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The Year Ahead for New York's Health Care

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Although many will remember 2010 as the year of the iPad, Facebook, and WikiLeaks, perhaps most enduring over the next decade will be the progress we've made in New York State's--and the nation's--health care system.

Looking back, 2010 saw the passage of one of the most sweeping pieces of health care legislation--the Affordable Care Act (ACA)--since the creation of Medicare and Medicaid. (This was the top item on my Health Care Wishlist for 2010!) When fully implemented, the law will usher in the largest expansion of coverage and access to care since the 1960s.

Although we accomplished much in health care during 2010, there is still plenty of work to be done before we're providing every American with access to high-quality care--and doing so in a way that is financially viable. The passage of the ACA alone doesn't ensure that all New Yorkers will actually get the care they need.

For one, there remains much work to be done at the State level to ensure that health care reform has the impact it's intended to. New York must make final decisions about how it will set up its health care exchange, where individuals and small businesses will be able to purchase coverage. The State will also have to work to expand access to primary care and begin the process of reforming its payment system. We've previously discussed some of these issues here.

In addition to implementing health care reform, there are three other major questions we must address in 2011 to maintain and improve the overall health of New York State.

Can We Contain Costs?
By far the biggest challenge facing the nation and individual states is the rising cost of health care. Both public and private spending on health care are projected to have steady growth over the next decade. Over the next 10 years, New York State is projected to spend more than $2.5 trillion on health care, a level of spending that is simply not sustainable. Our State government can't afford it; employees can't afford it; and--most importantly--most of our fellow citizens can't afford it.

It's been clear for some time that costs need to be contained; yet we haven't made substantial progress to date on controlling them. We know the solutions--reducing hospital readmissions, expanding primary and preventive care, improving efficiency, changing payment incentives. 2011 should be the year that all stakeholders begin working together to implement these strategies; the health reform law provides timely opportunities to do so.

Will We Finally Hear Our Veterans?
In the past year we've heard and read dozens of stories about veterans struggling to cope with the challenges of reintegrating into their civilian lives as they return from the wars in Iraq and Afghanistan. And far too often those stories end in tragedy.

In 2011, we have an opportunity to begin changing the narrative for our returning veterans, and it starts by providing more timely access to the resources veterans need to cope with the psychological and emotional injuries suffered during combat. From the moment veterans return home, they need to be connected with appropriate services and supported as they adjust back to civilian life.

Will We Finally Treat Diabetes as an Epidemic?
More than 1.8 million New Yorkers have diabetes and another 3.7 million have pre-diabetes, putting them at serious risk of developing the disease. That's roughly 25 percent of the State's population. Similarly, approximately 25 percent of adults in New York are obese. If a quarter of New Yorkers came down with the flu or some other disease, we would be mobilizing a full-scale emergency response.

There is no such alarm for diabetes, despite its deadly consequences.

Preventing and managing diabetes doesn't require us to develop a new drug. Rather, it requires a mix of strategies to ensure that health care providers are delivering effective, high-quality care for their patients with diabetes; to provide tools and information that help patients monitor and manage their condition; and to help those with pre-diabetes to make changes in their eating and physical activity to lower their risk of developing the disease. It also requires greater access in communities most affected by the disease to healthier food options and public recreation space. In 2011, we need to focus statewide attention on these interventions, or else the epidemic will continue to grow unabated.

In the coming year, we can build on the national health care success we saw in 2010. There are major challenges ahead, but we can overcome them if we work together and focus on implementing the solutions we know will have an impact.