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Newark creating health plan for uninsured : VICTOR EPSTEIN


By: Health Insurance
Submitted: 2009-09-28 18:55:46 | Word Count: 613


Health care reform has come to New Jersey's largest city.

Newark has enrolled 400 uninsured and underinsured residents in a pilot program that enables them to obtain routine medical care from family doctors. The goal is to prevent people with chronic illnesses from seeking more costly treatment at hospital emergency rooms as a last resort.

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The yearlong program is expected to save area hospitals more than $2 million.

"It's cost effective and it's kinder," said Teresa Heinz, whose foundation is spearheading the initiative with the administration of Newark Mayor Cory Booker. Heinz, the wife of former presidential candidate and Massachusetts Sen. John Kerry, is helping fund the initiative through her family's charity. New Jersey had more than 1.4 million uninsured residents and its hospitals spent over $1 billion on uncompensated costs last year, according to the New Jersey Council of Teaching Hospitals.

Many of those fees originated in public hospital emergency rooms, which must provide basic medical services to patients regardless of income. They've become a safety net for the uninsured as more people have been priced out of the health care insurance market.

However, hospital care is more costly than routine visits to a doctor's office. Costs are exacerbated by the rise of life-threatening complications in uninsured patients with chronic conditions, like diabetes and congestive heart failure, who often delay seeking care.

Kevin Rigby, a vice president with Switzerland-based Novartis Pharmaceutical Corp., said Tuesday that the Newark plan is a national model. Novartis is one of seven pharmaceutical companies that are working with the foundation on the program by donating $1.6 million worth of prescription medicine.

"This could be the beginning , the kernel , to show what could be done," said Jan Faiks, vice president of the Pharmaceutical Research and Manufacturers of America trade association.

The Heinz family's foundation estimates that more than 50,000 Newark residents lack health insurance. The foundation, PhRMA and the American Heart Association are collectively spending $200,000 to start the program.

The Newark initiative comes at a time when federal policymakers are debating health care reform in the wake of decades of spiraling insurance costs.

The average U.S. family is spending $13,375 a year on health care insurance , 131 percent more than a decade ago, according to the White House. Families in New Jersey, home to many of the nation's pharmaceutical companies, spent 95 percent more during the same period.

"Had this been done in the late 70s, 80s or 90s, we wouldn't have 44 million Americans that are uninsured," said Jeffrey Lewis, president of Heinz Family Philanthropies. "That was wrong."

The foundation is funding similar initiatives in Chicago, California and Clarksdale, Mississippi. Additional programs are planned for Baltimore, Michigan, New York City and Parma, Ohio.

The financial burden of caring for uninsured patients has contributed to the closing of at least nine acute care hospitals in New Jersey since Jan. 1, 2007. That compares with only 13 closings in the state the prior 15 years.

The pressing need for affordable health care means Newark cannot wait for policymakers in Washington, D.C. to craft a national solution, city officials said.

"Let's just do it and let other people follow our example," said Booker.

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