Opinion: A road map to lower cost, higher quality health care

Lizette Delgado-Polanco and John Harmon

This year was a chaotic one when it came to health care. There were speeches, there were bills and there were even votes.  But in the end, health care costs continued to increase for most New Jerseyans. This cannot continue. People in our state struggle every day to pay for care they think is too expensive and not high quality. They need and deserve a change.

As members of the steering committee of Better Choices, Better Care NJ, we set out with our colleagues – who represent the labor, business and health care communities – to directly address the issues that are driving up costs and preventing better quality care. Better Choices, Better Care NJ spent the last year directly engaged with consumers through a variety of means. We received feedback from those worried about how they would pay for their health care, or upset that a family member could not find the kind of care they needed.

Given this information, we decided to act. After much discussion and research, we released a 15-point plan we believe can create lower cost, higher quality health care. Our plan, “Moving New Jersey to Affordable, Quality Health Care,” tries to simplify the typical health care jargon and complicated terms that are too often thrown around.

Instead, we wanted to reduce the issues to their most basic forms: the problem, the consequences and the necessary solution.

We looked specifically at four different areas of health care: Increasing access to affordable, quality health care; keeping health insurance costs from skyrocketing; reforming Medicaid; and promoting patient centered care.  From there, we mapped out 15 specific issues which, if fixed, can reduce costs and improve quality.

These 15 issues touch upon many elements of the health care process. Some are basic and simple changes that could have immediate impact.  For example, health care companies are currently required by state law to print out millions of pages of information every year. We can change state law to require this kind of information be provided online, with an option for paper copies.  This could easily save millions of dollars.

Others are not as basic, but just as important. Many New Jerseyans count on Medicaid for their health care, and the system costs the state billions of dollars each year.  While New Jersey’s Medicaid program is effective and efficient in many ways, regrettably, when it comes to behavioral health, the program uses outdated ways and means to provide services.

For behavioral health services, Medicaid uses a fee-for-service system, where doctors and hospitals are paid based on the amount of care they provide, not the quality.  If Medicaid were to move towards a patient-centered care system, where the incentives are given to keep people healthy and reduce doctor and hospital visits, it could save countless dollars while increasing the quality of care for those needing behavioral health services.

It would be impossible to discuss health care without mentioning the Affordable Care Act (ACA). While still controversial, the ACA is the law, and its provisions have been in place for several years now.  That includes the health insurance exchange, which was created to make it easier for people to purchase health insurance plans that meet minimum standards of coverage and affordability.

There have been efforts in Washington to limit advertising and public awareness about the exchange, as well as eliminate subsidies for low-income individuals and families accessing health insurance through the exchange. But declining enrollment in the individual market will negatively impact those who purchase coverage through the individual market through increased premiums, less attractive health plans and fewer coverage options.  To combat this, the state should consider a variety of options, including creating its own advertising and marketing to encourage participation in the exchange.

These are just some of the ideas we have put forward, but all of them can save consumers money and improve care.  As we head into 2018 and beyond, Better Choices, Better Care NJ will be actively engaged in ensuring the ideas outlined in our plan – which can be viewed at https://betterchoicesbettercarenj.com – are acted upon and implemented. The quickly evolving health care landscape means we all must play a more proactive part in protecting the future of health care in New Jersey.

Lizette Delgado-Polanco is a steering committee member of Better Choices, Better Care NJ, and serves as the political director for the Northeast Regional Council of Carpenters.

John Harmon is a steering committee member of Better Choices, Better Care NJ and the founder, president and CEO of the African American Chamber of Commerce of New Jersey.