Thread: Private clinic network for illegal invaders to be started

Extending care to all
Tuesday, January 2, 2007

By MARY JO LAYTON
STAFF WRITER


New Jersey would become one of the few states offering universal health care, through a state-subsidized plan that would insure 1.4 million people, under a proposal being drafted by lawmakers.

State Sen. Joseph Vitale, D-Middlesex, who hopes to introduce a bill by April, said all residents would be required to have health insurance, much the same way all New Jersey drivers must purchase auto insurance. Those who couldn't afford it would join the subsidized plan -- even enrolling as they seek emergency care.

The cost could reach $1.7 billion in its first year alone, Vitale said, but the tab would be reduced by new enrollees' premiums.

Without reform, he said, people will continue to turn to expensive emergency care for routine treatments; hospitals will spend millions more on charity care for uninsured patients; precious health care dollars will be spent in the least efficient way.

"We've spent nearly $8 billion on charity care in recent years, and what do we have to show for it?" Vitale said. "We have more uninsured, people who are sicker, hospitals that are in trouble and a system that is spinning out of control."


By the numbers
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A proposed universal health care plan would cover:
614,000 low- and middle-income residents who earn too much to qualify for Medicaid

300,000 low-income residents who are eligible for subsidized care

447,000 immigrants and homeless people

In theory, every stakeholder -- patients, hospitals, physicians and businesses -- agrees that health insurance is something each person should have. And all agree that the issue likely affects nearly every family in the state, from the 100,000 young adults who forgo insurance to those who suddenly lose their generous plans because of a divorce or a layoff.

Yet, at a time when the state Legislature is mired in property tax reform and facing a budget gap that could reach $3 billion next year, the sticker shock can be a conversation stopper.

"I'd love to do it," said Senate President Richard J. Codey, D-Essex. "But how do you pay for it at a time when we're talking about trimming the tree financially? We're trying to provide property tax relief."

Backs concept

Governor Corzine supports the concept of universal health care but is eager to see the details in the legislation before committing to any particular bill, spokesman Anthony Coley said.

"Increasing access to health care has been a priority for the governor and will continue to be an area of focus for the administration," said Coley. "We look forward to working with the senator on a goal we share: reducing the number of uninsured New Jerseyans.''

The bill would cover low- to middle-income residents who earn too much to qualify for Medicaid but don't make enough to buy health insurance on their own. These families would pay premiums on a sliding scale, according to income.

Vitale declined to discuss the cost of those premiums, saying rates are still being set by actuaries.

The state's largest managed care companies -- those with statewide networks -- could bid on the plans, which would work like a typical HMO or PPO, which is more expensive and allows patients to go out of network. Two or three managed care companies would be selected.

The bill also would cover low-income residents who already qualify for subsidized care but have never registered. These residents would be enrolled in existing Medicaid HMOs.

Network of clinics

Uninsured legal and illegal immigrants and the homeless would be treated at a statewide network of clinics. The state cannot legally arrange insurance policies for undocumented immigrants, so the clinics are the best alternative, Vitale said. And anyone still in need of hospital treatment could obtain it.

Vitale described the $1.7 billion cost as a "worse-case scenario" and said it would be offset significantly by premiums. Eventually, he said, with more people insured, the overall charity tab at hospitals would drop and, in turn, help fund universal care. Furthermore, the state would spend millions less in "bailouts" to hospitals operating in the red, he said.

Joel Cantor, a health expert at Rutgers University, called the proposal "ambitious" and "feasible."

"If states are going to achieve universal coverage, it would have to be a plan like this. You need to maximize existing coverage. They're not in the position to tear down the system and build it from scratch," said Cantor, director of the Center for State Health Policy.

New Jersey has almost twice as many uninsured residents as Maine, Vermont and Massachusetts combined -- the only states that currently provide or plan to provide universal coverage.

Massachusetts expects to add 500,000 people to the rolls of the insured in July. That plan, much like Vitale's, requires residents to purchase insurance and offers income-related subsidies to help make premiums more affordable. It also offers an innovation known as "the connector," which matches people with insurance plans.

The Bay State plans to reallocate $1 billion -- about half the total it spends on charity care -- over the next few years to offset the cost of providing health care to about 8 percent of its population, said Michael J. Widmer, president of the Massachusetts Taxpayers Foundation, a non-partisan group that lobbied for universal coverage.

"The coalition that came together in support of this -- employers, patient groups, the religious community, unions and hospitals -- is unlike anything I've seen in terms of the sweep of support and breadth in my 30 years plus in Massachusetts,'' he said, adding, "It's quite stunning."

Showing caution

The mood in New Jersey is more cautious, especially in the business community.

So far, there are no employer mandates under consideration, Vitale said. Businesses that don't provide insurance would only have to create pretax accounts and deduct premiums from workers' paychecks.

However, Vitale said he wouldn't rule out contacting the state's largest employers -- those with several thousand employees or more -- who aren't providing insurance to see if "there would be a partnership in terms of premiums."

"It could be that we'd require a contribution by the employer to the plan," he said.

Companies already burdened with insurance costs that have nearly doubled in the last six years are fearful that the debate on universal health care won't focus on affordability, said Christine Stearns, vice president of the New Jersey Business and Industry Association. It represents 23,000 businesses, the vast majority of whom employ 50 people or less.

"New Jersey is the most expensive state to buy health insurance, and we consume more health care than in most states," Stearns said. "No matter how you slice it, it's a huge issue for small companies."

Dr. Robert DeGroote, a Hackensack surgeon who has dropped out of many managed care plans because of low reimbursements, supports the concept of universal care but expressed many concerns.

"I have no problem with universal health care as long as I am paid fairly for what I do," DeGroote said. "Now that Medicare and Medicaid have discounted care further and further, I don't trust the government to do anything well.''

New Jersey hospitals, which provide more than $1 billion in charity care annually, are eager to hear details of Vitale's proposal, said Ron Czajkowski, spokesman for the New Jersey Hospital Association.

"We applaud and welcome any effort to reduce the number of uninsured in New Jersey,'' he said.

Immigrants fearful

For the immigrants Luisa Torres counsels at the Hispanic Multi-Purpose Center in Paterson, talk of universal health care can't come soon enough.

"There are immigrants that live in the area that need care, but they're afraid to go to a clinic because they don't have insurance,'' said Torres, the deputy director. "They end up in the hospital.''

"We have clients who come in for prescriptions, but we can't help them. We refer them to area pharmacists who give them a break,'' Torres said. "Having insurance would be a big help.''

E-mail: layton@northjersey.com



Copyright © 2007 North Jersey Media Group Inc.

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Now would be a good time for NJ residents to raise hell and insist that they bar anyone who is not legal from gaining such services!

Right you are Kate!

Its' about time we put a hefty tax on ALL outgoing remittances to Mexico to help foot the bill. I think that could cover a good portion of this.

Yes, it should be technically easy to skim fees from all those places with the signs, "envie dinero a Mexico" - they're all over the place.