Ralph says the system needs to be fundamentally reengineered.
"Not just continuing to take monies away from providers who service the Medicaid population," she said. "We really applaud this task force going forward and it looks like we could have some movement going forward."
Ralph is also applauding Cuomo's efforts to give the North Country a louder voice in Albany. The governor recently appointed a trio of North Country officials to high-level posts in his administration - Dede Scozzafava, Joe Martens, and Darrell Aubertine.
But Ralph adds she's still not certain that Cuomo grasps the importance of hospitals to the North Country's overall economic health. Last year, the Healthcare Association of New York State released a report showing that hospitals are often the largest employers in their communities.
That point needs to be driven home with Cuomo, Ralph says.
"I think if he has people close to him that understand those issues, that's helpful," she said. "And of course we have our three elected representatives who have his ear - particularly state Senator Betty Little. She will be very powerful in getting our message across."
On the federal front, Ralph says she doesn't want to see lawmakers overturn last year's health care reform bill.
North Country Congressman Bill Owens said recently that he had spoken with hospital CEOs from across the 23rd district - including Ralph - and he learned that repeal was not a preference.
Ralph agrees, noting that having 32 million Americans uninsured is - quote - "unconscionable." But she adds that the bill isn't perfect.
"I think there are some things in it that are very bad and some things that are very good," Ralph said. "It'd be really nice - and maybe this is wishful thinking - if both sides could get together and say this is a very good piece, or this will be very difficult, or this has unintended consequences."