Betsy Ryan is president and CEO of the New Jersey Hospital Association. Her blog, Healthcare Matters, examines the many issues confronting New Jersey's hospitals and their patients. Readers are encouraged to join the discussion, because healthcare matters - to all of us.

Teaching Hospitals Are Essential to Healthcare’s Future

New Jersey is home to 48 “teaching hospitals” that provide essential education and experience to the next generation of physicians and other clinicians. Their work will become more important than ever as the country faces a looming physician shortage.

The United States is expected to face a shortage of 62,000 physicians by 2015, according to the American Association of Medical Colleges.

By 2020, the shortfall is expected to exceed 91,000. Clearly, the current supply of physicians is not sufficient to meet the demands of an aging population and a changing healthcare system with greater emphasis on primary care. The shortage will only be exacerbated by the 32 million Americans we expect will get health insurance under the Affordable Care Act.

Teaching hospitals are essential to the future of healthcare delivery, not only because they serve as the “classrooms” for physicians, nurses and other healthcare professionals, but because they are centers for the development of emerging medical services through research and clinical trials. Teaching hospitals provide many specialized services including burn units, transplantation programs and trauma centers. And they perform yet another essential social service – safety net healthcare to New Jersey’s uninsured.

I am proud of the contributions of all of our state’s hospitals – large and small, urban and suburban, independent or part of a larger system. Each holds a unique and valuable place in our healthcare delivery system. And so it is with teaching hospitals, who serve the larger healthcare community by preparing the physicians of tomorrow.

Statistics show that about 30 percent of the nation’s physicians will enter retirement age in the next decade. Their replacements are preparing for the future today in our teaching hospitals.

Written by Betsy Ryan at 17:35

Categories :

Today, A Sigh of Relief for the Future of Healthcare

I’m an attorney, and I’ve spent virtually my entire career in the realm of healthcare policy. I admit to a bad case of the nerves heading into today. But I am quite thrilled to say the pundits were wrong on this one. Hardly anyone predicted it, but today the Supreme Court of the United States upheld the Affordable Care Act by a 5-4 vote.

The ruling is great news for uninsured Americans and healthcare consumers across the country. While the Affordable Care Act has its supporters and its detractors, there’s widespread agreement that our healthcare system is unsustainable on its current course and changes are needed to reduce healthcare costs and preserve healthcare quality. That work to reform our healthcare system can now continue with the reassurance that the Affordable Care Act will provide the policy foundation to support those efforts moving forward.

Nearly 1 million uninsured New Jerseyans will be added to the insurance rolls over the next two years, thanks to this law. (Although the law will not apply to nearly 400,000 uninsured residents.) Millions more Garden State residents will enjoy protections like access to insurance regardless of pre-existing healthcare conditions and no more lifetime limits on insurance coverage. The law also includes funding, demonstration projects and other innovative efforts to help hospitals, physicians and other healthcare providers reinvent healthcare delivery so it is higher in quality and lower in cost. In short, healthcare reform will help us bring value to healthcare. And that’s important for all of us who count on the reassurance that the care we need will always be there.

Written by Betsy Ryan at 17:02

Categories :

Where Are the Jobs? In Healthcare

When the gloomy May jobs report came out last week, the stock market lost all of its gains for 2012. But all the news in the report is not bad. According to an analysis by the Altarum Institute, healthcare jobs continue to grow, continuing a trend since the recession began.

In May, healthcare employment rose by 33,000 jobs, according to the federal Bureau of Labor Statistics. Most of the growth (23,000 jobs) was found in the ambulatory care setting, which includes hospital outpatient services. Hospital inpatient services also added jobs. All told, healthcare workers now comprise 10.8 percent of the total employment picture, an all-time high.

A recent essay in the New England Journal of Medicine questions whether this job growth is a good thing. The authors ask whether more healthcare jobs fuel an inefficient healthcare system that could operate just as well with fewer people. It’s an interesting point – but one I disagree with. While some of the new jobs are in hospitals, most are in community-based settings. That signals a shift in the deployment of healthcare resources and it reflects systemic efforts nationwide to make healthcare delivery more efficient and sustainable. And this is happening at the same time that our population is aging, with 10,000 Baby Boomers turning 65 each day in the United States. There’s no question that we need healthcare professionals to take care of the growing needs of this aging population.

New Jersey hospitals employ 140,000 individuals. Add in all of the other healthcare settings – like nursing homes, ambulatory care centers, home health and others – and healthcare ranks as the state’s second largest employer. From NJHA’s point of view, we appreciate that Gov. Christie recognizes this vital role of hospitals and healthcare by proposing a 2013 state budget that preserves current hospital funding levels and increases nursing home funding by $10 million. In addition, the Governor has spared New Jersey’s Medicaid program from cuts, which has been a target in some other states. That’s important, obviously, for access to healthcare services but it’s also very important for the New Jersey economy. Cuts to critical state funding streams translate to cuts in staffing.

I anxiously await the first federal jobs report that comes out after the U.S. Supreme Court rules on the constitutionality of the Affordable Care Act; that ruling is expected by the end of the month. As we’ve seen throughout this recession, healthcare and jobs go hand in hand. And any decision that greatly alters the future of healthcare will undoubtedly have a monumental impact on some of these trends.

Written by Betsy Ryan at 16:36

ACA Countdown: What Do You Think the Supreme Court Will Decide?

We are entering the final countdown for a decision by the U.S. Supreme Court on the constitutionality of the Affordable Care Act (a.k.a “Obamacare” for those who oppose the law.) How do you think the Supreme Court will rule? Will the Court uphold the law, strike it down in its entirety, punt or waver somewhere in the middle?

While there is no consensus on how the Court will rule, most legal scholars agree this is the most watched decision since Bush v. Gore, when the office of the President hung in the balance (along with some hanging chads). Court watchers and the media tell us that the Court is likely to rule toward the end of its session, which concludes June 29. There’s an anxious buzz building – one day last week Twitter exploded with reports that the Court was ready to issue its decision. Turns out it was a false alarm, but it shows the depths of the anticipation.

Lots of people are speculating on how the justices will rule. Some believe the law will be upheld in full, and others believe it will be struck down. There are lots of possibilities in the middle. For instance, the justices could strike down the individual mandate but uphold the rest of the law. Or they could order that a special “master” be appointed to cull through the law to make a recommendation on each individual section. They could punt on a decision until the individual mandate goes into effect and the first person is fined for not having individual coverage (because some have argued the case isn’t ripe for a decision until someone is levied a fine under the law.) The options are limitless, but the consequences are real to the countless uninsured Americans who have the hope of health insurance coverage very nearly in their grasp.

Written by Betsy Ryan at 19:55

Categories :

Dr. House and His Fictional N.J. Hospital Bid Farewell

I watched the last episode of House last evening with my husband, who is an avid fan of the show. I used to be a regular viewer too but fell out of the habit. I know there has been a lot of media attention on the last episode, and I thought it appropriate that someone from the New Jersey hospital community should say an official, “Goodbye and thank you, Dr. Gregory House.” Unless you’re a regular viewer, you may not realize that the long-running TV series was set in the fictional “Princeton-Plainsboro Hospital.” Some of what occurred there was definitely far-fetched (it was TV, after all) but there’s no denying that a hospital setting provides plenty of fodder for life-and-death drama. Dr. House, of course, always seemed to create his own drama by terrorizing many an intern, resident, administrator and patient, but he also was always able to diagnose the patient by the end of the hour and be the hero. Thanks, House. Your N.J. hospital family will miss you.
Written by Betsy Ryan at 20:13

Categories :