Losing Vitale-ity?

NJ.com — Wednesday, November 14, 2007

Posted by John Glasel

On November 13, one of our state's finest consumer organizations, New Jersey Citizen Action, hosted a conference at Rutgers (full disclosure: my organization, Health Care for All/NJ, is a dues-paying constituent of NJCA and was a co-sponsor of the event). An overflow crowd heard experts from across the nation discuss ideas for reforming our dysfunctional health care system.

The conference, titled "Health Care for All," was moderated by Rutgers professor of public policy Joel C. Cantor and Roger Hickey, co-director of Campaign for America's Future, a Washington-based advocacy group. Sy Larson, of New Jersey AARP and NJ Workmen's Circle leader Martin Schwartz assisted with introductions. National health reform issues were discussed by speakers from Physicians for a National Health Program, Princeton University, the AFL-CIO and the Campaign for America's Future's other co-director, Diane Archer. Of particular interest to attendees were descriptions by speakers from Massachusetts, Maine and Wisconsin of problems they surmounted in their home states.

Political figures were on hand, too. Heather Howard, policy counsel to Governor Jon Corzine, made closing remarks. Other politicos on hand included an advisor to the Obama presidential campaign (on leave from a Seton Hall law professorship), assistants to congressmen John Conyers, Jr. (D-MI) and Frank Pallone (D-NJ), and the chair of the NJ state senate's committee on Health, Human Services and Senior Citizens, Joseph Vitale (D-Middlesex).

Most of the experts agreed that health care should be a right, not a privilege. Everyone should be covered by insurance, or its equivalent, guaranteed care. Health care activists (and political junkies) will remember that about a year ago Sen. Vitale announced that he had formed a "task force" that would soon announce "universal" health care legislation. First expected in March or April, 2007, its introduction was pushed back until this Fall. Recently, Mr. Vitale announced that it wouldn't be unleashed until next year.

Although his web site has for many months presented a "framework" of his proposal-to-be, the senator once again detailed it to the conference attendees. The recitation reflected input from hospitals and other providers, but not much about how the plan would improve the lot of most of the state's un- and under-insured citizens. During a Q & A afterward, he was asked if his "task force" (whose membership has never been disclosed) included any consumer representatives. His answer: "Me and Dave Knowlton." Knowlton is a former Deputy Commissioner of Health in Gov. Christine Todd Whitman's administration who now runs a health care consulting business.

Mr. Vitale said his plan will provide New Jerseyans with affordable commercial insurance policies. Probably reflecting the wishes of insurers on his "task force," he talked about an "individual mandate" where everyone must pay insurance premiums, with state subsidies for lower income people. He won't consider a plan financed by taxation, even though it would avoid the cumbersome bureaucracy required to determine eligibility for subsidies.

BTW, that's what very nearly was enacted in Wisconsin this year (it lost by only 2 votes in the legislature). When this reporter asked the Badger State activist how they achieved so much support for a tax-based system, he said they had made it a major political issue. "What's fair is fair," he said. Garden Staters, listen up!

The issue of finding affordable comercial insurance was a thorny one in Massachusetts, where it couldn't be done. They ended up exempting about 60,000 lower-income people from the tax penalties they plan to inflict on Bay Staters who don't buy insurance. It remains to be seen how well some of Massachusetts policies deemed "affordable" for middle-income people will protect them against medical emergencies. Commercial insurers' profits and overhead can run as high as 30 percent of premiums. Compare that to government-run insurance, like Medicare, where administration costs less than 3 percent.

Can consumer input be injected into Vitale's super-secret "task force?" Maybe we should start by contributing to his re-election campaigns. It seems to work for the insurance companies. Just like local real estate development, state-wide health care reform is being held hostage to "pay to play."

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