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With All This Reform, We Need to Keep Our Patients First

New Jersey article by Stephen Sweeney

New Jersey ranks near the top in both hospital and health insurance costs, which is why health reform has to put the needs of the consumer first.

Last year, I pushed successfully to persuade the labor-management committees that oversee health insurance for public employees and their families to authorize patient-centered health care plans that save money by providing better health care.

Teachers in Union Township and the East Orange Community Charter School, county workers in Sussex and Cumberland, and city employees in Newark and Hackensack were among the first to sign up for patient-centered health care plans  that ultimately will save tens of millions of dollars for them and for taxpayers.

What public employees like about the consumer-friendly plans being offered by Horizon and Aetna is that it gives them a family doctor who knows them and their families’ medical history, and can provide them with the preventive care upfront that saves expensive hospital bills later.

Participants are not charged any copayment for visiting their family physician. The idea is to get people the treatment they need as early as possible, not build in financial disincentives that keep people out of the doctor’s office.

Our Patient-Centered Health Care initiative was the culmination of two years of policy development working with America’s Agenda: Health Care For All, a respected national health care alliance, and with New Jersey physicians and business and labor leaders.

It is a consumer-friendly philosophy — providing better health care at a lower cost — that underlies the OMNIA health care plans that Horizon markets to both private sector and government employees and retirees.

Just as state and local governments and their employees have a shared interest in holding down the growth in health care costs, so do New Jersey businesses, workers and their families.

New Jersey is a high-cost state, but there is no reason that New Jersey has to have the hospital costs and the second-highest insurance premiums in the nation, and that we cannot follow the example of a state like Vermont, whose community-based health care teams cut inpatient hospital stays by 21 percent, emergency room visits by 31 percent and health care costs by 12 percent.

That is why I personally testified before the Senate Commerce Committee on Monday and urged my fellow legislators to put the interests of the consumer first, and not set up barriers to the implementation of patient-centered health care networks and other initiatives designed to cut health care costs while improving the quality of health care.

This effort should include transparency and accountability by those responsible for serving the health care needs of consumers, including the hospitals and insurance companies.

I support requiring insurance companies to fully disclose the criteria they use in determining which hospitals or providers participate in tiered health care plan. That is why I sent a letter to insurance companies asking for 10 years of financial information and balance sheets on their New Jersey health insurance operations.

I also support greater transparency in advance from physicians on treatment costs and copayments.

So I sent a letter to 65 New Jersey hospital executives asking them to provide 10 years’ worth of detailed information about earnings and profit margin amounts for the entire health system and each acute care hospital that is part of that system.

We have New Jersey hospital posting double-digit profit margins, including one for-profit hospital that was the highest-priced in the nation, according to The New York Times.

The rising cost of health care hurts families, businesses and unions, which is why they are increasingly choosing patient-centered health care in states throughout the country. Taxpayers cannot afford 7 percent increases in health care costs, and neither can businesses or individuals and families forced to buy health insurance in the private market.

We can no longer afford a health care system that rewards hospitals or physicians for the number of patients they can get through the door or the number of tests they can order.

We need to reward hospitals and doctors for the quality of care they provide.

We need to do everything we can to ensure greater choice, greater consumer awareness and better results, and the new tiered health care networks are an important step in that direction.

Stephen Sweeney (D-Gloucester) is president of the New Jersey Senate.

 

Source:  http://www.nj.com/

Posted by:  The Wealthy Doctor

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With All This Reform, We Need to Keep Our Patients First - overview

Summary: New Jersey ranks near the top in both hospital and health insurance costs, which is why health reform has to put the needs of the consumer first. We need to do everything we can to ensure greater choice, greater consumer awareness and better results, and the new tiered health care networks are an important step in that direction.

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