NY Democrats must renew the fight for health care

For almost a century, Democrats picked the biggest fight in American politics. They took on the U.S. health care system.

From FDR’s 1944 State of the Union address declaring the right to health care a “self-evident” truth to Joe Biden’s historic expansion of Medicare’s authority to negotiate drug prices, Democrats made health care the moral and political centerpiece of their agenda.

That is no longer true. In the last presidential election, health care barely registered as an issue. While Republicans flirt with decimating Medicaid — jeopardizing health care for more than 70 million Americans — Democrats are drifting toward indifference.

Of course, Democrats are in the minority in Washington, unable to wield executive or legislative power. But in New York, they hold a uniform grip on government. Democrats occupy every statewide office, the biggest cities are led by Democratic mayors and governed by city councils with Democratic majorities.

And yet, New York’s health care system is in the throes of one of its worst convulsions.

In the last 20 years, more than 20,000 hospital beds have disappeared across the state. On April 9, Mount Sinai’s Beth Israel Hospital — the last major hospital in lower Manhattan — shut its doors. I was one of the lawyers who sued the Mount Sinai Health System for violating its obligations to the community, and our own state Department of Health for approving the closure without a meaningful mitigation plan for the more than 500 beds lost.

We lost. But we weren’t just fighting to keep one hospital open — we were up against a decades-long, deliberate effort to dismantle the state’s health care infrastructure.

In 2005, Republican Gov. George Pataki authorized the Commission on Health Care Facilities in the 21st Century, known as the Berger Commission, to streamline New York’s sprawling hospital system and eliminate redundancies to concentrate resources where they were most needed.

But it fell far short. Research shows that hospital closures by and large have not reduced costs or generated efficiencies in health care delivery. Sometimes they raise costs, by shifting patients from smaller hospitals that don’t survive cost-cutting schemes to more expensive teaching hospitals or by delaying care until patient conditions worsen and require more intensive interventions later.

What began as reform turned into grim liquidation. The result: longer wait times to access emergency care, higher mortality rates, and exacerbated racial and socioeconomic disparities in quality and access to care.

Hospitals are not simply buildings to close when budgets tighten — they are the foundation of our health care infrastructure.

They are also front line responders during disasters. When COVID-19 overwhelmed our systems, Superstorm Sandy flooded our streets, and the 9/11 attacks shocked our country, hospitals bore the brunt of recovering from each crisis.

Beyond patient care, hospitals train future health care workers, offering clinical experience and exposure to complex cases across specialties.

Without hospitals, our ability to respond to the most urgent and animating health care problems of our time collapses.

We need a comprehensive, statewide reassessment of our hospital infrastructure — one that guards patient care, and ensures our facilities are resilient and capable of meeting the demands of a rapidly changing health care landscape.

There is no need to wait for Washington to rediscover its conscience or competence. New York Democrats have every instrument of government at their disposal to restore moral clarity to health care — and to reclaim the fight their party once waged with conviction.

This guest essay reflects the views of Sommer Omar, a Manhattan-based public interest attorney affiliated with Advocates for Justice.