Some valuable new data was released recently showing progressive improvement in the quality of care given in New Jersey hospitals. So while my previous blog may have convinced you that I’m only focused on the Sports page (it’s looking good for that N.J. Turnpike series!), I also read with great interest the Hospital Performance Report issued by the N.J. Department of Health and Senior Services. This report showed that N.J. hospitals continue to improve the quality of healthcare in our state. Our hospitals improved their performance in all four overall categories contained in the report – heart attack care, pneumonia care, surgical care and heart failure care. In fact, this year we saw an increasing number of “100s,” which is the top score that reflects full compliance with certain standards of care. This year’s report also included several patient safety indicators for the first time, and New Jersey’s hospitals performed better than or on par with the national average in 10 out of 12 indicators.

Hospitals and their dedicated teams of physicians, nurses and other healthcare professionals work hard at providing quality care and looking out for patient safety. This work is continuous as new improvement strategies are identified and implemented. Earlier this month, another report issued by the ratings service HealthGrades reaffirmed what we saw in the state report – continued improvement in the quality of care provided by New Jersey hospitals. The HealthGrades report showed New Jersey among the top five states in the country in improvement for heart failure and stroke care, along with coronary intervention procedures.

At NJHA, we have focused a lot of time and attention on helping hospitals improve through the NJHA Institute for Quality and Patient Safety. We can’t and won’t rest on our laurels. Quality and patient safety are too important.

Postscript: For those who responded to my last blog post, I must report that my husband and son are telling me I‘ll have to move out if we do indeed have a Yankees versus Phillies World Series. I am almost sure they are joking.

On a national scale, the big debate is still about healthcare reform. NJHA is actively involved with our congressional delegation, and the American Hospital Association in shaping the final package. Right now we’re tracking five – count ‘em, five – different proposals.

But while lawmakers battle over healthcare, the big debate in my house right now is… major league baseball. Everyone in my house loves baseball, but it can be as divisive as the public option. I grew up a Philadelphia Phillies fan, but my husband and I spent five years in New York City during the most recent glory days of the Yankees. I became a Yanks fan as well, but for some reason, my husband was immune to the lure of the Bronx Bombers. So you might think I am jumping on the bandwagon, but there is a reason why I have a favorite National League team and a favorite American League team.

But, like I said, I live in a divided household. My husband and son are Phillies fans, and they actively dislike my AL team. They even make fun of the designated hitter rule. In the first round series, the Yankees were preparing to sweep the Minnesota Twins, while the Phillies and Colorado Rockies were beginning one of the coldest games in playoff history (at the ridiculous start time of 10 p.m.) A crisis loomed: Which game would we watch? As we wrestled for control of the TV, the Yanks won and TBS switched over to the Phillies game. Crisis averted. If only things would work out so smoothly on Capitol Hill.

If I have my dream of a Yankees-Phillies World Series (would we call that the NJ Turnpike Series?) it will be a difficult time in my household, but I am more than willing to endure the gentle ribbings from my husband and son for that series. Maybe I can convert them to be dual fans? That’s probably as likely as getting S. C. Congressman Joe Wilson to agree with President Obama. But I can dream.

NJHA was honored to host the two major gubernatorial candidates Sept. 18 at a special meeting of our Board of Trustees. We also invited hospital CEOs to attend the meeting. The room was packed when our first candidate, former U.S. Attorney Chris Christie (R ) arrived. After being introduced by NJHA Board Chairman John Gribbin, Mr. Christie made a brief 10- minute statement. He cited some of the many problems confronting New Jersey’s healthcare community – poor reimbursement, the charity care burden – and promised to do “more listening than talking” on healthcare issues. He then proceeded with about 35 minutes of questions and answers with NJHA and its members. Questions ranged from dealing with public corruption in New Jersey, to providing healthcare to undocumented immigrants. It was a good dialogue.

Shortly after Mr. Christie departed, Gov. Jon Corzine (D) joined us. Gov. Corzine also made a brief 10-minute statement, discussing his commitment to healthcare access even as he was forced to confront unprecedented state fiscal woes. The Governor also responded to questions from the group, ranging from the need to fund Graduate Medical Education in the state to ensure adequate numbers of physicians, to the charity care formula, to dealing with public corruption in New Jersey. A very good dialogue occurred.

