The US health system does not provide health care to the country's entire population.[1] Instead, most citizens are covered by a combination of private insurance and various federal and state programs.[2] Health insurance was most commonly acquired through a group plan tied to an employer.[3]
Essential health benefits (EHBs) are required for non-grandfathered individual and small group plans, meant to reflect benefits typically included in employer-sponsored plans, but are not mandated for large group market and self-insured plans.[4][5] There are no minimum coverage standards for dental plans, and routine adult dental services are not considered EHBs.[6][7] New York has enacted additional mandates that exceed federal EHB requirements, for example Timothy's Law requires that health insurance policies provide comparable coverage for mental health services as they do for physical health services to ensure mental health parity, including for substance use disorders.[8][9] Self-insured ERISA plans (often large employer plans) are exempt from state insurance mandates due to federal preemption but are subject to federal requirements like the Mental Health Parity and Addiction Equity Act.[10]NY State of Health is the health insurance marketplace and selects the benchmark plan for EHBs.[11] The state Health Care Reform Act (HCRA) establishes funding mechanisms to support various health care initiatives and governs reimbursements from insurers to health care providers.[12]
The Centers for Disease Control and Prevention describes the public health infrastructure as three components: workforce capacity and competency: the recruitment, continuing education, and retention of health professionals; organizational capacity: the consortium of public health agencies and laboratories, working with private and nonprofit organizations; and information and data systems: the up-to-date guidelines, recommendations and health alerts, and the information and systems that monitor disease and enable efficient communication.[19]
New York State relies on a county-based system for delivery of public health services.[20] The New York State Department of Health promotes the prevention and control of disease, environmental health, healthy lifestyles, and emergency preparedness and response; supervises local health boards; oversees reporting and vital records; conducts surveillance of hospitals; does research at the Wadsworth Center; and administers several other health insurance programs and institutions.[20] 58 local health departments offer core services including assessing community health, disease control and prevention, family health, and health education; 37 localities provide environmental health services, while the other 21 rely on the state's Department of Health.[20]
At the local level, public health workers are found not only in local health agencies but also in private and nonprofit organizations concerned with the public's health.[19] The most common professional disciplines are physicians, nurses, environmental specialists, laboratorians, health educators, disease investigators, outreach workers, and managers, as well as other allied health professions.[19] Nurses represented 22% of the localities' workforce (and 42% of full-time equivalent workers in rural localities), scientific/investigative staff represented 22%–27% of the workforce, support staff represented 28%, education/outreach staff represented 10%, and physicians represented 1%.[20]
The American Hospital Directory lists 261 active hospitals in New York State in 2022. Two hundred and ten of these hospitals have staffed-beds with a total of 64,515 beds. The largest number of hospitals are in New York City.[21] The January 1, 2022 listing by the New York Health Department of general hospitals covered by the New York Healthcare Reform Act show 165 hospitals 63 closed hospitals, and 51 hospitals that had been merged with other hospitals.[22]
The oldest hospital in New York State and also oldest hospital in the United States is the Bellevue Hospital in Manhattan, established in 1736. The hospital with the largest number of staffed beds is the NewYork-Presbyterian Hospital in Manhattan with 2,678 beds in its hospital complex.
↑ Access to health care in America. Institute of Medicine, Committee on Monitoring Access to Personal Health Care Services. Millman M, editor. Washington: National Academies Press; 1993.
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