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Last Tuesday (8), New York Mayor Bill de Blasio announced a plan to increase the access of 600,000 uninsured New Yorkers – half to illegal immigrants – to the municipal system. from hospitals and clinics. basic health. In doing so, he wants to ensure that all New Yorkers have access to health services, regardless of income or immigrant status. The plan, called NYC Care, will cost $ 100 million.
The complex health care system in the United States does not work like the universal systems of Brazil or several European countries, in which a network of clinics, hospitals and services is entirely funded by the government. Americans are required to have health insurance, which can be subsidized by employers or paid out of pocket.
There are specific public services for vulnerable populations such as retirees, children, veterans and people living below the poverty line, but these services, as well as Obamacare, are only to US citizens or legalized residents.
New York already has a municipal health system consisting of 11 public hospitals and 70 clinics, all for free, and an inexpensive health plan implemented in Obamacare.
But New Yorkers tend to use the public network only in an emergency, without seizing the service for routine consultations or simple exams, and many immigrants do not even know that these services are also offered.
The idea behind this initiative is to relieve the municipal emergency room by providing better access to the existing free network of general practitioners and prevention services.
In a first phase, the city intends to achieve this by promoting the municipal health plan, called Metroplus, whose monthly prices depend on residents' income and can even leave for free. But Metroplus is only available for US citizens and current residents, which would exclude illegal immigrants.
The second phase is for those who can not or do not want to have a health plan. The system will register interested parties who will not need to present documents proving their immigrant status, then appoint a general practitioner for each user and facilitate the planning of consultations, which will be remunerated according to the financial possibilities. of each one. There will also be a free 24-hour telephone service.
The initiative also includes mental health care and treatment for drug and alcohol abuse. The program is scheduled to begin in August in the Bronx and expand to the entire city by 2021.
The New York Care model is not unknown. It has been inspired by an existing initiative in San Francisco since 2007, which has been highly appreciated for its results. A study conducted in 2011 showed that 75% of participants had consulted a doctor within 12 months of their participation in the program, and that the number of emergency room visits and preventable stays at the hospital had also decreased considerably.
Mitchell Katz, idealist of the Californian program, is currently at the head of the network of public hospitals in New York.
A Tricky Time for Trump
NYC Care is just a slap in De Blasio's glove to President Donald Trump, who proposes a solution to two thorny problems for the White House: illegal immigrants and the health.
Trump is breaking with the new Democratic majority in the US Congress on his dream wall on the Mexican border.
At the same time, other newly elected elected members of the legislature pledge to work to expand Obamacare or even create a universal health care system in the United States.
At the state level, the newly elected governors of California and Washington also announced plans to explore initiatives similar to those of New York in their states.
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