I just read the news that Sen. Frank Lautenberg, New Jersey's junior senator, will not seek re-election. What an amazing career he has had – and will continue to have as he serves out this final term. I was just in Washington, D.C., yesterday with a number of NJHA members, meeting with members of Congress and their staffs to discuss the important policy issues for New Jersey patients, hospitals and other healthcare providers. Sen. Lautenberg has always been a tireless advocate for the Garden State and a great supporter of hospitals and  healthcare providers in New Jersey. I wish him the best and thank him for his public service.

NJHA was recently honored to have Gov. Christie speak at the NJHA Annual Meeting, attended by hospital and healthcare leaders from across the state. And we were especially honored to hear his message of praise and appreciation for New Jersey’s healthcare community for its service during Superstorm Sandy.

“In the end, it was all of you, with all the difficult health issues that presented… that helped the people of New Jersey get through it,” Gov. Christie told NJHA members. “I thank you on behalf of the people of our state.”

Three months after the storm struck our state, I think we’re all engaging in a period of reflection. The recovery phase will continue for quite a while, but we can at least begin to examine what went right and what went wrong during our collective response to Sandy. Gov. Christie shared some of what went right: Despite two hospitals and 11 long term care facilities evacuating during the storm, and 137 healthcare facilities that lost power, patients continued to receive the care they needed. That’s testament to the dedication and commitment of New Jersey’s healthcare professionals, some of whom slept at their workplaces or literally swam, paddled or waded through flood waters to reach their patients.

“Those are the kind of people that you have in your organizations – people who put their own self interests totally aside,” said the Governor.

For New Jersey, 2012 was an amazing display of resiliency. Thousands of New Jerseyans – many our own healthcare employees – lost their homes or their family belongings. Some lost their livelihoods. I’m sure all of us lost some special Jersey places that helped shape us. But we kept our resolve, and we truly remained Jersey Strong.

I’m a proud New Jersey native, born and raised in Roebling, famous for our steel mill and as the birthplace of John Roebling, designer of the Brooklyn Bridge. But what many people may not know is that John Roebling was seriously injured during an accident at the bridge construction site, developed tetanus and died. His son Washington, also an engineer, was left to lead the bridge’s construction. But Washington himself became a virtual invalid after suffering a severe case of the bends going up and down the underwater caissons of the bridge. And while he remained confined to his sickbed, the half-finished bridge ran the risk of becoming a political and financial albatross. What kept the project on track? Emily Roebling – Washington’s wife – who despite no formal training in engineering became a strong and assertive conduit for her husband and helped complete the engineering feat that is the Brooklyn Bridge.

Thanks to the Roeblings, the story of the Brooklyn Bridge has a distinctly Jersey accent – one that shows real teamwork, the strength of family, determination and tenacity. The same strengths that keep our state – and our healthcare community – strong in the face of natural disasters or any other challenges that come our way. 

I was really glad to read recently that both Bellevue Hospital Center and NYU Langone Medical Center are caring for patients again in New York City. They had been closed following the devastation of Superstorm Sandy.  I think we all remember the news coverage of the dedicated nurses, doctors and others working hard as a team to transfer their patients and walking those little babies down many, many flights of stairs.  Both are located side by side on the East River and when the waters rose, they flooded. 

New York and New Jersey have been through a lot with Sandy, and healthcare facilities are no exception. New Jersey had two hospitals close for far shorter periods of time in the days immediately following Sandy. It isn’t easy to evacuate a hospital, and reopening takes much work also.

I’m Jersey born and raised, but I have a special connection to the hospitals in New York City. Bellevue is part of the nation’s largest public hospital system, New York City Health and Hospitals Corporation (HHC).  I’m very proud to have worked at HHC in the mid 1990s. When I took the job I did so knowing the City had a residency requirement.  Little did I understand how hard it was to find a place to live in Manhattan, so I actually lived at Bellevue for three months or so out of necessity, paying rent for former medical residents’ quarters.  I recall the CEO of Harlem Hospital was next door to me for a time.  It was not luxurious by any means, but I developed a special affinity for the place because it was my home.  NYU was and is its next-door neighbor and a friend of mine works there.

So welcome back Bellevue and NYU. It’s good to have you back on the front lines caring for your communities. 

