As we turn the page on 2023, I’m looking ahead to a better 2024. I’m sure we all hope for the same big things: a less divided, more peaceful world; good health; a sense of safety and security.
I also wish for New York to be a healthier place. It’s become a December tradition for me to share a wish list for the upcoming year; here are my top three for 2024:
Remember the lessons of COVID. It’s been liberating to feel like COVID is behind us. This year marked the end of the public health emergency and life is largely back to a pre-pandemic normal for many of us. I understand the instinct to keep the pandemic firmly in the rearview; it’s only human to want to put that trauma behind us. At the same time, though, I worry about what strikes me as a willful collective amnesia when it comes to COVID. We are making a mistake if we forget the lessons of the pandemic.
It’s a question of when, not if, another public health crisis hits the United States. To rise to that challenge, we need to learn from our successes and mistakes and address what left us flat-footed when COVID hit: underinvestment in public health infrastructure; an insufficient stockpile of supplies and equipment; a lack of trust in government agencies and public institutions; an inadequate safety net of social services; and a health care system with a history of racism and inequities, to name just a few. These challenges are still present; many of the policies that helped people to survive, like continuous Medicaid coverage and enhanced food benefits, were temporary measures that have expired.
As tempting as it is to forget about COVID and its lessons, doing so is guaranteed to be deadly. In a 1948 speech, Winston Churchill said, “those who fail to learn from history are condemned to repeat it.” Let’s consider ourselves warned.
A well-resourced primary care system. Primary care offers by far the best bang for the buck in our health care system; it improves individual and community health, enhances health equity, and saves money. Yet, we chronically underinvest in primary care, spending only 5–7 cents of the health care dollar in this area. I’ve written and testified about this issue quite a bit, so I won’t repeat all the stats. The bottom line: redirecting a larger share of our health care resources into primary care needs to happen. Numerous other states have done so with success — and New York is lagging.
Governor Hochul’s Commission on the Future of Health Care has already identified primary care as one of its priorities. Multiple new federal and State demonstration models (like the Making Care Primary and AHEAD models and the pending Medicaid 1115 waiver) would pay for and deliver care in ways that prioritize primary care. To realize the promise of these developments, the State must set specific and ambitious goals for rebalancing the primary care payment and delivery system. We get what we pay for, so let’s put our money where our mouth is.
Healthy food for all. New York can harness the massive power of public purchasing to produce a healthier food environment. Through its agencies and institutions, the State of New York purchases and serves hundreds of millions of meals annually, primarily in low-resource communities. New York City alone spends more than $500 million a year to serve more than 200 million meals in schools, hospitals, long-term care facilities, homeless shelters, senior centers, childcare centers, correctional facilities, and so on.
Scale like that opens the door to transformative change: if public institutions change their approach to food purchasing and spend their dollars on foods with higher nutritional value, we will be healthier. A leading model for change is the Good Food Purchasing Program (GFPP). New York City and Buffalo are among the 20 cities across the country that have adopted this model. Earlier this year, legislation supporting GFPP was introduced in the New York State Legislature. It passed the full Senate and made it far in the Assembly. I’m optimistic that models like GFPP can get over the finish line and ensure that millions of New Yorkers will eat healthier meals.
And finally, I wish you and your loved ones a healthy and happy new year.
By David Sandman, President and CEO, New York Health Foundation
Published in Medium on December 14, 2023
