New York’s long-term care programme causing concern

Generous benefits, perverse incentives and powerful lobbies have made New York's long-term care system the most costly in the nation, says Crain's New York Business.

Long-term care, including nursing home services and home health and personal care, consumed $16 billion in 2004. The price tag – which comes to $833.37 per capita, or two-and-a-half times the U.S. average – swelled 23 per cent over 2000 levels.

"If there's a state that's doing everything wrong, New York is probably it," says Devon Herrick, a senior fellow with the National Center for Policy Analysis in Dallas, which this year published a harsh critique of New York's Medicaid system.

Medicaid, originally intended to help the poor and disabled, is now increasingly used by the middle class; aggressive elder law attorneys are helping New Yorkers shelter assets and disavow family responsibilities in order to get the state to pay for care that patients and their families could afford on their own.

About one-third of the Medicaid dollars spent on personal care in the United States in 2004 were spent in New York, mostly in New York City, according to data from the Centres for Medicare and Medicaid Services.

The governor's commission on Health Care Facilities in the 21st Century is expected to issue recommendations in December on institutions that should be closed or downsized.

Advocates for reform are concerned that health care providers will balk, as they did last year when commissioners wanted to freeze new capital projects while they sorted out redundancies in the system. Most say that any major reform will fall to the next governor.

Source: Judith Messina, Long-term Care's Perfect Storm, Crain's New York Business, June 5, 2006.

For more on Health: http://www.ncpa.org/iss/hea/

Health Policy Unit Bulletin/ 20 June 2006