After months of debates, state lawmakers are now in the final week of the scheduled legislative session.  If this week follows the historic pattern, lawmakers will approve hundreds of bills this week alone.  Last session, of the 1,000 bills passed during the six months of the 2022 legislative session, 380 passed during the last few days of work.

Passing legislation is not the only significant action to be taken.  The state Senate will also decide whether to give approval to Governor Hochul’s nominee to head the Health Department.  Under New York law, the Health Commissioner must be a medical doctor.  The individual under consideration, James McDonald, has been head of the agency as an interim Commissioner since late 2022 and was nominated for the permanent position by the governor in March.  Dr. McDonald, a pediatrician by specialty and who grew up in New York’s Capital District, was most recently the head of the state of Rhode Island’s health agency.

Last week, the relevant state Senate committees held hearings on the nominee and asked questions to assess Dr. McDonald’s qualifications.  He emerged from that session unscathed and is expected to get final Senate approval during this week.

The state’s Department of Health is an enormous agency that covers vast policy areas, with the department overseeing a budget of some $100 billion.  During the Senate hearing, Dr. McDonald was asked about a wide range of issues, ranging from how the state handled the COVID-19 pandemic, to New York’s state vaccination policies, to plans to fight addictions, to environmental concerns – particularly drinking water protections.

Since individual Senators were timed to a three-minute exchange with Dr. McDonald, the questions tended to be ones that were likely to garner the most public interest, as well as more parochial concerns.  As a result, Senators were unable to dig deeper into health policies (at least not in this public session) and major topics that are clearly of public concern were left unaddressed.

Here are two examples:

One is the skyrocketing growth of infections that are increasingly resistant to antibiotics.  Due to the overuse and misuse of antibiotics in humans and animals, many strains of bacteria have evolved resistance to medically important antibiotics, meaning they are not killed by the drugs.  Instead, the bacteria survive, multiply, and spread.  In fact, the more antibiotics that are used, the faster antibiotic-resistant bacteria (a/k/a “superbugs”) develop, putting more people around the world at increased risk of contracting an antibiotic-resistant infection.  The spread of antibiotic resistance knows no geographic boundaries; it is already compromising medicine’s ability to treat and prevent disease, especially in those who are typically more vulnerable––children, seniors, and those with compromised immune systems.

The World Health Organization considers the rise of “superbugs” to be one of the biggest threats to global health, food security, and international development today.  The U.S. Center for Disease Control and Prevention has stated that fighting this threat is a public health priority and estimates that each year, at least 2.8 million people get an antibiotic-resistant infection, and more than 35,000 people die.  A study commissioned by the U.K. government predicts that if action is not taken now to combat antibiotic resistance, by 2050 the annual death toll will have risen to 10 million globally.

How will New York State’s Health Department tackle this rising threat?  Dr. McDonald was not asked.

The second issue is the poor quality of medical care in New York hospitals.  For the past ten years an organization established by the United States’ largest companies has been issuing reports on the quality of care in hospitals nationwide.  In its most recent report, it ranked New York one of the ten worst in the country in terms of overall hospital safety. 

Why do New York hospitals perform so poorly in terms of safety?  According to the researchers: “The system as a whole didn’t seem to have emphasized safety.  We’ve seen other states work together and look at what’s working well at other states and implement it.  It just doesn’t seem to be happening in New York.  It has to be front of mind every single day in a hospital.” 

Since substandard medical care is a top concern of New York patients, families and employers––we want to be cured, not injured by the care we receive––New York’s dismal performance is inexplicable and frightening.  What was shocking was that Dr. McDonald was not asked one question about it.

As mentioned earlier, the process by which the Senate considers and then approves nominations is limited.  Still, there are important issues that New York’s Health Department must tackle beyond those covered in the Senate’s hearings.  If the Senate confirms the nominee as expected this week, New Yorkers deserve to get answers.  Our lives may depend on it.