October 30, 2011-- Dr. Niranjan Rao, President of the MSNJ, Dr. Alieta Eck, President of AAPS, Dr. John Eck, co-founder of the Zarephath Health Center and several others went to Trenton on October 28th to meet with Democratic and Republican leaders. We discussed the fact that Medicaid simply costs too much and does not provide good value for the NJ taxpayers.
$2.8 billion is spent on Medicaid HMOs and out-patient facilities such as federally qualified health centers. If one can assume 20% administrative costs in these entities, this would amount to over $500 million spent on secretaries, coders, overseers and others who do not see patients. Contrast that with $90 million in direct payments to physicians. The Medicaid fees are so low that most physicians do not participate, thus frustrated patients often go to the ER, the most costly venue to get care. Patients, physicians and taxpayers are paying a huge price for a dysfunctional system.
The group met with key Senate staffers on the Democratic side followed by key Senate Republican staff. Both groups listened carefully and asked the right questions. Will doctors participate? Will covering for medical malpractice the entire practices of doctors who volunteer pose an undue burden on the state?
The fact that physicians currently spend $350 million on medical malpractice each year provided a probable ceiling on expected state outlays. And if NJ lost the federal matching funds in the Medicaid system, there would still be enough savings for New Jersey taxpayers to be relieved of a great deal of the cost of helping the poor.
We are convinced that doctors will step up to the plate. If they knew that the state would protect them in their private practices, primary care physicians would volunteer four hours a week in non-government free clinics. Surgeons, ob-gyns, anesthesiologists would agree to doing two cases per month on patients referred from the clinics.
The clinics would be set up in the communities with volunteers coming from churches, synagogues, mosques. They would not require government funding, as none of the volunteers would be paid and the overhead would be minimal. The Zarephath Health Center can see patients for $13 per patient visit-- funded by a box at the front desk and private donations.
The next step will be the writing of the bill, slated to be completed after the November elections. Then we will begin a campaign to reach the NJ Assemblymen and Senators to convince them to co-sponsor and endorse this plan. We could see a vote by early spring, 2012.
The best entitlement reform would be the gradual dismantling of the Medicaid system. The poor do not need "insurance." They need medical care when they need medical care.
The national AAPS is funding our NJ lobbyist, and your help would be greatly appreciated. If you have not already become a member of the AAPS, please go to www.aapsonline.org and do so. This will greatly help implement the plan in NJ and then spread it across the country. Here is a chance to take our profession back-- to enhance our public relations, and demonstrate that physicians are not greedy, but really do care about the poor.