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June 15, 2000, Thursday, Late Edition - Final
SECTION: Section A; Page 1; Column
1; Metropolitan Desk
LENGTH: 1146 words
HEADLINE: Citing Own Cancer, Giuliani Offers Plan On
Health Coverage
BYLINE: By
ELISABETH BUMILLER
BODY:
Mayor Rudolph W.
Giuliani announced a health initiative yesterday aimed at
aggressively enrolling nearly one million uninsured New York
City children and adults in Medicaid and other government
health care programs. He said his ambitions for the plan came
about partly because of his change in attitude toward illness after he learned
he had prostate cancer.
"If we can do this, it becomes a model for the
rest of the country," Mr. Giuliani said as he presided over a news conference in
the city's public hearing chamber. He added that "this is a big goal that has
eluded New York City and most of America in the past." If successful, the
program would also help redefine Mr. Giuliani's legacy as he prepares to leave
City Hall for possible future political campaigns.
As the mayor
explained it, the plan, called Health Stat, is an expansion of
a more modest program that his administration began working on six months ago.
The new plan will divide the city into eight regions, each run by a manager.
Within each region, schools, hospitals, food stamp offices, job centers, police
precinct headquarters and others will either help enroll or give information to
the more than 900,000 people eligible for state and federal
health insurance who are not now covered. Mr. Giuliani
described them as "people who literally could have health insurance today if
they knew about it, we knew about them, and we made the proper connection and
got them to fill out the correct forms and got them covered."
"There's
no reason that that shouldn't be done," he said, "other than the fact that it
just hasn't been organized in the right way."
The uninsured would feed
into two existing programs, Medicaid and Child Health Plus, plus a third
program, Family Health Plus, which is expected to start in January 2001.
Insuring children, Mr. Giuliani said, would be the first priority. Health care
experts say one of the biggest problems in insuring children is reaching their
parents, who are often unaware of their eligibility and are intimidated by the
forms.
The mayor said he did not know what the Health Stat program would
cost, but acknowledged that it would be "a good deal of money."
Budget
projections for enrolling 344,000 people by 2004 -- the scope of the program
before Mr. Giuliani expanded it a month ago -- put the cost to the city at $130
million. The Health Stat program would nearly triple the number of enrollees.
The program is the mayor's first major policy initiative since he ended
his Senate candidacy and said he wanted to use his remaining 18 months in office
to try to embrace those New Yorkers he had alienated in the past.
For
one of the first times while announcing a major policy effort, the mayor invited
former enemies like Alan G. Hevesi, the city comptroller, and Mark Green, the
city's public advocate.
The City Council speaker, Peter F. Vallone, and
the chancellor of the New York City schools, Harold O. Levy, whose appointment
Mr. Giuliani initially opposed, were also present. The mayor singled out each
man at the end of his remarks. "I would like to work with all of you," he said.
Mr. Green had worked with Mr. Giuliani in coming up with a part of the
plan, and is to have a role in putting it into effect.
"The mayor said
the words a few weeks ago that he wanted to reach out to shunned communities and
officials and work together in the city's interest," Mr. Green said. "Those
words have been backed up, at least today, by a real deed."
The program
was also in striking contrast to the Giuliani administration's policy of
removing people from the welfare rolls. Health care experts said that while the
two programs were not inconsistent -- health insurance has been shown to help
people make the transition from welfare to work -- the seemingly contradictory
messages could cause confusion among the uninsured people the city is trying to
reach.
"When you're putting out a message that public assistance is bad
and you should stay away, it's hard to reconcile that with a message that health
insurance is good and you should come," said David Sandman, a program officer at
the Commonwealth Fund, a private philanthropic organization in New York.
But Mr. Sandman and other health care policy experts also praised the
plan as a significant step toward solving the problem of the city's 1.8 million
uninsured residents without creating a new, more expensive health insurance
program from scratch.
"This is a level of intensity in terms of signing
people up for public programs that we don't see in many other parts of the
country," said James R. Tallon, the president of the United Hospital Fund, a
philanthropy group.
The outreach efforts, Mr. Giuliani said, would
include holding "enrollment events" at schools and enrolling summer school
students and participants in the city's summer jobs program.
Health care
experts said they applauded the mayor's efforts but said the problem was complex
and labor intensive, and would take years to solve. "This is a very big
challenge, and it's not just a matter of getting the word out," said Mr. Sandman
of the Commonwealth Fund.
The administration of the plan is patterned
after the New York City Police Department's successful Compstat program, in
which 76 precinct commanders meet weekly to monitor crime statistics in their
areas and deploy forces as needed.
To gauge progress or change methods
of outreach, Mr. Giuliani said, the city will hold Compstat-like weekly meetings
monitoring the number of uninsured signed up in each region. The initial
meetings will be held at the city's Office of Emergency Management, the command
center in the World Trade Center where Mr. Giuliani goes to oversee city crises
and bad weather.
Mr. Giuliani said the Compstat idea came to him about
three weeks ago while he was showering. "That's literally where it happened," he
told the assembled city officials and reporters at the news briefing.
At
around the same time, shortly after Mr. Giuliani withdrew from the Senate race,
he decided to expand the program to try to reach nearly one million uninsured
residents. In his State of the City speech in January, Mr. Giuliani had set a
smaller goal of signing up 200,000 to 300,000 uninsured people who are eligible
for Medicaid.
But when he withdrew from the Senate race on May 19, Mr.
Giuliani said he wanted to increase the number of people covered by health
insurance because of what he had learned from his illness.
"One of the
things that I felt from the beginning of this and continue to feel is a
tremendous sense of compassion for the people that have to make decisions like
this alone," he said. "One of the things, maybe, that I can do is figure out how
we accelerate making sure that people are covered. I mean, there are a lot of
things that I can accomplish that I haven't accomplished
before."
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GRAPHIC: Photo: Mayor Rudolph W. Giuliani yesterday as
he announced an initiative to enroll more New Yorkers in government health
insurance programs. (Chester Higgins Jr./The New York Times)(pg. B14)
LOAD-DATE: June 15, 2000 