Congress wrapped up its votes yesterday with a deal on the fiscal cliff and a non-vote on Superstorm Sandy relief. I don’t even know where to begin…

I guess the fiscal cliff: Like any compromise, the deal includes some good news and some bad news for New Jersey healthcare providers and the people they serve. My number one concern: $15 billion in added cuts to hospitals over the next 10 years. The money was used to avert a scheduled Medicare payment cut to doctors. NJHA has long supported a fix to the physician pay cut, however we are extremely disappointed that it was accomplished with even deeper cuts to hospitals. We in the healthcare community share a common goal of caring for our seniors – so cuts that pit one healthcare provider against another fail to accomplish the overall mission of providing quality and accessible care to our communities. Hospitals in New Jersey and across the nation have already been targeted for billions in Medicare cuts under the Affordable Care Act. Now, these additional cuts place yet another burden on hospitals as they fight to provide high-quality care to our patients. NJHA will continue to work with our congressional delegation to find a more permanent solution to the physician payment formula, but will oppose any additional cuts to hospitals and other providers.

As for Sandy relief: It is hard for me to imagine how Congress has not yet acted to provide much-needed relief to New York and New Jersey for the devastation caused by Superstorm Sandy. And yet, the sad fact is we are still waiting for action. The Senate did act upon President Obama’s recommendation for a relief package, but the House of Representatives has not. I applaud our New Jersey delegation for pushing Speaker Boehner to post the measure for a vote last night.  Unfortunately, he failed to do so.

N.J. Governor Christie and N.Y. Governor Cuomo issued a joint statement saying, “It has now been 66 days since Hurricane Sandy hit and 27 days since President Obama put forth a responsible aid proposal that passed with a bipartisan vote in the Senate while the House has failed to even bring it to the floor. This failure to come to the aid of Americans following a severe and devastating natural disaster is unprecedented. The fact that days continue to go by while people suffer, families are out of their homes, and men and women remain jobless and struggling during these harsh winter months is a dereliction of duty. When American citizens are in need we come to their aid.”

The Senate measure will die on the Senate floor unless the House acts by Thursday, when a new Congress is sworn in. There are real people in real need in our region.  Please don’t make them wait any longer.

As the year winds down and 2013 looms, much of our focus has shifted to important issues looming in Washington, D.C. No issue has dominated the attention of Washington more than the fiscal cliff.

The fiscal cliff is comprised of numerous components including the expiration of the Bush tax cuts, expiration of the debt limit, a severe scheduled reduction of Medicare rates paid to doctors, the expiration of emergency unemployment benefits, the expiration of payroll tax cuts and deep deficit-reduction cuts that include a 2 percent Medicare pay cut for hospitals and other healthcare providers. All of these big issues are converging at once, and there are not many days left before the year’s end for Congress and the President to hammer out an agreement.

The fiscal cliff could have a dramatic impact on our healthcare. In New Jersey alone, the 2 percent Medicare cut would reach $93 million in federal cuts to hospitals in 2013 and would total $133 million in one-year cuts for all types of New Jersey healthcare providers including hospitals, nursing homes, home health providers and rehabilitation facilities. We’re especially worried about the impact of those cuts because the healthcare community already gave plenty to fund the Affordable Care Act. Nationally, providers took a cut of $155 billion in Medicare payments over a 10-year period to help fund the reform law. In New Jersey the cut is $4.5 billion over 10 years. To avert the fiscal cliff, both the President and the Republican leadership are talking about large additional Medicare cuts. But while such cuts remain on the table, the American people say they oppose deep Medicare cuts to healthcare providers. Two-thirds of respondents to a recent national poll www.aha.org/content/12/12-natl-survey-findings.pdf said they fear such cuts would hurt senior citizens’ access to healthcare services.

The devil is in the details, which are ever changing. NJHA is busy in Washington, working with our delegation to ensure that they know about the recent history of cuts to our nation’s healthcare providers and the impact of further cuts on healthcare providers’ operations and on consumers’ access to services. Our healthcare providers – and the people who count on us, including a growing aging population – need to have predictability in a field that is in the midst of enormous change and transformation. Our hope is that Congress and the President come to a balanced agreement that averts the fiscal cliff for the nation, and averts additional huge cuts to our healthcare community.