Dr. Daniel Laroche of the Empire State Medical Association contributes the following recommendation via e-mail:

1. Contact all local New York medical schools and hospitals to immediately enforce nondiscriminatory laws by recruiting underrepresented Black and Hispanic physicians, medical students, residents and allied health personnel.

Currently New York City is 65% Black and Hispanic. The percentage of Black and Hispanic medical students in the city is 5-10%.

Leadership in medical schools and hospitals has failed to diversify medical staff to address current healthcare disparities.

Curriculums and entrance requirements must be reviewed and adjusted to reduce barriers which prevent staff diversification. Of note, in 2042, ½ of all Americans will be people of color.

2. Repeal the New York Medicaid cuts for health care for those patients with dual Medicare eligibility.

Rationale: These cutbacks have reduced Medicaid patients’ access to private physicians in underserved neighborhoods.

Because physicians will receive less reimbursement than physicians who practice in wealthier communities, Medicaid cutbacks discourage physicians from setting up practices in poor communities.

Physicians who open primary practices (greater than part-time) in underserved neighborhoods in designated zip codes in central Brooklyn, southeast Queens, south Bronx, and Harlem should receive special tax breaks, such as paying no property tax on home or office and/or a 50% discount on state and city taxes.

Medicaid reimbursements must be increased to increase the number of physicians who accept Medicaid and provide more patients with a medical home. Reimbursements to dentists must also increase so that patients can obtain care from local dentists in their community. This will reduce delayed care complications, emergency room visits and hospitalizations, which are more costly. Delayed health care is expensive health care.

Failure to increase physician reimbursement will lead to a shortage of outpatient locations to access preventive and therapeutic care. Of note, costs for physician practice operating expenses continue to rise: a recent federal mandate to convert all patient records to electronic medical records will cost each practice an average of $30,000 to $40,000. With ongoing support costs ranging from $4,000-$8,000 per year.