Get health insurance off sick list, candidates say

BY MICHAEL DAIGLE

DAILY RECORD



Republican incumbents Richard Merkt of Mendham Township and Michael Patrick Carroll of Morris Township are being challenged for their 2-year seats in the state Assembly's 25th District by Democrats Thomas Jackson of Morris Township and Janice Schindler of Mountain Lakes.



The candidates are being asked one question a week until the Nov. 8 election. This week we posed an additional question:



One of the fastest-growing cost areas for state hospitals is charity care, fueled by a rising number of working poor without health insurance seeking care in emergency rooms, inadequate reimbursement by the state for charity care costs and large numbers of immigrants seeking care. What can be proposed to avoid having more of this cost picked up by the state government, and thus taxpayers? Should the state set minimum standards for company insurance plans so the taxpayers do not pay the bills for otherwise employed workers? Is it time to pressure the federal government to reopen the discussion about health insurance policy?



Jackson



The real issue is how we can make health care costs more affordable in New Jersey. Today, we have nearly 1.4 million people uninsured, nearly 265,000 of whom are children. Compounding this problem is the fact that some large employers, like Wal-Mart, are brazenly shifting their health-care costs to the state, and ultimately to the taxpayers.



During the 1980s, I worked for what was then one of the country's largest health-care insurers. I witnessed firsthand the shift from traditional indemnity programs to preferred provider programs to true managed care programs like health maintenance organizations (HMOs), all of which were efforts to stem the double-digit rise in health care costs. None of these programs have worked.



My opponents, no doubt, will recommend some combination of shifting costs to employees and tort reform. The fact of the matter is that shifting more costs to employees is a form of an indirect tax increase, and controlling frivolous lawsuits will only result in less than an incremental decrease in the cost of health care.



The problem is that we have a structural defect in our health care delivery system. We need to enact legislation that would require large corporations to provide health insurance to their employees and stop shifting the cost onto the state; offer tax breaks to individuals who are not covered on a group plan; allow small businesses to pool their health care costs so that insurance becomes more affordable; and focus on preventative health care to drive down health care costs in the long term.



Schindler:



A majority of New Jersey's 1.4 million uninsured individuals are working poor -- individuals who make too much money to qualify for Medicaid but too little to pay for health insurance. They often receive primary care in hospital emergency rooms. The state subsidizes the hospitals for a portion of the expenses incurred.



To compensate for the remaining portion of these unpaid expenses, hospitals are forced to charge higher rates to private insurance companies, which in turn increases the premiums paid by businesses and their employees. Consequently, I support programs that increase access to affordable health insurance.



These programs include: taking a portion of these charity care dollars to subsidize health insurance for the working poor; creating insurance pools for individuals and small businesses so that people can have bulk buying power; requiring insurance companies to allow parents to cover their adult children aged 19 to 30; and encouraging small businesses to form association health plans to purchase insurance for employees with the assistance of a new risk pool created by the state.



I will work to allow families to "buy in" to programs such as Family Care at a cost which amounts to a substantial savings over purchasing health care in the private sector.



I support the bipartisan "Family Health Care Coverage Act" that reforms the NJ FamilyCare Program and provides for an expansion of NJ FamilyCare and Medicaid eligibility for parents and adults without dependent children and consolidates NJ KidCare and NJ FamilyCare programs into the NJ FamilyCare Program. Our incumbent, Assemblyman Carroll, voted against this bill.



I will work to make health care more affordable by consolidating state programs that buy prescription drugs. I support the increased use of generic drugs to save additional costs.



Finally, I will work on a bipartisan basis to demand that the federal government provide the necessary and appropriate funding for the many unfunded mandates imposed on New Jersey.



Our incumbents voted against a resolution urging Congress to extend the temporary increase in Medicaid benefits (AR147).



Carroll:





While many folks decry the growing number of uninsured, they simultaneously advocate policies essentially guaranteed to increase their number. Policies such as community rating (in which someone with AIDS pays about the same premium as a perfectly healthy 22 year old), and mandatory top-of-the line coverage hugely inflates costs.



In Kansas, a basic insurance policy can be had for $172 per month; that's one-sixth of what a policy costs in New Jersey. We're a more expensive state, but not six times more expensive.



If we adopted more rational requirements, we could hugely decrease the costs of a basic policy, and cover virtually all the un- or under-insured with a basic policy. (A proposal in Congress would allow precisely this to happen.)



The state should most certainly not impose additional mandates on businesses. Those businesses which didn't immediately fold or move would simply increase their prices to cover the additional burden; whether the costs of governmental mandates are paid by "consumers" or "taxpayers" is really a moot point.



And, yes, the time has come to pressure federal officials to adopt the proposal to permit interstate competition among insurance carriers.



The last thing we need, though, is yet more governmental control. As the old adage runs, if you think health care's expensive now, just wait until it's "free."



Merkt:



The present, over-regulated, health insurance system in New Jersey is near breakdown. The answer is not more government, because the state created the problem with scores of health insurance coverage mandates, charity care mandates to hospitals, managed care mandates, a ponderous bureaucracy, and rules, rules, rules.



The state has driven the cost of health insurance beyond the means of many New Jersey families and businesses.



Having created massive groups of uninsured, the state promised universal health coverage in New Jersey by ordering hospitals to provide charity health care, regardless of patients' ability to pay. But for years, the state shorted hospitals on payment for free health care they were ordered to provide, putting their survival at risk.



Whenever the state mandates that anyone provide a service, the state must fully pay for the cost of its mandate.



It should look at less expensive ways of delivering health care services, such as clinics, which are far more cost-effective and appropriate for minor ailments. And it should roll back many of the coverage mandates and rules it has enacted to reduce the cost of health insurance for individuals and small businesses.