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Panel of Experts Discuss Future of Healthcare in NJ at “State of the State Symposium”
Written by HardNewsNJ staff   
Friday, 20 February 2009 15:12

TRENTON – Eleven experts in health care policy offered suggestions for reducing health insurance costs and improving accessibility for New Jersey residents Thursday at the first-annual “State of the State Healthcare Symposium” in Trenton. Nearly 500 members of the public, mostly from the healthcare and insurance industries, attended the event.

Though the topics ranged from public health care education to underwriting standards, the question of the day was whether New Jersey should aim for universal health coverage.

“Massachusetts has been enormously successful in implementing its model for health care reform,” said panelist Joel Cantor, Director of the Rutgers University Center for State Health Policy. Massachusetts enacted a law in 2006 that requires almost every resident to obtain basic health coverage and provides state-sponsored insurance packages for residents who do not receive health insurance through their employer.

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Photos by Dan Burns/HardNewsNJ
Photos by Dan Burns/HardNewsNJ

The law makes health care affordable for all Massachusetts residents, but it comes at a price, according to panelist Michael Munoz, Vice President of Sales and Marketing for AmeriHealth, Inc.

“Depending on the state and federal government to make universal health coverage happen would be extremely challenging,” Munoz said. “The Massachusetts model cost them a lot more than they thought it was going to cost.”

The symposium, which was sponsored by the New Jersey Association of Health Underwriters and moderated by Michael Aron of NJN News, featured many similar debates over whether New Jersey is over-mandated, under-mandated, neither or both.

Though all panelists were in favor of the state’s July 2008 law that mandates universal health insurance for children, Patrick Young, Aetna’s President of Small & Mid-Size Market, Mid-Atlantic Region, pointed out that a slew of New Jersey mandates inflate premiums by 5 to 7 percent when compared to less-regulated Pennsylvania.

“We need to come to an agreement that allows individuals and small- and medium-sized businesses to make a decision on what type of coverage is suitable for them,” Young said.

Other input from the panelists included:

  • Sen. Joseph Vitale (D-19), Senate Health, Human Services and Senior Citizens Committee: “Given the current economic crisis and the stress on the state budget, it’s important that we hold the fort. We need to get every child in New Jersey insured and try to enroll parents as well. We have to increase access wherever we can and provide a plan for unemployed and vulnerable people. There is a social issue at play here; Folks who make $200 per week are vulnerable. We need to pare down the number – nearly 1.4 million – of New Jersey residents who don’t have health insurance and we have to continue the dialogue we engaged in today. If we take a break, we will be overcome by other issues.”
  • Assemblyman Gary Schaer (D-36), Chair, Assembly Financial Institutions and Insurance Committee: Stated the state Assembly is working on the problem from a policy and education perspective, stressing that New Jersey needs financial help from Washington if it is going to implement universal health care in the middle of a global economic crisis. “Like the other 49 states we’re looking to the federal government to help us get out of this mess,” he said.
  • Steven M. Goldman, Commissioner of the New Jersey Department of Banking and Insurance: “President Obama was not in favor of universal health care; he was in favor of universal coverage for children. There is an enormous complexity involved in implementing universal health care and there is bound to be fighting between the public and private sector. The choice for many business owners today is ‘Do I continue coverage for my employees or do I ensure that I have adequate capital to run my business?’ We can get to universal coverage, but not without an enormous fight.”
  • Michael McGuire, Healthplan CEO, United Healthcare of New Jersey: Said carriers need to take the lead in engaging their customers. They need to disseminate information on disease prevention, the best facilities to have their conditions treated and how customer behavior drives healthcare costs.
  • Michael R. D’Agnes, President & CEO of Raritan Bay Medical Center: Made the point that Medicaid only pays for 70 percent of the cost to treat patients, with the remaining cost being picked up by hospitals. That cost then gets passed along to patients and their insurance carriers, causing health insurance rates to rise. He also noted that a number of New Jersey hospitals, particularly in urban areas, have closed or are slated to close.
  • James Stenger, Chair of the New Jersey Small Employer Health Benefits Program Board: Stated that New Jersey’s smaller employer health (SHE) enrollment is still robust, but is down from its peak enrollment in 1999. The SEH board is currently looking into making it easier for employers who need to save money to downgrade their plan rather than eliminate them altogether. He also suggested implementing a mandate-free small business employer plan on an experimental basis.
  • Michael Munoz, Vice President of Sales and Marketing, AmeriHealth: “In reform discussions, there needs to be a greater focus on the largest part of the premium expense: medical cost – which represents 85-90 cents of every insurance premium dollar. Any reform that happens should also include some sort of accountability for employers and their employees to live healthier lifestyles and to take more responsibility for understanding the impact that the cost and quality of care have on the cost of insurance. At the end of the day, these are the things that drive premiums. Employers have a responsibility to work with their brokers and insurers to address these issues proactively.”
  • Joel Cantor, Director of the Center for State Health Policy, Rutgers University: Said he believes New Jersey will have universal healthcare in five years, but it will take a government mandate to do so. He also pointed out that, despite the challenges the industry faces, New Jersey’s insurance participation rate for small businesses is one of the highest in the nation.
  • Sara Collins, Program on the Future Health Insurance, The Commonwealth Fund: Stated that, with the election of President Obama, it is critical that we address healthcare costs promptly. She also mentioned that we need to ensure that healthcare mandates do not rid the system of selection.
  • Richard Popiel, MD, Vice President & Chief Medical Officer, Horizon Blue Cross & Blue Shield: Pointed out that there are many factors that drive up healthcare costs, including misuse by patients, under-use leading to complications from delayed treatment and overuse stemming from a fierce malpractice environment. All three lead to an excessive amount of premium dollars being wasted.
  • Patrick Young, President, Small & Mid-Size Market, Mid-Atlantic Region, Aetna, Inc.: “Nationally, 11 million children are eligible for the State Children’s Health Insurance Program, but are not enrolled. So what can be done today? Make a concerted effort to enroll those 11 million people and change the laws to give individuals the ability to write off healthcare costs on their taxes.”

 

good photo of panel
A panel of experts

Michael Thompson, an account executive at AmeriHealth, said he looks forward to attending the next symposium. “It was a very informative event and should be something that occurs on a more frequent basis so that the broader group can experience an exchange of ideas and have a better understanding of what’s going on in the market place.”

Michael Aron, the moderator. said he enjoyed moderating the event and thinks it is a significant step in the right direction for New Jersey.

“I think it was a very interesting discussion,” Aron said. “Everybody seems to be in favor of universal coverage, but there was a strong sentiment that our health care system is dysfunctional and it is going to be extraordinarily complicated to fix.”

Approximately 15 percent of New Jersey residents lack basic health insurance, which boosts the state’s charity care costs to approximately $750 million per year. The NJAHU’s goal in organizing the event was to foster dialogue among government leaders, health insurance executives and health care providers, so that positive change could be initiated, according to NJAHU President-Elect David Oscar.

“Hopefully, by working together, we can create solutions,” Oscar said.

 

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