Health Bill

NY Health If passed, Bill No. A05389A would establish the New York Health program, which would be a comprehensive system of access to health insurance for residents of New York State. Among the elements of the bill are that it would create the administrative structure for the plan, determine the scope of benefits and the payment methodologies, and it would establish the New York Health Trust Fund, which would hold the monies used to finance the plan.

A commission would be established in order to implement the plan, and the foundation for negotiations between New York Health and healthcare providers would be established (NYSA, 2014). The bill creates a sweeping change in the health care system in New York, so it would affect nurses in a few different ways.

At its heart, A05389A would affect the payer ecosystem, which is not directly related to nursing, but because it would allow nearly 2 million New Yorkers to gain new access to the health care system, and would give greater access to many more, this would have the effect of increasing demand on the health care system. If we look at this from an economic perspective, that increase in demand will initially soak up excess capacity in the marketplace. Providers that current are operating below capacity may find themselves at capacity.

Others will find themselves operating above capacity. In the short-run, this might mean that some nurses are going to be overworked, or that there will be a shortage of nurses in a given area. As a nurse, I realize that the initial impacts of this bill might be unfavorable. But in the long run, the effects are different because the industry will adjust. The most important factor will be that increased demand throughout the healthcare system will create increased demand for nurses.

Healthcare providers will need to create more positions, which means more opportunities to gain full time work, more opportunities to move into newly-created nurse leadership positions, and more hours for those who are currently working part-time. If the providers in the state are still struggling to find nurses, this will drive up wages as a means of attracting them. If at that point there is still a shortage, either the higher wages will attract new people into the profession or the existing nurses will be overworked.

It is too early to say which of these will occur, but the State predicts that 1500 new nurses are going to be required in the state by 2018, and health care providers are likely to going to face competition from other states to attract talent (NY Dept of Labor, 2014). There is also the question of what will happen to the payer ecosystem. It is assumed that the state will have significant bargaining power, and the new patients created by this bill would therefore not be particularly profitable for providers.

Thus, management may choose to serve this additional patients without increasing costs. It is too early to say if this will be the case, but it is reasonable that many nurses could see their workloads increase, or there may be an increase in the use of nurse aides or nurse practitioners to offset some of the added workload. I'm not sure if there are people who think this bill is a bad idea.

Perhaps there is worry that the state cannot afford it, or that the ACA will take care of the uninsured. But there are still people who are falling through the cracks in the system. Only one-quarter of uninsured Americans has received coverage in the first year of the ACA, so there is clearly more work to be done, to provide health coverage for all Americans. We can start right here, right now, at home, providing New Yorkers with the care that they deserve.

The bill, of course, is aimed at getting more New Yorkers access to health care. This affects nurses, too. Most nurses get into the profession because we care about people, we care about our neighbors and we care about our communities. We are already seeing more people gaining access to health care via the Affordable Care Act's health exchanges -- almost a million in NY State alone (Matthews & Thompson, 2014).

When you see these people, coming in for the first time to get a nagging conditions dealt with, when you talk to mothers who are taking their children in for their first-even checkup, you can really see the value of these laws. We live in the richest society in the world, so there is no reason why we cannot look after our own people.

It is powerful to see such justification of what I chose to do, and now it is time to finish the job, and get all New Yorkers access to health care. I just want to say that I.