Healthcare

Our Problem - Uninsured, Underinsured, & Overpriced

It is time to change the way we approach healthcare as a state and as a nation.

We are faced with a number of specific issues:

  1. Year after year, consumers see their disposable incomes reduced by rising premiums, co-payments, and deductibles
  2. Our current system allows healthcare rationing to only those who can afford certain treatment.
  3. Small and mid-size businesses struggling to provide health insurance for employees are hit hard by increasingly unaffordable premiums. This directly discourages companies from growing and hiring full-time workers.
  4. The Affordable Care Act has made a huge positive difference for tens of millions of Americans, but now Republicans have pledged to gut it, which would throw hundreds of thousands of New Jerseyans off of health insurance.
  5. In spite of its successes, the Affordable Care Act has not done enough to address these problems, resulting in a rising cost burden for the average American and millions left uninsured.

Partisan gridlock at the national level prevents the best solution, a nationwide single-payer system, from coming to fruition. But we can forge ahead in New Jersey. Given our size and diversity, success here will be the model for the entire nation!  

Our Solution - New Jersey Cares - A Universal Single Payer Healthcare System

By implementing a single payer system we can establish the largest single payment pool, gain bargaining power to negotiate decent prices, and provide universal coverage. This means more efficient use of services and a more equitable New Jersey. We can create a system effective for all participants and providers: Doctors, hospitals, nurses, employers, and, most of all, the people of New Jersey.

You’ll notice we don’t speak of health insurance in our proposal. We don’t like thinking of healthcare as insurance because insurance is something you use after an unfortunate but unlikely event. The question is not if you need healthcare. The question is when you will need it. Healthcare is a human right and a state and nation as wealthy as our own should and can provide great healthcare to all of its people.

We propose a "Medicare-for-all" style, single-payer healthcare system, New Jersey Cares (NJC). NJC will cover all New Jerseyans, and all will contribute based on their ability to pay. The management and administration of our healthcare dollars will no longer be the purview of for-profit insurance companies, nor will they be a burden to employers. NJC is based on 4 principles formed from a foundation of transparency and simplicity:

1) Expanded coverage: NJC will cover all New Jerseyans’ medically necessary services. This will include oft-neglected mental health services and rehabilitation. It will also cover children’s dental care. Physicians, health professionals, and patient advocates will determine the covered services. Services deemed gratuitous will be excluded from coverage. Like Medicare, NJC will prohibit private insurance that duplicates public coverage in order to prevent conflicts of interest in the provision of services. This will prevent insurers from lobbying to undermine NJC. In NJC, as is the case with Medicare, inclusion of the well-off will serve as a key guarantor of adequate coverage.

A women’s access to birth control and family planning must be expanded and protected as a guaranteed benefit. Republicans in Congress and President Trump are assailing women’s health. Being a woman is not a pre-existing condition. NJC will expand access to services in these areas. It is 2017, women’s health services must be made sacrosanct.

2) Funding and Efficiency: All existing privately-paid premiums and employer-based premium payments will be replaced by a progressive payroll tax, 'nudging'-payments (see point 4 below), and existing state and federal funding. Universal access for all New Jerseyans will greatly reduce overhead, as we see that private insurance companies currently have a 12.4% overhead versus only 2.2% in Medicare (1). Furthermore, the scale of NJC will enable the single-payer system to vastly reduce the cost of prescription drugs, by negotiating as one party with the medical providers, which is fully in line with comparable industrialized countries. To put it in other words: NJC will do away with the lobbyism-fueled pharmaceutical price-gouging, and pave the way for a more open and efficient medicinal market in New Jersey.

The result: Everyone will be covered; healthcare costs will be reduced for all but the wealthiest; and healthcare expenditure will be directed efficiently—rather than lining the pockets of large health insurance companies, who make money by denying affordable services.

3) Healthcare interaction: Consumers will see the same doctors and medical professionals if they so choose; they will go to the same hospitals and clinics. No more out-of-network nightmares. New Jersey Cares will pay for services directly. This will make things easier for New Jerseyans because they will not have to contend with painstaking insurance paperwork. Standardization will also reduce the added bureaucratic and administrative expenses found in systems with many healthcare providers and for-profit insurers.

4) Behavioral change: A single-payer system will change the overall cost structure of healthcare by encouraging preventative care, with a focus on family doctors. Regular doctor visits will decrease the number of expensive procedures ordered and drugs prescribed by several orders of magnitude.

NJC is styled on the single-payer model employed by other industrialized nations where universal healthcare has been in place for more than 100 years. Here, a 'gate-keeper' approach to medical care, where the family doctor is a larger part of your medical care, considerably lowers the average cost of medical care delivery. Small co-payments for specialist services will ensure that services are used in an efficient and equitable manner.

I believe healthcare is a right for all Americans and New Jerseyans. In office, I will work to ensure that everyone—be they poor, rich, or somewhere in between—has efficient and high-quality healthcare.

 

(1) https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds/Downloads/TR2016.pdf

 

Showing 2 reactions

Please check your e-mail for a link to activate your account.
  • commented 2017-05-31 12:43:52 -0400
    Gina — abortion should be covered as reproductive care. Regardless of how individuals personally feel about abortion, it is a medical procedure — period. Exclamation point. The last thing any of us want is to turn the clock back 50 years where women are forced to unsafe options where death is the outcome for mother and baby. Speaking only for myself and not for the entire campaign, I’m not a “fan” of abortion (as if anyone “roots” for one), but as a medical professional and human being, I am an advocate of both pro-life and pro-choice in the sense that a woman should never be placed in position of harm because of pregnancy and legislative fiat.

    No healthcare plan is perfect, nor will any campaign be foolish enough to present such to constituents. Given that we have an insurance system in place that doesn’t cover everything and offers supplemental and secondary plans for consumers of healthcare services, there are going to be “bugs” in the process of creating a new system of coverage. The campaign is aware of these nuances and it will be working with healthcare professionals and experts in order to address every possible scenario that might interfere with smooth functioning of a new system’s implementation.

    As for regulation, the state’s Department of Health and Human Services in conjunction with the Department of Banking and Insurance would theoretically share this responsibility.
  • commented 2017-05-31 11:58:43 -0400
    What about abortion? Will abortion be covered?

    Will insurance companies be able to provide supplemental policies for things that the single payer plan will be unable to cover? Obviously no matter how good the plan is not everything can or even should be covered. Will NJ residents have the option to purchase supplemental plans to cover those things? If so how will they be regulated?
Volunteer Donate