NJ Dems Killing People For Corporate Profits

Sweeney's death panel (4.00 / 1)

Medically necessary tertiary health care services may be
performed by an out-of-State specialty or subspecialty health care
provider when there is no in-State health care provider reasonably
available to treat the particular condition based on an expedited
determination by the carrier and the commission or plan
administrator, in consultation with the Department of Health and
Senior Services, that such service is not otherwise available through
an in-State health care provider, or when there is no in-network
provider who is reasonably proximate to the covered person's place
of residence. Such treatment by the out-of-State health care
provider for tertiary care shall only be performed on the basis of a
referral from an in-network health care provider.

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by: 12mileseastofTrenton @ Thu Jun 16, 2011 at 13:03:39 PM UTC

Sick (0.00 / 1)

You have become Karl Rove!

You now have zero credibility.

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by: firstamend07 @ Thu Jun 16, 2011 at 13:40:50 PM UTC

[ Parent ]

Sweeney has Created Death Panels (4.00 / 1)

His bill creates the exact type of panels deciding who gets critical health coverage that people were opposed to.  I wish it weren't so.    

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by: princetonblue @ Thu Jun 16, 2011 at 13:53:53 PM UTC

[ Parent ]

"Reasonable" only to a govt. bureaucrat (4.00 / 5)

This is a potential death-panel situation, no joke. Government bureaucrats and "plan administrators" should have no business determining who will treat me when I have a life-threatening medical situation. Just because someone in NJ is qualified on paper, does not mean they have the skills for obscure medical situations.
[This is princetonblue's wife writing this comment]

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by: princetonblue @ Thu Jun 16, 2011 at 13:40:03 PM UTC

I have to agree... (3.67 / 3)

this was all about containing cost. That provision has no business being in the bill.

"Where ever you go, there you are." - Buckaroo Bonzai

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by: William Weber (WjcW) @ Thu Jun 16, 2011 at 14:46:05 PM UTC

[ Parent ]

That sounds just like (0.00 / 1)

Obamacare! Sweeny though you guy like Obamacare so much he put it in your plan. He's looking out for you.

Seriously, this is similar to many private sector HMO programs. Live long and prosper.

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by: TparT @ Fri Jun 17, 2011 at 23:01:38 PM UTC

[ Parent ]

Lies (0.00 / 0)

Like many tea party statements, this isn't like many private sector plans.

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by: princetonblue @ Tue Jun 21, 2011 at 01:40:09 AM UTC

[ Parent ]

Maybe it's a coincidence... (4.00 / 2)

... but George Norcross is the Chairman of a large South Jersey hospital chain. Perhaps he would prefer people use his hospitals even if some of the Philly hospitals might have better specialized care.

Blog: http://www.deciminyan.org

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by: deciminyan @ Thu Jun 16, 2011 at 15:00:20 PM UTC

The bill will be renamed the Norcross bill (4.00 / 2)

princetonblue,

deciminyan nailed it.

Norcross is pals with Sweeney. Sweeney sponsors the bill. It is interesting that when Christie was US Attorney he wanted to prosecute Norcross and now he seems to be buds with him also. I wonder what the pay off schedule looks like.

Also interesting that some of the supporters of the bill are on Norcross' payroll!

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by: theman @ Thu Jun 16, 2011 at 23:23:19 PM UTC

Codey is on this (0.00 / 0)

http://www.politickernj.com/48...

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by: 12mileseastofTrenton @ Fri Jun 17, 2011 at 10:14:49 AM UTC

Other Dems come out against Sweeney/Norcross (0.00 / 0)

http://www.nj.com/news/index.s...

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by: 12mileseastofTrenton @ Sat Jun 18, 2011 at 14:31:45 PM UTC

Killing for Corporate Profit (4.00 / 1)

Princeton Blue, you and your spouse should go to the Assembly Budget Committee on Monday at 10am and testify.   You should also talk to every committee member that you can.

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by: cwadudley @ Sat Jun 18, 2011 at 22:39:34 PM UTC

Why the Out of State Provision Makes No Sense (4.00 / 2)

*  A prohibition on going out of state to obtain medical care is unprecedented.  Experts at Rutgers (Joel Cantor of the Rutgers Center for State Health Policy) and at the New Jersey Health Quality Institute (Dave Knowlton) agree.

* This severe penalty will prevent plan members from choosing health providers on the basis of quality.    Members with serious health problems such as cancer will no longer be able to go to nationally recognized facilities such as Sloan-Kettering or Fox Chase.   Instead of choosing a facility based on the facility's  experience in performing a procedure and the volume of the procedure they perform, the basis for decision will be a geographically boundary.    

* The authors of this provision assume that New Jersey hospitals and other health providers can not compete on quality and cost and need help.  We believe that New Jersey providers are the first class and can handle the competition.

*   This is an anti-competition provision that will likely lead to increased costs.   For instance, Cooper Hospital in Camden is a tertiary hospital (advanced care) that competes with prestigious hospitals in Philadelphia that are only fifteen or twenty minutes away.   With the its main competition, the Philly Hospitals, out of the way Cooper will have an advantage in negotiations with the insurance carriers like Horizon and Aetna.   The likely result is higher prices.

*  It's unconscionable to stop competition on health care quality.   University hospitals in Philadelphia and New York have been early adopters of procedures to end hospital acquired infections and injuries.   This has created pressure for all hospitals including those in New Jersey to institute such procedures.  The ability of patients to go to the highest quality provider leads to an overall improvement in health quality by all providers.  

*   The penalty for a patient going to an out of state provider is draconian and will put families in a terrible situation -- get the best care for a loved one and face crushing health care debt.   Families will be legally required to pay the difference between the low payments made by the health plan and CHARGES of the facility.   The bill doesn't allow patients to negotiate with providers to pay lower amounts such as the amount typically paid by health plans which are often half or a third of the amount of charges.  

*  This ban interferes with the doctor/patient relationship.  Many New Jersey doctors have relationships with out of state facilities;  these doctors will be placed at a disadvantage even through their relationship exists to provide the best quality of care.   Special interests should not be dictating to physicians concerning health quality.    

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by: cwadudley @ Sat Jun 18, 2011 at 22:43:53 PM UTC