The Times Union
By: Raga Justin
New York is about 30 years overdue for a massive health care overhaul, according to a new report
ALBANY — Health policy experts and officials have long bemoaned a state health care system that has among the highest costs in the country as patients face longer wait times and often dismal outcomes.
And New York is about 30 years overdue for a massive health care overhaul, according to a new report published Monday.
The report, from the Community Service Society of New York, highlights what it describes as an increasingly lopsided regulatory environment in the state that has led to more expensive, inequitable and hard-to-access health care.
A push to deregulate New York’s health care system in the 1990s, spearheaded by former Republican Gov. George E. Pataki, had been intended to allow hospitals and insurance plans to negotiate insurance rates more directly without state intervention, a move that officials thought would increase competition and efficiency in the hospital system.
Instead, prices and spending per capita has drastically shot up, said Elisabeth Benjamin, vice president of health initiatives at the Community Service Society.
In 2020, New York spent $14,000 per patient, representing the second-highest rate in the nation. That spending contributes to vastly higher insurance premiums than much of the rest of the country as well: the report found that in 2023, the average family premium paid per employee was over $26,000, tied with Massachusetts at No. 2 in the country. Consumers have seen their individual deductibles increase rapidly as a result.
“If free market system reform was the panacea, we should have gone down to 12th most expensive,” Benjamin said. “But we got worse. I’m not saying we got much worse, but it didn’t get better, which was the whole promise.”
Capital Region residents have also experienced long wait times at area hospitals. A previous Times Union analysis found that emergency room visits to Albany Medical Center Hospital are among the longest in the nation and have grown significantly longer in recent years.
But around 70 percent of visits to emergency rooms could be avoided by better access to primary care providers, according to the report.
Benjamin said the organization has numerous recommendations, including setting up an independent Office of Health Care Affordability, an independent office that would be able to examine and regulate health care pricing transparently. Other states, including California and Oregon, have implemented a similar statewide office, she said.
Benjamin pointed to key legislation that has stalled at state Capitol, including the Fair Pricing Act, which would standardize the price charged
for the same routine service across different sites of care.
The report also points to increased hospital consolidation as a driver of expenses and which decrease New Yorkers’ access to health care, particularly primary care.
A consolidated state health planning body, the Public Health and Health Planning Council, was formed in 2010 to review and approve new health facilities across the state. But the organization is heavily swayed by industry stakeholders, Benjamin said, and tends to approve all mergers between hospitals, which has strengthened a handful of powerful hospital systems, often at the expense of patients.
“We really allow these big behemoths to exist, and then we see these incredibly high prices with outpatient services and a huge number of hospital closures,” Benjamin said. “And it’s happening in places that are disproportionately where people of color live.”
The report comes as state officials have publicly telegraphed their desire to reshape the health care apparatus in New York.
Around 90% of the worker shifts at upstate New York health care facilities are at unsafe staffing levels, according to previous reports, as the state continues to grapple with an overall staffing crisis in the medical sector.
