May 20, 2015

Honorable Richard Gottfried
Chairman
NYS Assembly Health Committee
Legislative Office Building, Rm 822
Albany, New York 12248

Dear Assemblyman Gottfried:

We commend you on your legislative efforts to advance legislation that promotes better health and access to care for all New Yorkers. We take this opportunity to express our position on one of your current efforts, namely advocacy for the New York Health Plan (A.5062), a single-payer system. Some of our physician members support this bill as a means to create health system efficiencies while reducing insurer control and influence over the practice of medicine. A significant number of our members, however, feel that they would lose clinical autonomy under a single payer system. Moreover, based upon their experience with the Medicare and Medicaid systems, they are also concerned that a single payer system would result in a significant and unwarranted reduction in payment for the services they render.

At our most recent House of Delegates held earlier this month, a resolution which called upon MSSNY to support legislation to implement a single-payer system was passionately debated by the physician delegates. While there was support among the physician delegates, there was also overwhelming opposition. The Resolution was not adopted. Consequently, we cannot support your proposal.

The Affordable Care Act is precipitating momentous change within the healthcare delivery system, especially in New York State. For many years, physicians have had to contend with enormous overhead expenses inherent in practicing in New York including high liability premiums. Now, as a result of new administrative burdens and the costs associated with practice transformation, many physicians are finding themselves with little choice but to sell their practices and become employees of hospitals.

Nevertheless, there remain many physicians in independent practice who are taking steps to prepare for advanced primary care or integrated practice models endorsed by ACA.

We commend you and thank you for your efforts in advancing the collective negotiations bill (A. 336), which the Assembly Health Committee has reported to the Assembly Ways& Means Committee. All of organized medicine supports this bill, which empowers physicians in their negotiations with hospitals and health insurers and which helps garner physician support for the State’s Health Innovation Plan (SHIP) and the Delivery System Reform Incentive Payment (DSRIP) Program. Enactment of this measure will have a powerful impact on the healthcare delivery system and the patients we serve.

Sincerely,

JOSEPH R. MALDONADO, JR., MD, MSc., MBA, DipEBHC