I think the audience was impressed with the depth of knowledge of both candidates, and we at NJHA were honored to have them both meet with our Board and hear their healthcare concerns.

Don’t forget to vote Nov. 3! New Jersey is one of just two states with a gubernatorial election (the other being Virginia), and the entire Assembly is up for election as well. The issues confronting our healthcare system and our state are far too important for any of us to stand on the sidelines.

The nation this week hears an address from President Obama that may make or break healthcare reform efforts. The August recess was a rough one for the President and the Democrats in Congress. The anxiety voiced at town hall meetings, whether you agree with the concerns or not, gave many pause about moving forward on the path (and there are multiple and varied paths) that Congress has indicated. The Democrats themselves are not in agreement on a key reform proposal – the public plan option. House liberals tend to support this, and the more conservative House Blue Dogs don’t. Support for the public option among Senate Democrats is even more tenuous.

So it is up to the President to hit the reset button and convince the country that healthcare reform is needed. Some critical items I will be listening for include: Does the President support the public option? (We know he does, but is it a line-in-the-sand item for him?)

• How will healthcare reform be paid for? (Or, who’s ox is going to be gored?)
• What is the President’s expectation on a time frame to pass healthcare reform? (As I have written in the past, every day we inch toward the House elections in 2010 makes the vote more difficult for each member of the House.)
• What is the reaction of the Republicans? If the public plan option is watered down or abandoned, will they support the plan? Is bipartisanship a possibility?
• What role will insurance companies play in reform? So far, hospitals, doctors and the pharmaceutical industries have stepped up to the plate, conceding some givebacks, but we have yet to hear what insurance companies will give up.

Stay tuned…

There is an amazing public debate going on about national healthcare reform. Some of it is heated. Some of it is based on truth. Some of it is based on misstatements of fact (to be kind) or inaccuracies (less kind) or outright lies (opposite of being kind). But almost all of it is based on a very passionate debate on what is best for our citizens when it comes to healthcare reform, and who can argue that a healthy debate is not a good thing?

I thought I’d take a moment to weigh in on some facts and observations.

1. Our country spends 17 percent of our Gross Domestic Product on healthcare. This is far more than any other industrialized nation. I just read an article about the Scandinavian healthcare system, and the three countries that comprise Scandinavia each spend about 9 percent of their GDP on healthcare. Now I will deviate from facts and suggest that 17 percent is simply not sustainable. That percentage is projected to grow dramatically and will become a weight on our economy. We spend far more than other countries, and yet we still don’t provide healthcare coverage to all. We need to reform our healthcare system, and if not now, then soon.
   
   
2. The option of a government plan for health insurance is scaring people. Why? Because many citizens are not convinced that the federal government can do a good job (often pointing to the Postal Service, which does a good job by me.) On the other side, some people point to our fine military and note what a terrific and heroic job they do on a day-to-day basis. Others point to Medicare and indicate that it is one of the largest governmental payers already and the federal government doesn’t mess that up. They go on to point out that Medicare has an exceedingly low overhead for administering the entire program (3 or 4 percent) as compared to most insurers which can range between 15 and 25 percent.
   
   
3. The so-called “Death Panels” never existed, but if they ever did, they are dead. The provision would have paid doctors to have conversations with patients regarding their options at the end of life. This isn’t a bad thing – I think every individual should consider their personal choices about end-of-life care and share their decisions with their families and physicians. Sometimes at the end of life, hospice is the best thing if the patientso chooses. New Jersey ranks 33^rd in the nation in use of hospice care, and we should do better for our citizens.
   
   
4. Health insurance coverage does not equal access to healthcare. I worry that if all Americans were insured tomorrow we would not have enough primary care physicians to treat everyone and would have long wait times for appointments. Some in Massachusetts are experiencing this with up to six-month wait times. Those wait times aren’t necessarily the fault of Massachusetts’ healthcare reform law, but rather the lack of resources to fully support the plan. We need to devote resources to ensure we have enough doctors, nurse practitioners and physician assistants to provide access to healthcare for all Americans. (And that’s needed regardless of whether Congress passes a reform bill.)