News
from STATE SENATOR
Liz Krueger
COMMUNITY
BULLETIN – January 2006
Message from Liz . . .
On January 10th, I attended a roundtable discussion of
the
Of course, disparities in health care treatment are only
part of the explanation for these statistics – environmental facts such as exposure
to pollution and lead, as well as less ability to meet basic nutritional needs
also have severe negative impacts on poor New Yorkers and people of color. But differences in health care treatment
exacerbate these impacts. Studies of
health care delivery document this problem.
A 2001 study published in the New England Journal of medicine documented
that whites were more likely to receive cardiac catheterization when presenting
with chest pains than were African Americans.
The United Health Foundation found that only 56% of African American
women received adequate prenatal care, compared to 72% of white women. Other studies have shown that uninsured
patients and those with Medicaid are treated primarily in clinics and emergency
rooms frequently staffed by interns and residents. These differences demonstrate how our
insurance based healthcare delivery system is inherently two-tiered, with one
level of service for the wealthy and insured and another for the uninsured and
those on Medicaid – in fact one could even say it is three tiered, as those on
Medicaid have significantly more access to care than those with no funds or no
insurance. Since the poor and minorities
are more likely to lack insurance, they bear the burden as the above statistics
indicate. Minority groups make up
one-third of the population in the
What can be done about this situation? The long term solution must be the development of a system that recognizes access to basic health care as a right, not a luxury item only available to the well-off or well-insured. I believe that it is good public policy to ensure that all Americans, regardless of their level of income, should have access to quality care. A private employment-based insurance model of care is unlikely to ever meet such a goal, which is another reason why we need to move toward a single payer model of universal health care.
Of course, we are unlikely to achieve such a goal in the short term given the political realities we now face, and in some ways the fight for the moment will be to ensure that the current health care crisis does not exacerbate inequalities in service based on race, ethnicity or income. Two current fights along these lines have to do with proposed Medicaid cuts and possible hospitals closings. Federal changes to Medicaid this year will likely include the potential for higher premiums and co-pays for recipients, making it even more difficult for them to afford to access health care given their limited financial resources. As the federal government backs away from Medicaid, we will need to fight at the State level to preserve benefits. While it is right to attack waste and fraud in Medicaid (and all government programs); it is critical to remember that Medicaid fraud is disproportionately perpetrated by providers, not participants. And our desire to help municipalities and businesses avoid absorbing unreasonable costs of health insurance should not under-cut the importance of access to quality health care for lower income people, or we will only exacerbate the disparities in health care services that already exist.
In its efforts to address the financial problems of many hospitals, the State has also established a Hospital Closing Commission, with the mandate of identifying hospitals that could be closed to create cost-savings and increase efficiency. However, it is not clear that the commission will consider issues of healthcare disparities. In considering the recommendations of the commission, it will be critical that the legislature and the Governor evaluate whether the hospitals identified for closure serve communities without easy access to other facilities. If this is not taken into account, the worthy goal of efficiency could trump the primary purpose of our hospital system, which is to ensure quality health care for all New Yorkers.
As legislators, we will no doubt have to fight these rear-guard actions as we continue to look to a long term solution to our health care crisis that acknowledges that it is unacceptable to have a system that creates such significant disparities in service delivery. I believe the ultimate solution to our health care crisis will be a single payer system, where efficiencies of scale and combined bargaining power will control costs while at the same time guaranteeing access to quality health care for all.
Community Spotlight
Medicare Prescription Drug Coverage Assistance Available:The New York City Department of the Aging and Met Council on Jewish Poverty are cosponsoring Medicare Prescription Drug Coverage Enrollment and Assistance Centers throughout New York City 105 East 22nd Street 2 Lafayette Street Affordable Housing Opportunities in Manhattan
In
addition, Chelsea Associates has announced that the waiting list for affordable
Studio, 1 and 2 bedroom rental apartments in the Vanguard Chelsea has been
reopened. Rents for these units will
range from $396 to $511 per month depending on unit size. To be eligible, applicants must have
household incomes between $13,200 to $25,120 depending on family size. Applicants residing or working in
Heat Season Rules:The City Housing Maintenance Code and Multiple Dwelling Law requires building owners to provide heat and hot water to all tenants. Building owners are required to provide hot water 365 days per year at a constant minimum temperature of 120 degrees Fahrenheit. Between October 1st and May 31st, a period designated as "Heat Season," building owners are also required to provide tenants with heat under the following conditions: · Between the hours of 6:00 AM and 10:00 PM, if the outside temperature falls below 55 degrees, the inside temperature is required to be at least 68 degrees Fahrenheit;
· Between the hours of 10:00 PM and 6:00 AM, if the temperature outside falls below 40 degrees, the inside temperature is required to be at least 55 degrees Fahrenheit.
