query and show that it is very possible.