The latest buzzterm in New York healthcare is "health homes". You might not have heard of this yet, and although currently geared toward the Medicaid community exclusively, within five to ten years this will likely be the model for all healthcare plans - including Medicare (although, it is worth noting, these are in 'government years'). As someone involved on the periphery of this new way of confusing healthcare, I can tell you it promises to be quite the accomplishment...for what value governmental promises carry.
Before discussing the clusterfluff that has been the attempt to manage and implement this massive endeaver across FOUR gubernatorial administrations (in six years, no less!), in this posting I will describe the background that led to this attempt at a solution (and, no, 'obamacare' does not have anything to do with this).
The year is 2006; gasoline is under $3/gallon, the unemployment rate has dropped to under 5%, and the Dow Jones is steadily rising toward its highest point ever (October 9, 2007 - I know, during the Bush Administration...). Also, in New York State, a Commission on Health Care Facilities in the 21st Century is about to release a report...the now infamous 'Berger Commission' report.
Now, you may say to yourself, "gasoline is cheap (at least in hindsight), unemployment is at 4%, the stock market is doing well - times are good, jobs are secure, and a grand time is to be had by all", right? WRONG. Despite the 'shock and awe' that was the financial collapse at the end of 2008, at least in New York State government, the writing was on the wall, and significant advance preparation was made.
The sum impact of the report (also nicknamed the 'closing commission') was to close over a dozen healthcare facilities across the state, merge several more in overlapping (and non...) areas, and reduce services in still many more yet. Ultimately almost 10% was slashed out of the state healthcare budget (which also happened to be the largest healthcare budget of any state in the country) overnight. To say this did not have an impact on the financial crisis less than 2 years later is shortsighted to say the least.
There were several reasons given for the urgency and necessity of this de facto legislation (it was never actually voted in; it was simply not voted out - a brilliant 'auto-pilot' built into the original legislation leaving essentially no politician holding the bag for the blame); increasing healthcare costs (which has been true every single year since the dawn of medicine, and will be true every year to come), an alarming shortage of nurses throughout the state (some studies at the time stated that within 10 years NY would have only 20% of the nursing staff required to meet projected capacity), but ultimately - "we need to do healthcare smarter" was the battle cry that carried the day. The phoenix that would rise from the ashes of the Berger Commission also had a name, and that name, conveniently, was 'HEAL-NY'.
HEAL-NY was the promise of $15 billion, across ten years (don't worry, we're on track...), to 'fix' healthcare. I think it's important to point out that nobody had defined the problem of healthcare, other than "it's too expensive"; so, naturally, throwing more money at something that's already too expensive...somehow equates to less money spent ('Obamanomics', for all intents and purposes, could be called 'Patakinomics', and countless politicians before them).
In the next Health Homes post, I will talk about all the 'brilliant' ideas they came up with to spend the $15 billion check our tax dollars paid for...stay tuned.
