A Wish List for 2023

As another year winds down, it is a natural time for reflecting on what was and looking ahead to the possibilities on the horizon. In that spirit, it’s become an annual tradition for me to share a wish list for each year.

My 2022 wishes haven’t fully come true, but there’s been progress on all of them. Most importantly, the worst of the COVID-19 pandemic is behind us. We still need to be vigilant about protecting ourselves and others from the virus. But with vaccines, testing, and treatments widely available, COVID looks and feels much different than it did two years ago and even one year ago. Things feel better and safer; it feels “normalish,” as I’ve taken to calling it. And while there is no doubt that we live in troubled times, there are other developments to feel optimistic about too.

Here are some wishes for 2023:

1. A rebalanced health system built on primary care. This was on my list last year, and we made substantial progress. But it’s not over the finish line yet, so it’s staying at the top of the list. A mountain of evidence tells us that primary care is both associated with better health AND saves money. It’s among the best bangs for the buck in health care. Yet we underinvest in it; only about a nickel of every health care dollar is spent on primary care.

New York should join the growing number of states that have increased their investment in primary care without increasing total spending on health care. In fact, Rhode Island increased the share of its commercial insurers’ primary care expenditures by 5% and their total health care expenditures fell by 14%. I’d call that a very good deal.

Both houses of the New York Legislature passed bills to establish a primary care reform commission to define and measure our baseline spending on primary care, set targets for enhanced investments in primary care, and test out pilot programs to identify the most promising models. 2023 should be the year that such an effort gets going.

2. Free meals in every New York public school. For two school years during the COVID-19 pandemic, a federal policy ensured that every student in the nation had access to free school meals. It was a lifeline for kids and families; a New York Health Foundation survey on food and health found that 87% of families that participated in the program found it helpful. But that policy expired, and families are again worrying about their kids going hungry. With food prices at record highs, the timing could not be worse. And too many students must contend with the shame and bullying that can come with not being able to afford school lunch.

An estimated 30% of public school students in New York State lack access to free school meals. Hungry children cannot be healthy and learn. Absent federal action, many states are implementing universal free school meals statewide. New York should join their ranks.

3. Expansion of overdose prevention centers (OPCs) statewide. Crises require courage, and I’m proud that New York is home to the first OPCs in the nation, established by OnPoint NYC about a year ago in East Harlem and Washington Heights. OPCs are clinical, safe, hygienic spaces where people can use drugs under the supervision of trained professionals to prevent deaths and get connected to care and drug treatment. They are co-located in existing needle exchange programs and provide medical and social services like free meals, counseling services, and showers. Last week, I visited the center in East Harlem to see firsthand the literally life-saving work it is doing. I was impressed by the professionalism and compassion the staff demonstrated and in awe of the difference they’re making. In the first 12 months of operation, the two centers have been used more than 45,000 times by more than 2,000 participants. Most significantly, the centers have prevented more than 600 potentially fatal overdoses.

Communities throughout New York State would benefit from having OPCs in place to address the ongoing opioid crisis. The U.S. Department of Justice is expected to drop its opposition to OPCs, but it has repeatedly delayed its decision. If the DOJ does eventually agree that OPCs are permissible, it would pave the way for more centers and for public dollars to flow their way. I hope that New York builds on its willingness to be bold in establishing the first OPCs in the country by supporting additional centers statewide.

I know I’m swinging for the fences with these three wishes. And there’s no genie in sight to grant them — making them come true will require hard work, patience, financial resources, political will, and some luck. Turning wishes into reality takes commitment.

As always, I wish you and your loved ones a healthy and peaceful new year. May all your wishes come true.