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New York Needs a Health Care Watchdog
Tackling health care costs will be a top priority of the new governor. While much has been made about Medicaid fraud, the underlying increases in the state’s Medicaid program are fueled by increases in overall health costs. And those increases are not unique to New York. Health care costs consume a significant portion of the nation’s and state’s domestic budgets. For the last 19 years, health care cost inflation has outpaced inflation in other sectors of the economy – sometimes severalfold. New York state revenues pay for roughly $44 billion in health costs, while private payors spend roughly $83 billion more. Yet there is little, if any, meaningful public oversight of either the quality or efficiency of the health care services in New York state. Too often the debate on health care spending within the state focuses on capping aggregate spending rather than an approach that would focus on using only high-quality, efficiently delivered services. And using high quality health care is important. Substandard medical care not only kills thousands of New Yorkers – it adds costs to the state’s health bill. According to the National Academy of Sciences’ Institute of Medicine, as much as $29 billion in health costs result from medical mistakes – a number that translates into an additional $2 billion in New York. Consumers have long had access to information about the value of a household appliance or automobile, but when it comes to making decisions about health care, consumers and major purchasers of health care have little, if any, reliable comparative information. In order to increase public accountability and to help consumers and employers make wise health care choices, a new, independent health care monitoring entity should be created. The state of Pennsylvania has created such an entity. Pennsylvania created the Health Care Cost Containment Council in 1986 through the combined advocacy of employers, labor and consumer organizations. The Council is an independent state agency responsible for addressing escalating health costs, ensuring the quality of health care, and increasing access for all citizens regardless of ability to pay. The new governor should look to the lessons learned in Pennsylvania and create just such a watchdog here in New York. The race for governor is playing out now. It’s important for the candidates to clearly articulate their visions for how to restrain increasing health care costs. Cutting back on services for the poor is too often the path politicians are willing to travel. Focusing on real reforms – like monitoring the costs of health care as well as its quality – will mean lower costs and better care. A Health Care Cost Containment Council is one important piece of such a comprehensive response. That’s all for now. I’ll be keeping an eye on the Capitol and will talk to you again next week.
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