URBAN AGENDA: Giving Patients A Voice in the Health Care Policy Debate

David R. Jones, Esq., President and CEO of the Community Service Society of New York | 5/2/2019, midnight
Everyone should have health insurance. We all know this, yet thousands of New Yorkers simply can’t afford it.
David R. Jones Contributed

Everyone should have health insurance. We all know this, yet thousands of New Yorkers simply can’t afford it. And, as a result, uninsured New Yorkers avoid seeking health care, making it more expensive when they do. For those of us fortunate to have health insurance, we are often surprised by the parade of incomprehensible medical bills and statements we receive.

Despite good news about jobs and national economic growth, fear of a major health event has become an economic reality for both low-income and middle-class New York families. Health care costs can wreck a family’s finances. Yet government policymakers rarely are willing to address rising health costs in a significant way.

A recent survey by Altarum’s Healthcare Value Hub in partnership with the Community Service Society (CSS) – shows how the health care affordability crisis is playing out in the marketplace and highlights the crisis: more than half (52 percent) of adults in New York State experienced health care affordability burdens this past year, with the problem being even more dire for New York City residents, who face higher costs of living.

Worse still, the survey shows that more than three quarters (76 percent) of New York State residents worried about future care costs. A closer look reveals that a full 82 percent of lower-income New York households (earning less than $50,000 a year) face these worries. So do 67 percent of households earning more than $100,000. The survey also found that 62 percent of New York residents most frequently cited health care as the top issue government must address, far above taxes (43 percent) and the economy (39 percent).

One measure of the high cost of health care is how much consumers pay in premiums. New York has among the highest premiums for employer-sponsored coverage, ranked third behind only Alaska and Wyoming. The average premium for a family plan in New York costs more than $21,000 a year. For an individual plan, the premium is more than $7,300, according to an analysis by the New York State Health Foundation (NYSHealth). Today, health care costs consume nearly eight percent of all household income in the state.

Clearly, addressing the health care affordability crisis should be a priority. But a big problem in coming up with patient-centered solutions for the health care dilemma is that patients are often missing from the conversation on how we make the system more affordable and more responsive to their needs.

A Rigged System

Over the years health care delivery has morphed into a margin-driven enterprise in which everyone feeds at the trough – hospitals, doctors, insurers and pharmaceutical manufacturers – while patients get stuck with the bill. And that bill is going up.

It’s a rigged system, and patients are fed up. How do we know? Because CSS and our community-based partners assist more than 120,000 New Yorkers every year with their health care problems. We help New Yorkers enroll in health coverage, address post-enrollment needs and navigate the complex health care system issues.

Based on our unique relationship with patients and drawing on the work of people such as best-selling author Dr. Elisabeth Rosenthal and former Consumers Union President Jim Guest, we had an idea: unleash the on-line and in-person power of patients to make change.