Last week Governor Hochul answered one big question about her Commission on the Future of Health Care – the names of its members – but left a fundamental mystery unresolved:
Which of the many problems in New York’s health care system is this high-powered group of experts supposed to tackle as a top priority?
The Nov. 2 announcement also raised an entirely new issue: What will be the role and makeup of the “stakeholder advisory board,” whose existence was first revealed in the last sentence of her press release?
As promised – albeit belatedly – Hochul has assembled a panel of bona fide experts, most of whom have served at high levels as health-care providers and executives, academics and government officials.
But even the best health-care minds aren’t likely to get much done if they lack a clear mission or if their work is subject to interference from vested interests.
Hochul’s list of appointments includes a few familiar insiders – such as former state budget director Robert Megna and former Medicaid director Brett Friedman – but most come from outside the Albany circle of industry groups and lobbyists.
The chair is Sherry Glied, dean of the NYU Wagner Graduate School of Public Service. She was formerly an assistant secretary of the U.S. Department of Health & Human Services during the Obama administration and a member of the President’s Council of Economic Advisers under Presidents George H.W. Bush and Bill Clinton.
Another member, Nancy-Ann DeParle, who worked in the Obama White House as director of the Office of Health Reform and later deputy chief of staff. She was previously the administrator of the Centers for Medicare & Medicaid Services during the Clinton administration.
There’s no shortage of problems in New York’s health care system: the high and rapidly rising cost of Medicaid and commercial health insurance, shortcomings in the quality of care provided by its hospitals and nursing homes, and weaknesses in its public health system that were revealed by the coronavirus pandemic.
Which of these topics, if any, the commission will address is anything but clear from the latest summary of its mission, as featured on the commission’s website:
The Commission will provide ongoing strategic recommendations to transform the health care system in New York State, with a goal of ensuring that the limited resources of the State and other health care payers are optimized to enable the delivery of accessible, equitable, high-quality care for all New Yorkers, through a resilient health care ecosystem and a strong health care workforce. It will be tasked with identifying strategies to ensure the long-term resilience of New York’s health care system.
The Commission will offer formal recommendations submitted annually. The Commission’s first recommendations will be due before the end of 2024 and will be released publicly. The Commission will focus on the full continuum of care, including physical and behavioral health, and recommendations will span policy, regulation, funding, and other strategies to drive long-term transformation within the health care system.
The commision is also expected to “work with a Stakeholder Advisory Board to ensure collaboration across the entire health-care system.” This sounds like a vehicle for the Albany insiders who were excluded from the commission itself. Who will sit on this board? Will it include the state health commissioner, Dr. James McDonald? How much influence will stakeholders have over the commission’s reports and recommendations? The governor has not yet said.
Hochul has succeeded in recruiting well qualified and experienced people to give her advice on New York’s health care system. Let’s hope their time and expertise do not go to waste.