NYC Mayor deBlasio announces health care for NYC residents

[HumblePi]

[h=1]Mayor de Blasio announces health care for all NYC residents[/h]https://abc7ny.com/politics/mayor-de-blasio-announces-health-care-for-all-nyc-residents/5034167/


NEW YORK (WABC) --
Mayor Bill de Blasio announced Tuesday that New York City is rolling out a $100-million-per-year program to provide health care to all residents, including undocumented immigrants.

The new program, NYC Care, will ensure health care for the estimated 600,000 people without health insurance in the city.

The mayor said he believes too many city residents turn to hospital emergency rooms for health care. Instead, NYC Care is intended to connect these New Yorkers with primary-care doctors, specialty care, mental health services and prescription drugs.

Health care will be guaranteed to all residents, regardless of someone's ability to pay or immigration status.

Patients will be charged on a sliding scale, with the poorest New Yorkers paying nothing.

 

[eohrnberger]

For those who are challenged by division: $100,000,000 (budget) 600,000 (people) that's a mere $166.67 / person / year.

So how much medical care are you going to get for $160 / year?

Everyone will claim to be poor and refuse to pay.
Quality of services rendered will go into the toilet, it'll be medical care of the last resort.

 

[Nemiroff]

For those who are challenged by division: $100,000,000 (budget) 600,000 (people) that's a mere $166.67 / person / year.

So how much medical care are you going to get for $160 / year?

Everyone will claim to be poor and refuse to pay.
Quality of services rendered will go into the toilet, it'll be medical care of the last resort.

Everyone cant claim to be poor, that has a paper trail....

Also, the city will save a ton by not subsidizing uninsured ER visits.

 

[jaeger19]

For those who are challenged by division: $100,000,000 (budget) 600,000 (people) that's a mere $166.67 / person / year.

So how much medical care are you going to get for $160 / year?

Everyone will claim to be poor and refuse to pay.
Quality of services rendered will go into the toilet, it'll be medical care of the last resort.

Hmmm.. as opposed to what? I don't think you get insurance. Right now.. those people are still using services.. just the most inefficient way.. i.e the emergency room.

Second.. not all of those 600,000 people will be using the insurance. Only a small portion of those folks will be using it. and if it prevents them from using say the emergency room.. it could save millions.

 

[eohrnberger]

Hmmm.. as opposed to what? I don't think you get insurance. Right now.. those people are still using services.. just the most inefficient way.. i.e the emergency room.

Second.. not all of those 600,000 people will be using the insurance. Only a small portion of those folks will be using it. and if it prevents them from using say the emergency room.. it could save millions.

Everyone cant claim to be poor, that has a paper trail....

Also, the city will save a ton by not subsidizing uninsured ER visits.

Or probably not.

Will Medicaid expansion save the country money as people stop using expensive emergency rooms for primary care?

Not yet, suggest the latest findings from a landmark study published online Wednesday in the New England Journal of Medicine.

The study of Medicaid patients in Oregon who got Medicaid in 2008 found their ER use stayed high two years after they gained the health insurance coverage — even as they also increased their visits to doctors' offices.

All eyes have been on Oregon to answer this question about ER use because, eight years ago, the state tried an experiment. It wanted to expand Medicaid, but it didn't have the money to cover every eligible resident.
https://www.npr.org/sections/health...-room-use-stays-high-in-oregon-medicaid-study

 

[Greenbeard]

Or probably not.

Coverage expansions that expand access to primary care do tend to be associated with reductions in ER visits. Healthy San Francisco, which presumably is the inspiration for NYC Care since it's the same model of a municipal heath program linking people to primary care clinics, saw ER visits fall after its implementation in 2007. For that matter, so did Oregon after its 2012 Medicaid reforms ("Oregonians use ER less, docs more after Medicaid expansion").

 

[eohrnberger]

Coverage expansions that expand access to primary care do tend to be associated with reductions in ER visits. Healthy San Francisco, which presumably is the inspiration for NYC Care since it's the same model of a municipal heath program linking people to primary care clinics, saw ER visits fall after its implementation in 2007. For that matter, so did Oregon after its 2012 Medicaid reforms ("Oregonians use ER less, docs more after Medicaid expansion").

I think at best the data from the results is conflicted and inconsistent, as the Oregon study I cited showed the opposite after 2 studies, I believe. :shrug:

 

[marke]

[h=1]Mayor de Blasio announces health care for all NYC residents[/h]https://abc7ny.com/politics/mayor-de-blasio-announces-health-care-for-all-nyc-residents/5034167/


NEW YORK (WABC) --
Mayor Bill de Blasio announced Tuesday that New York City is rolling out a $100-million-per-year program to provide health care to all residents, including undocumented immigrants.

The new program, NYC Care, will ensure health care for the estimated 600,000 people without health insurance in the city.

The mayor said he believes too many city residents turn to hospital emergency rooms for health care. Instead, NYC Care is intended to connect these New Yorkers with primary-care doctors, specialty care, mental health services and prescription drugs.

Health care will be guaranteed to all residents, regardless of someone's ability to pay or immigration status.

Patients will be charged on a sliding scale, with the poorest New Yorkers paying nothing.

Might work. That is only just above $150 per year per illegal patient. He must mean by "sliding scale" that legal Americans with jobs will be paying much, much more to help defray the obvious imbalance in costs. Good old Bill. Always has an eye out to help criminals, illegals, drug addicts, alcoholics, mentally deranged and others at the ever increasing cost of high taxation of anyone still working in the state.

