Bright idea in New Jersey: Make hospital care even more expensive!

As New Jersey's July 1 deadline to adopt a state budget looms, hospital groups and some legislators are fighting to stop a new tax that Gov. Jon Corzine (D) has proposed in an effort to reduce the state's $4 billion deficit. In his budget proposal this year, Corzine suggested imposing a bed tax on all 74 hospitals operating in public-private partnership with the state. The measure is expected to raise approximately $430 million by forcing hospitals to pay an average of $1,424 a month per bed and might bring in some matching Medicaid funds from the federal government.

Corzine wants to split the $430 million in half, giving $215 million back to hospitals at rates dependent on their Medicaid utilization and putting the other half into the state's general fund in order to seek the federal matching funds. The plan has the health care industry crying foul because it hurts large hospitals with low rates of Medicaid usage and unfairly benefits small ones with large numbers of Medicaid patients.

Not only is it a bad idea that could cause division in the hospital industry, said New Jersey Hospital Association spokesman Ron Czajkowski, it's an example of horrible timing because the industry is on "spongy, if not fragile, financial turf." The average nonprofit hospital in the state has an operating margin of 1 percent. "We have a high charity-care caseload," Czajkowski said. "Medicare and Medicaid don't pay dollar for dollar, and we're dealing with the impact of the illegal immigrant population that costs $250 million a year. In addition, we have the same problems the rest of the country has with managed [care], where they are still slow or no-pay contributors to hospitals. "Forty-two percent of the state's hospitals operated in the red last year, and if a tax like this goes through, there will be cutbacks on services and layoffs," Czajkowski continued. "Some of those that are already in bad shape might close down."

Under current New Jersey law, hospitals are required to care for all patients seeking medical attention, regardless of whether they have insurance. In 2005, the state budgeted $583.4 million to reimburse hospitals for those charity-care cases, said Department of Health and Senior Services spokeswoman Gretchen Michael--an amount Corzine proposes keeping the same in the FY 2007 budget. But Suzanne Ianni, executive director of the Hospital Alliance of New Jersey, pointed out in her April 3 testimony before the state Senate Budget and Appropriations Committee that the amount is inadequate because it's based on 2002 data. Over the past four years, the state's charity-care costs have risen from $778 million to more than $1 billion, she said. Medicaid doesn't reimburse dollar for dollar, so the 2002 estimates were low to begin with.

"People receive care whether or not they have health insurance because of hospitals' public-private partnership with the state," Ianni said. "We know that Gov. Corzine wants a responsible budget this year but ignoring the substantial increases in charity-care delivery is irresponsible of this budget. Our government must meet its responsibility to ensure health care for its citizens."

The Trenton Times pointed out in an April 9 editorial that if the tax is approved, it will most likely result in even higher health care costs for consumers as hospitals pass the cost along to their patients, ultimately through higher insurance premiums. State Sen. Paul A. Sarlo (D-Wood-Ridge) opposed the tax. "We can't solve our charity-care problem on the backs of hospitals who serve our working residents who have health insurance," he told NorthJersey.com on April 8.

At press time, the state legislature was still in discussions with Corzine. The governor's press office referred calls for comment to Ms. Michael at the Department of Health and Senior Services.

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Nowhere for her to give birth

What happens when you rely on the great god "Gubmint" and their wonderful "planning": An interstate trip to give birth!

A critical bed shortage has led to a pregnant mother expecting twins having to travel to Canberra Hospital yesterday because of a gridlock in infant intensive care wards. A rush of multiple births - including triplets at Nepean Hospital - put pressure on an over-burdened system. The woman was flown by air ambulance to Canberra early yesterday morning. High occupancy rates in maternity and neo-natal wards across Sydney caused a serious shortage across the state.

A spokesman for ACT Health confirmed they received a NSW patient early yesterday, and said interstate transfers were "routine". "A pregnant woman was transported to the Canberra Hospital from Sydney because there were no neo-natal beds available elsewhere in Sydney," he said.

A NSW Health spokeswoman said there was a shortage in both maternity and intensive care cots across the state. "From time to time we do need to transfer patients and their babies to specialist services outside of Sydney," she said. "When the patient and her children are stable, they will be offered transfer back to Sydney."

A lack of specialist nurses is aggravating the situation, prompting one Sydney hospital on Thursday night to call in off-duty nurses. "This is a recurrent problem, it happens all the time," one specialist told The Saturday Daily Telegraph. There are currently more than 140 positions vacant in NSW in this specialist nursing field, causing major problems in all hospitals with neonatal intensive care units. "This is a highly specialised area and these babies need one on one care 24-7," an expert said. "There is not enough nurses to match the beds."

The fact women are having children later in life means there are more premature babies than ever before and technology can keep a premature infant alive at 23 weeks. About 2 per cent of all babies born in NSW are treated in one of the state's nine specialist units. There are 125 intensive care cots across NSW and the ACT. Survival rates for babies admitted to neonatal intensive care units have risen from 87 per cent in 1997 to 92 per cent in 2005.

Opposition health spokeswoman Jillian Skinner said it was an outrage a woman was made to travel during a stressful and vulnerable time.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.

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