New York

New York spends more money per capita on healthcare than most states, and costs keep climbing.

New York spent about $126 billion on health care in 2004.[1]
New York’s healthcare bill keeps going up, at a 6% average annual increase between 1991 and 2004.[2]
Between 2001 and 2005, healthcare premiums increased 24.3% while earnings of families buying family coverage actually declined 1.84%.[3]
New York spent much more ($6, 535) on health care per capita in 2004 than the national average ($5,283).[4]
For workers covered by an employer-based health plan, employees pay 18% ($781) and employers pay 82% ($3,458). Nationally employees also pay 18% or an average of $723.[5]
Family premiums cost more. Employees in New York contribute 23% of the costs, an average of $2,609 every year. Nationally, employees pay an average of $2,585 for coverage.[6]
Per capita expenditures in New York exceed the nation in almost every category of care: hospital care, drugs and other medical nondurables, nursing home care, home healthcare, and other personal healthcare.[7]

Despite higher costs, too many patients in New York are injured by unsafe care.

On a number of measures of hospital care quality, New York hospitals fall short, including infection prevention for surgery and higher rates of heart attack deaths while hospitalized and reduced utilization of certain procedures recommended for heart patients that improve outcomes.[8]
According to data collected by the Niagara Health Quality Coalition, almost 3,000 hospital patients with IVs or catheters suffered an infection due to their medical care in 2006. Hospital infections can cause permanent disability or death. [9]
Although the true number of patients harmed by medical errors in each state is a well-kept secret, the Institute of Medicine estimates as many as 98,000 Americans die from these preventable mistakes each year.[10] These errors range from doing surgery on the wrong part of the body to serious bed sores to getting the wrong dose of medication.[11]
People with diabetes and asthma end up in the hospital at a higher rate than the average for all states.[12]
New York spends more money on nursing home care but also sees better quality of care as measured by standard metrics like reported pain, mobility, and depression.[13]

New York has implemented reforms to expand care.

New York insures more poor children and adults through its Medicaid program (18% of the population) than the programs in general in other states (13% of the population).[14]
New York has implemented individual insurance market reforms designed to pool costs and provide access for people with pre-existing health conditions.[15]
Small employers (2-50) can access insurance for employees under similar reforms, even if the employee has a health condition.[16]
The Elderly Pharmaceutical Insurance Coverage (EPIC) program helps over 360,000 senior citizens pay for their prescription drugs, saving them 80%, according to the New York Health Department.[17]
Children ineligible for Medicaid can get coverage through Child Health Plus, free to families earning up to 1.6 times the poverty level and subsidized for higher income families.[18]
Adults with incomes just above federal poverty can receive health coverage through Family Health Plus.[19]

New York faces particular challenges with the uninsured, prenatal care and chronic disease.

Between 2005 and 2006, 14% of New Yorkers were uninsured, an estimated 2.6 million people.[20]
Too many women die in childbirth and New York ranks below other states in key measures of maternal and child health.[21] New York has taken steps to address the problem by providing free prenatal and pregnancy services to women up to 200% of the federal poverty level.[22]
New York has a higher incidence of cancer than the rest of the nation (474 per 100,000 New Yorkers compared to 460 nationwide),[23] and more New Yorkers die from heart disease (248 per 100,000 compared to 217 nationwide)[24] and HIV (9 per 100,000 compared to 5 nationwide).[25]

New York has taken some steps to reduce costs associated with poor quality care and high cost behaviors.

The New York Patient Health Information and Quality Improvement Act of 2000 created a website for people to look up physicians and learn if they have legal actions against them, and www.myHealthFinder.com allows New Yorkers to pick hospitals based on well-established quality indicators.[26]
New York has taken an aggressive stand against smoking, taxing cigarettes at $1.50 per pack and in 2003, the state passed a state-wide smoking ban.[27]
New York has enacted a hospital infection reporting law. The first report on state-wide hospital infection rates is due in June 2008.[28]

Footnotes:

[10] Institute of Medicine, To Err is Human, Kohn, Linda, Corrigan and Donaldson, 2000, pp.26.

[11] Ibid 10, pp.35.