Record Editorial: Critical condition

One of the most urgent reminders of the need for national health care reform is hitting New Jersey's hospitals hard.

As the economic downturn worsens, more and more uninsured and underinsured people are showing up in emergency rooms around the state. And hospitals are providing more charity care to patients who cannot pay.

A recent survey by the New Jersey Hospital Association offers these details: 80 percent of the hospitals surveyed reported a spike in charity care services — some by as much as 40 percent — and three-quarters of the hospitals reported an increase in emergency room visits.

New Jersey is already home to 1.3 million uninsured residents, and that number could grow as the ranks of the unemployed increase in coming months. The recession will have wide-ranging ripple effects on hospitals. If the downturn continues, as expected, there will be more layoffs. Even people lucky enough to keep their jobs could lose some of their health benefits or have to spend more money out of their own pocket for medical care. And for the jobless, unemployment and health benefits eventually run out.

In such cases, stressed-out people with no health insurance often wait until they are very sick to see a doctor, and then it is usually in an emergency room, and the cost of treating them is much higher.

The hospital survey — released within weeks of the governor's state budget address on March 12 — may be intended as a reminder to Governor Corzine and the Legislature that hospitals cannot afford to lose any state aid. No significant cuts in charity care are anticipated at this point, except for an accounting change that would "forward-fund" about $25 million in state spending on hospital charity care.

The hospitals say what they need is much more funding. They say they are providing $1.3 billion a year in charity care to uninsured or underinsured patients and only getting $603 million in annual payments from the state.

But in this unprecedented crisis, the state cannot be expected to do much more than it is doing already to help hospitals cope with charity care cases. The new federal stimulus package includes some $2 billion in Medicaid payments for low-income and disabled residents in New Jersey, which should provide some relief.

However, that money is spread over two years, and there is no way of predicting at this point how severe the downturn will be, how long it will last or how many people will lose their jobs and health coverage. We do know that charity care funding was inadequate even before the downturn, given the high number of uninsured people in New Jersey. The state's FamilyCare program continues to make a difference, but it can only do so much in reaching uninsured children and in some cases, their parents.

President Obama came into office promising dramatic health care reform. Whatever stopgap measures financially strapped states can take will not solve the overriding problem that the nation's health care system is broken.

But the patient in this case — the broken system — may get a lot sicker before it begins to improve. No time should be lost in getting national health care reform off the ground.

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