Mayor of New York City Bill de Blasio has scheduled "universal health care" in the largest city in America – and although it is not a single payer, the initiative shows that Democratic politicians are showing more creativity for what they can do to develop health care at home. Trump era.

De Blasio unveiled this week a new plan that would ensure every New Yorker, regardless of financial fitness, to see a doctor and get affordable medical treatment in the city's historic public hospitals.

"From that moment in New York, the right to health care is guaranteed to everyone," said the mayor on Tuesday. "We say the word guarantee because we can make it happen."

For most New Yorkers, their insurance will not change at all. they will do it through work, as well as Medicaid, Medicare or the Affordable Care Act, as they have always done. De Blasio's wants to invest more money in the city's safety net – an idea inspired by the success of its predecessor in San Francisco – and should help people who have no insurance or regular doctor to get medical care. It is also a necessary, albeit limited, solution to a long-term crisis for the city's public hospital network.

The promise of "Medicare for all" Democrat voters and health care have been one of the main problems of the elections of 2018. Today, Blasio is one of the many mayors, governors and other democratic politicians who seek to improve the situation. access to health care, even as Republicans in Washington control the White House and the Senate.

The plan is to bring uninsured New Yorkers to primary care physicians

Through a program called NYC Care, any uninsured New Yorker is able to visit one of the 70 clinics in the hospital system and see a primary care physician. They will be billed on a sliding scale designed to keep care affordable. (We have not yet seen the details of who would pay how much.)

The program targets 600,000 uninsured city residents; about half of them are undocumented, the others are eligible but they are not registered for one reason or another. The city spends $ 100 million every year to help hospitals cover the cost of treating these people, and then launches an awareness campaign to make sure people know that coverage is available.

It's sort of an aggressive branding campaign, but a health advocate of the city feels that it's absolutely necessary.

"We hope people will know that they have access to a primary care physician and that they can start there" rather than going to the emergency room, says Katie Robbins, director of New York Health.

Another key element of this strategy will be to increase enrollment in MetroPlus, the city's Medicare, Medicaid and Obamacare exchange health insurance plan, and provide the public hospital system – 70 clinics and 11 hospitals – with its health care network. providers.

Blasio's new health plan was motivated by a funding crisis in hospitals

The impetus given to Blasio's plan is a much needed injection of funds for troubled public hospitals in New York City. There has long been a dispute between New York and New York over the hospital charity formula, which, according to Robbins, is skewed in favor of academic medical centers and public hospitals.

A report 2017 found that public hospitals in New York provided 52% of unpaid care in the state, but received only 15% of charitable dollars. Private hospitals, for their part, were responsible for 42% of this care and received 85% of public funds.

The derisory funding from the state has resulted in a fiscal crisis in New York. Two years ago, the budget office of the city reported that public hospitals faced a deficit of $ 6 billion until 2020.

De Blasio's new $ 100 million a year plan is a small help to keep the system afloat and ensure uninsured New Yorkers know that affordable care is available in clinics of the hospital. The mayor said that no new tax would be needed to fund the program.

"Public hospitals have been totally in trouble," says Robbins. "It's the mayor of Blasio who says: that's what we can do."

The successful San Francisco program is the model of the New York City Plan

Mitchell Katz, general manager of the hospital system, oversaw the similar program launched in San Francisco ten years ago. The San Francisco Health Plan and the New York Plan share the same basic structure: uninsured residents could visit the city's clinics and obtain affordable medical care.

The San Francisco program, as evidenced by this report 2011, has been largely judged a success. Three quarters of the participants consulted a physician during their first year of registration; visits to the emergency decreased accordingly; and there was also a decline in preventable hospitalizations for the uninsured.

Now, New York hopes to consolidate this success. It's not something that every city can do – or rather, it's easier because public hospitals are the foundation of the New York health system – but it does point a way forward for local officials who see too many people who still do not have access to basic health care. It's not a single payer, it's not really a universal health care system, but it's a start.

"Giving people direct access to care is not the same as a right to full coverage," says Larry Levitt of the Kaiser Family Foundation. "But in a voluntary and fragmented insurance system like we do now, there will be people who fail, and a more organized and accessible safety net makes perfect sense for them."