Bloomberg On Health Care: Translating His Mayoral Record To The National Stage

Former New York City Mayor Michael Bloomberg has spent greater than $200 million arguing that he needs to be the Democratic nominee for president, blanketing the airwaves with ads.

One of those ads emphasizes well being care — leaning into the characterization of Bloomberg as a reasonable Democrat with expertise getting outcomes. It presents a powerful listing of statistics and accomplishments.

“Mayor Bloomberg helped lower the uninsured by 40%, covering 700,000 more New Yorkers,” says a New York-based nurse featured within the business. “Life expectancy increased. He helped expand health coverage to 200,000 more kids and upgraded pediatric care. Infant mortality rates dropped to record lows. And as mayor, Mike Bloomberg always championed reproductive health for women.”

But we had questions. Are these numbers correct? And in that case, how a lot credit score does Bloomberg deserve? Most essential ― what can his report inform us about how he may method well being care from the Oval Office?

The New York Record

Bloomberg’s marketing campaign directed us to unbiased estimates by the U.S. Census Bureau, which tracked New York City’s uninsured charges throughout Bloomberg’s time as mayor, which spanned 11 years from 2002 to 2013.

The numbers try. The metropolis’s uninsured inhabitants dropped from 1.eight million in 2001 to 1.05 million in 2013. Life expectancy did go up. And the variety of youngsters with out protection fell from about 270,000 to 67,900.

Data from the town’s well being division means that the toddler mortality fee additionally dropped considerably ― from 2001’s 6.1 deaths per 1,000 dwell births to four.6 deaths in 2013. That decline was forward of nationwide traits. During the identical interval, the nationwide toddler mortality fee dropped from 6.85 per 1,000 dwell births to five.86.

Bloomberg’s marketing campaign pointed to native efforts promoted by the then-mayor ― as an example, providing on-line assist for uninsured folks to seek out protection, making it simpler to distribute pamphlets advertising and marketing completely different protection choices, house visits for newborns and moms from well being department-employed nurses, and a city-funded program during which neighborhood organizations used case administration and peer training to fight toddler mortality.

But others questioned how significant these initiatives have been in driving the town’s medical insurance features ― and, extra broadly, how nice a job Bloomberg performed.

“Every single thing ― the 700,000, and the 200,000, all of that ― is directly related to state policy changes,” Elisabeth Benjamin, vp of well being initiatives for Community Service Society, an anti-poverty advocacy group in New York City, stated in regards to the enhancements within the metropolis’s uninsured charges.

Specifically, Benjamin pointed to efforts by then-Gov. Eliot Spitzer to broaden eligibility for the Children’s Health Insurance Program. That, she stated, drove a lot of the features for youths’ protection.

The state additionally expanded Medicaid eligibility, which helped extra adults get protection throughout Bloomberg’s administration, famous Sherry Glied, a well being economist and dean at New York University.

She gave Bloomberg extra credit score than Benjamin did, citing metropolis efforts to promote this system and signal folks up: “The city couldn’t have done it without the state, but the city played a role,” Glied stated.

As for all times expectancy ― that’s tough. Bloomberg gained nationwide consideration for efforts to limit tobacco and soda, as an example. But whereas folks have been anticipated to dwell longer below Bloomberg’s tenure, it’s unclear that change had something to do together with his work on insurance coverage or public well being.

For one factor, Glied famous, there was a very giant inflow of individuals shifting to New York City throughout that point. Many of them have been likelier more healthy to start with. And, massive image, it’s methodologically troublesome to determine why folks’s outcomes improved.

“It’s hard to parse this,” she stated. “This is the happy moment where everything goes in the right direction, but this is not a randomized experiment. There was no control New York City.”

So the numbers Bloomberg factors to are right. But it’s troublesome to say how a lot duty he had for these enhancements, and the way a lot was because of exterior elements.

Bloomberg, The Candidate

What does all this imply when taking a look at Bloomberg’s 2020 marketing campaign?

His well being care agenda locations him firmly among the many Democrats’ reasonable wing. He talks about constructing on the Affordable Care Act ― largely by increasing subsidies for folks shopping for personal insurance coverage, and capping what they’ll pay out-of-pocket ― in addition to making a government-run public choice for protection that folks should purchase into. He has additionally stated he would work to get rid of shock medical billing and empower Medicare, which insures older Americans, to decrease drug costs.

That plan isn’t a lot completely different from these put forth by former Vice President Joe Biden or former South Bend, Indiana, Mayor Pete Buttigieg. But Bloomberg is suggesting that his report in New York higher equips him to ship.

“He’s pointing to his record as mayor, where he did make health care a priority, as evidence that this is an issue that’s important to him,” stated Sara Collins, a vp on the Commonwealth Fund in New York.

Would that report translate to the White House? A comparability is troublesome to make as a result of the circumstances can be dramatically completely different.

As mayor, Bloomberg labored towards a backdrop during which state lawmakers additionally wished to broaden protection, and prolonged assets to advertise that effort. That’s no certain guess in Washington, the place the Affordable Care Act has remained a political punching bag for Republicans, a celebration that political analysts counsel has probability of holding onto the Senate in 2020. In that setting, constructing on the ACA can be a lot tougher than it was to broaden protection in New York.

There are different areas to think about, although. In New York, Bloomberg gained nationwide consideration for efforts to tamp down on smoking, handle diabetes and bolster entry to reproductive well being. Those are areas the place a president’s affect can matter.

“His record suggests that he sees the public health ― tobacco, salt, calories, all of that stuff ― as a pretty significant component of what happens to people’s health, and also as an appropriate place for the government to take action,” Collins stated. “It’s not hard to imagine where he’d be on Juul.”

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