Tenants who are cold in their apartments should first attempt to notify the building owner, managing agent or superintendent. If heat is not restored, the tenant should call the City's Citizen Service Center at 311 (311 can be accessed outside of New York City by dialing (212) NEW YORK
On January 4th, Governor Pataki delivered his 12th and final State of the State address, which may or may not provide a clear picture of the State’s priorities over the next several months. My prediction is that much of our agenda will not in fact be shaped by the Governor’s speech, simply because the speech was so light on actual policy proposals, and entirely ignored some major policy areas, such as health care and housing. That said, the Governor did lay out a number of proposals – some old and some new – which I will summarize and comment on below.
Tax Cuts: The Governor proposed a number of new tax cuts, including reducing personal income and business taxes, repealing the estate tax, expanding the STAR property tax reduction program, providing a direct property tax rebate, and providing a fuel tax credit to seniors. Most of these proposals lacked detail, but they are consistent with the long-term Pataki agenda that undermined state solvency during the last recession. During the economic boom of the 1990’s the Governor significantly reduced State taxes -- resulting in increased pressure on localities to increase local taxes. As the economy emerges from recession, the Governor is once again acting like we can make tax policy as if the economy will never again go into recession. Instead of undermining our State’s tax base, we should recognize that the good times will not last forever and implement tax policy that will serve us in both good and bad times. Remember, our debt per capita and reliance on one-shot revenue tricks is still out of control and we are still obligated to address the unresolved CFE court orders for increased public education funding.
Economic Development: The Governor proposed a number of new and expanded economic development programs, mostly aimed at encouraging additional high tech development. He proposes expanding the Centers for Excellence Program, creating an Empire Zone in every county, creating new “Tech Zones” to function along a similar pattern as Empire Zones, and funding additional biotech research. I have grave concerns regarding some of these proposals, given the history of Empire Zones and other economic development schemes. These programs have often functioned primarily as government giveaways, with little accountability or follow up on job creation promises. While I am hopeful that Public Authority reform legislation we passed last spring will help improve accountability for economic development programs, I believe that more needs to be done, and will continue to push for passage of my Corporate Accountability for Tax Expenditures Act. In addition, I am currently working on a package of corporate accountability legislation which would help ensure that if these gubernatorial proposals do advance, they are appropriately monitored to ensure they benefit the state. While concerned about the details, I do think focusing government attention on high tech -- bio-tech, stem-cell and nano-technology -- initiatives are moves in the right direction.
Education: The Governor did offer some interesting
ideas for improving education, though without enough details to fully evaluate
his proposals. He indicated he supported
additional funding for high needs districts, but as of yet has not supported
implementation of the Campaign for Fiscal Equity (CFE) court decision, which
would be the clearest path to his stated goal of addressing these needs. He also indicated he will support additional
funding for afterschool programs, which he has attempted to cut in previous
years. Other proposals included
expanding charter schools, and efforts to strengthen math and science education
at both the secondary and post-secondary level. I am particularly pleased with
the Governor’s proposal to provide free tuition at CUNY and SUNY to students
pursuing math or science degrees who commit to teaching in
Energy: The governor offered a number of
proposals ostensibly aimed at reducing dependence on fossil fuels, including
increasing the availability of biofuels, providing incentives for the
development of “clean coal” power plants, and providing tax incentives to
encourage the purchase of hybrid vehicles.
While some of these proposals have merit, others seem more aimed at
pleasing certain constituencies that may be important to the Governor’s pursuit
of the Republican presidential nomination.
Specifically, the Governor proposed encouraging ethanol production and
consumption, a policy particularly popular among
Crime: Governor Pataki reiterated his support for several crime measures, including civil commitment for sex offenders, increasing sentences for sex crimes, requiring a DNA sample from those who commit crimes, and eliminating the statute of limitation on rape. I carry legislation that would implement this last proposal.
That was the extent of the Governor’s policy proposals.
Among the issues the governor failed to address were health care, consumer
protection and housing policy, all areas where I hope the legislature will take
an active role in addressing the needs of New Yorkers. The Governor also ignored the need for
continuing to reform