 

[Nemiroff]

Or probably not.

No duh. This is healthcare not magic. The people we already failed are now having their kidneys and hearts fail. Giving them coverage now wont save them, but it will save the next generations and the costs associated with them. Its an investment and to think it will have immediate effects on people with end stage disease is seriously wishful thinking.

Do you think we should continue this cycle of people not getting treatment until the collapse and we cover their emergency bills? Or should we pay for some cheap blood pressure pills and keep people working longer, stronger?

 

[jaeger19]

I think at best the data from the results is conflicted and inconsistent, as the Oregon study I cited showed the opposite after 2 studies, I believe. :shrug:

No.. the data from the results is conflicted and inconsistent. Different programs have different results. So do different populations. If you suddenly start covering people that are so far gone medically, you will reduce perhaps their overall costs.. but not the number of ER visits.

If you start covering people who aren;t that ill "yet".. and prevent them from being ill.. you are going to have better results in reducing ER visits.

By the way.. ER visits are not necessarily the best way to judge the costs. it would also be needed to see if that ER visit ended up with someone being admitted to the hospital and the associated costs. The reasons is.. is that there is a social component with people that don't have health insurance.

For example... I have had patients who are in the habit of going to the ER whenever they get the slightest thing. And that's because 1. They developed that habit when they did not have insurance..
2. they feel that the hospital will give them the best care.... and they do not trust their general practitioner as much because they think that person is trying to simply keep costs down.. and that patients with "good insurance".. would be going to the hospital.

 

[jaeger19]

No duh. This is healthcare not magic. The people we already failed are now having their kidneys and hearts fail. Giving them coverage now wont save them, but it will save the next generations and the costs associated with them. Its an investment and to think it will have immediate effects on people with end stage disease is seriously wishful thinking.

Do you think we should continue this cycle of people not getting treatment until the collapse and we cover their emergency bills? Or should we pay for some cheap blood pressure pills and keep people working longer, stronger?

Problem is.. it isn't just about getting coverage but actually getting preventative medicine.. which frankly.. still eludes most Medicaid programs, the VA and most private insurance plans.

For example in Oregon.. Medicaid in 2008 and before.. pretty much did not pay for preventative medicine. Patients would still go the ER because thing like therapy.. which is a huge preventative was difficult to access. Its much better now.. but its still a bugger. I have a patient right now.. that I had to argue with Medicaid about (actually with Moda.. the entity that's put into place to administer some of the Medicaid). this patient hurt their arm and hand weeks ago.. and has a ulnar nerve injury, tendon issues.. and some bone contusion. I have wanted her in therapy for more than a month because she is not using her hand and its getting worse. She started therapy but she was only allowed 4 visits. In those 4 visits the therapists got amazing improvement and she needs to continue.. but..
I had to spend 45 minutes of my time yelling out potential diagnosis codes that could possibly fit her .. and qualify her for more visits. Stupid.

 

[eohrnberger]

No duh. This is healthcare not magic. The people we already failed are now having their kidneys and hearts fail. Giving them coverage now wont save them, but it will save the next generations and the costs associated with them. Its an investment and to think it will have immediate effects on people with end stage disease is seriously wishful thinking.

Do you think we should continue this cycle of people not getting treatment until the collapse and we cover their emergency bills? Or should we pay for some cheap blood pressure pills and keep people working longer, stronger?

The idea situation, given the history of health-care coverage, when it was started, by whom and why - which can't be ignored, would be for each person to be able to take care of themselves, by having a job that has health-care as an employee benefit in a free and open market.

A free and open market that is now finally gaining access to treatment / procedure cost information form hospitals providing the treatment / procedure, at least a step in the right direction.

Hospital Prices: Full Cost Lists Must Be Published From January 1 ...
[url]https://www.newsweek.com/end-hidden-costs-january-1st-all-us-hospitals-must-publis...[/URL]
Dec 27, 2018 - Currently, under the Affordable Care Act, hospitals must release public price lists, but from the start of 2019 they will be required to post these ...
​

Another step in the right direction is to open competition for drug prices.

Trump's New Medicare Rule To Reduce Prescription Drug Prices ...
[url]https://www.forbes.com/.../trumps-new-medicare-rule-to-reduce-prescription-drug-pri...[/URL]
Aug 7, 2018 - Trump's New Medicare Rule To Reduce Prescription Drug Prices Through ... to deal with advances in medical and pharmaceutical technology.
​

But that future, where everyone has a good job with benefits, is placed in jeopardy as the continued torrent of low knowledge, low skill workforce being allowed across, and encouraged, to illegally cross the border, with congress sitting on their hands ignoring the problem, as they have for some 40 years.

Of course there's the left's utopia and unicorns, where a kind and benevolent (rather than demonstrated irresponsible and power abusing) government smiles down at his children and takes care of then, provided, of course, that those children fork over some 50% - 70% (or more) of their income.

If you want to see what government run, single pay health-care, Medicare for all looks like, just look at the abject failures of the VA. Government run, single pay health-care, Medicare for all would inflict the same on everyone, and create a booming market for insurance and care separating themselves from from the government system, creating a two-tiered health-care system (unless, of course, the government monopoly outlaws competition - since when have monopolies delivered a good product or service at a competitive price? Never! - The same will be for this)

More government confiscation means more control (and a loss of liberty for the individual) and it also just mean the government screws it up more and makes it all worse. Remove government market distortions, and let the free market sort it out, this will be far more efficient and far more effective. This is what the history of government performance has taught us all.