New York State Hearing: New York Health Act

Mitchell Katz, M.D., President and Chief Executive Officer
NYC HEALTH + HOSPITALS
Wednesday, October 23, 2019

Good morning Chairpersons Gottfried and Rivera and members of the Assembly and Senate Committees on Health. I am Mitch Katz, M.D., President and Chief Executive Officer of the New York City Health + Hospitals (“Health + Hospitals”). I am here today on behalf of Health + Hospitals and the de Blasio Administration to express our support for the New York Health Act. We know that healthcare is a right and that a single payer system means better healthcare for all of us.

I believe in single payer as a hospital administrator and, more importantly, as a primary care doctor who sees patients each week in H+H facilities and who has cared for patients in public hospital systems across our country for several decades. I get to see from the system level to the exam room why our patients need a single payer system to take care of them. I see that health insurance allows our patients to stay healthy and to treat their illnesses preventatively, before they need a trip to the emergency room or a hospital admission.

As a primary care doctor, what is most important is care. A single payer system would allow me to spend more time on patient care than on filling out forms and fighting with insurance companies. And this isn’t a problem for just me, it’s a problem for all of the clinicians in our system. Single payer would alleviate administrative burdens that safety net hospitals face. The current health care system eats up about twenty percent or more of healthcare dollars through needless bureaucracy and administrative burdens. This money really should be going to care for patients.

I’m going to give you a few examples of how a single payer system would let us take better care of our patients. In the case of Health and Hospitals we have to negotiate separately with each insurance company and arrange to follow their rules on prior authorization procedures and send in information on their forms. Even when we do everything right, the insurance company sometimes refuse to pay us for services provided. We are currently in mediation with a for-profit insurance company that says a three year-old boy brought to one of our emergency rooms with a fever of 103 and who was unresponsive should have been treated as an outpatient. No responsible doctor would have sent the child home. However, because of the rules that govern how payments are made, the insurance company can simply just not pay us, even when we were providing the best possible care to the child.

The New York Health Act is necessary because even many insured people cannot get the full range of care they need. Recently, in my clinic I took care of a senior who had emphysema who went to the emergency room and was seen, however the co-pay was $60 for an inhaler. That kept him from getting the care he needed for his shortness of breath.

The current system leads to doctors like me to have to focus on insurance formularies rather than on keeping our patients healthy. I recently saw a new patient whose hypertension well controlled. He asked me to refill his medication. I agreed to refill the medication after the appointment, but when I went to input the prescription the formulary had change and it was no longer being covered. So even though his condition was perfectly well controlled and he was doing everything he could to stay healthy, the medicine was not paid for. The insurance company was deciding what to cover based on its financial needs, rather than on what drug is better for the patient.

Until we are to a single payer system, I support broadening coverage such as expanding eligibility for the Essential Plan and moving towards value-based payments. I believe the Cuomo administration has done an excellent job making sure that more of our payments are going to pay doctors for quality.

Thank you for the opportunity to testify before the committee in support of a single payer health care system. Thank you to the Chairs of the Assembly and Senate Health Committees for your tremendous support of Health + Hospitals, and I look forward to taking your questions.