New York is synonymous with opportunity in the American vocabulary. Millions have sought greater opportunity here, and New York City has long served as the literal and symbolic gateway to the American dream. But opportunity in New York is endangered as a growing segment of residents find that health care is too expensive, too far away, too inconvenient for working families, too insensitive to language needs and cultural differences -- in short, too far out of reach for too many. This report is prompted by the release of the recommendations of the New York State Commission on Health Care Facilities in the 21st Century -- commonly known as the Berger Commission or the Hospital Closing Commission. The Commission was tasked with recommending a slate of hospital closings and service reductions around the State, including in New York City. Those recommendations will be implemented by the State Department of Health unless the Governor fails to approve them or the Legislature rejects or changes them. This report offers new and crucial information to the Governor and Legislature's consideration of the Commission recommendations. The report: - Measures the current availability of quality health care to all New York communities, in the context of those communities' actual health needs; - Reviews the state, federal, and international laws that, together, guarantee New Yorkers equal access to quality health care; - Identifies the ways in which inadequate and unequal health care access violates New Yorkers' rights and harms all communities, as well as the ways in which further cuts recommended by the Berger Commission could significantly worsen those conditions; and - Offers viable policy solutions that will improve access to high quality, comprehensive care for all who live in New York.