Ending healthcare disparities

For many residents of New York State, zip code says more about health status than anything else. Life expectancy in Brooklyn’s Brownsville neighborhood is eleven years less than in Manhattan’s Murray Hill, just a few miles north.

Hispanics, many of whom live in zip code-defined poverty, had the highest percentage of poor or fair health when compared with other ethnic groups, according to 2012 state data.

Unwavering goal

For that same year, looking at national data, poor women got mammograms at 66 percent the rate of middle or high income women. Privately-insured individuals were more likely to be screened for colon, breast and cervical cancer than Medicaid patients. The Affordable Care Act addresses some of these very significant healthcare inequalities; still, the enduring effects of healthcare delayed are predictable and often dire.

Our efforts – in our care settings, as well as in research and in the field, at rallies and with state and local officials – have been directed at ending healthcare disparities and providing quality care for all New Yorkers. NYSNA’s commitment to these fundamental goals is unwavering. Our staffing campaign at its core is aimed at disparities: a state-mandated ratios law would require appropriate staffing at all hospitals throughout NYS, providing uniform, quality standards for safe care. (Please join fellow members on April 21 in Albany for NYSNA’s Lobby Day; proposed legislation for staffing ratios, the Safe Staffing for Quality Care Act, tops our agenda. Be there!)

There are other efforts underway to address disparities. On DSRIP funding, special monies for Medicaid to be distributed over the next five years, NYSNA has taken the lead in arguing that communities should have a prominent place in assessing need (see pages 6-7 for excerpts of testimonies at the DSRIP panel). Fair and appropriate use of these funds for Medicaid patients would go a long way to helping provide quality care to communities in need. Community input is key to DSRIP success.

Raising the minimum wage would also help reduce healthcare disparities (see my column, “Raising the minimum is a matter of public health,” in the June 2014 edition of New York Nurse). Paying wages that keep New Yorkers out of poverty is essential to public health and ending disparities. There has been positive movement in New York in this direction.

Raises in the minimum wage

Governor Andrew Cuomo has proposed raising the statewide minimum wage to $10.50 per hour by the end of 2016. For New York City, he has proposed raising the City’s minimum wage to $11.50. These higher wages would bring fodder to the fight against healthcare disparities.

There was more good news for wage earners recently. Governor Cuomo announced on February 24 that tipped workers – waiters, waitresses and others who work for tips in New York City – will receive a raise of their minimum wage to $7.50 an hour, to take effect at the end of the year.

NY needs single payer

Another and very important route to the elimination of healthcare disparities in New York is through the creation of a single payer healthcare system, embodied in New York in legislation, the New York Health Act. (See NYSNA President Judy Sheridan-Gonzalez’s column) The legislation, once enacted, would replace the commercial insurance system with a single method of coverage for all state residents. It would operate as “Medicare for all,” providing a uniform system of provider payments. Single payer puts patient need first.