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Access to health care her No. 1 job - The Record (Bergen County, NJ)

The Record (Bergen County, NJ)

Access to health care her No. 1 job -- Corzine aide endured son's cancer ordeal
Date: 02-11-2008, Monday
Section: NEWS
Edtion: All Editions
Biographical: HEATHER HOWARD

Dealing with a mysterious lump on her toddler's foot made Heather Howard realize how fortunate she was to have good health insurance and access to medical care.

'We saw three different surgeons,' said Howard, who recently succeeded Dr. Fred M. Jacobs as New Jersey health commissioner.

The lump turned out to be a cancerous soft tissue tumor, an extremely rare malignancy that baffled doctors. At one point, a surgeon even suggested that her son's foot be amputated, she said.

The lump was removed and Nate, now 4, is in remission.

'This really teaches you how lucky you are to have very good health insurance and be able to navigate the system,' she said.

Howard said her top issue as health commissioner is making sure New Jerseyans have such access to quality health care. Some 1.3 million residents, including 250,000 children, are without health insurance.

'Imagine people without health care coverage,' she said. 'They would see this [tumor] on their child's foot and say, 'It's just a bump. It'll go away.' '

Howard's son will need frequent checkups until he is 13.

The cancer 'is gone; but it has a possibility of recurring in his lung' via his lymph system, Howard said. Every six months Nate goes to Johns Hopkins Hospital in Baltimore for MRI and ultrasound exams. New Jersey 'has some fabulous physicians here,' Howard said, but going to Johns Hopkins maintains continuity of care.

Although Howard, 39, is not a doctor like her two immediate predecessors, she is a lawyer who knows how to navigate the system.

She was counsel and policy adviser to Governor Corzine in Washington when he was a U.S. senator, and again when Corzine became governor. She also was a senior policy adviser for Hillary Clinton when she was first lady.

In those roles, she pushed bills to expand access to prenatal care, increase federal funding for health care providers and protect state prescription drug assistance for elderly and disabled patients.

Howard wants to keep moving New Jersey incrementally towarduniversal coverage, such as last year's decision to make low-cost health insurance available to children of middle-income families by allowing them to 'buy in' to the state's FamilyCare entitlement program at the same rate it costs the state. This could immediately benefit 10,000 uninsured children in the state, she said.

Unfortunately, that program 'is under attack,' Howard said. The Bush administration wants to limit eligibility under the federally funded State Children's Health Insurance Program (SCHIP), including FamilyCare. The state has sued. Howard helped formulate that lawsuit, which was filed in October by the state attorney general.

Howard has other challenges, including hospital bankruptcies and closures and physicians' skyrocketing medical malpractice insurance premiums.

A recent report by a state commission, which recommended that New Jersey help financially struggling hospitals deemed essential to the community, will be a useful tool, she said.

The New Jersey Hospital Association is encouraged.

'We've had five bankruptcies and four closures of acute care hospitals in the past two years, and three closures pending,' said Betsy Ryan, president of the association. 'We were heartened to see that was one of her goals.

Howard said she has been monitoring patient care in North Jersey since the closings of Pascack Valley Hospital in Westwood and Barnert Hospital in Paterson.

'A hospital is such a vibrant part of a community,' she said. But, 'it's not always about keeping a hospital open.'

Barnert, for instance, could still be used to provide urgent care, long-term care or doctors' offices, she said.

'Perhaps closing Barnert will strengthen St. Joseph's Regional Medical Center,' Paterson's only remaining hospital, she said. 'We have an obligation to taxpayers. A lot of tax money is going to these facilities.'

Physicians, meanwhile, want Howard to do something about costly malpractice lawsuits and low reimbursements for charity care, said Dr. Richard J. Scott, Medical Society of New Jersey president.

'Heather is well aware that the same tort reform issues of 2003 remain unsolved,' said Scott, an orthopedic surgeon in Red Bank. New Jersey's is a 'hostile, highly litigious' environment that is driving doctors out of state, he said.

And while malpractice premiums are rising, doctors sometimes find themselves basically giving away their services. 'Each year, our physicians give out over $1 billion in charity care, for which they receive virtually no reimbursement or tax reduction,' Scott said. 'So we hope to have her hear us on that.

'The best thing we can hope for is that she can communicate to the governor the depth and breadth of the problems, so that he can begin to initiate solutions,' he said.

The hospital association is not concerned about Howard not being a doctor, Ryan said. The staff of the state Health Department includes 14 physicians and more than 200 nurses. Dr. Eddy Bresnitz, the state epidemiologist, is deputy commissioner.

'As long as she listens to the physicians [in her agency], we think the state will be OK,' Ryan said.

Meanwhile, Howard's son Nate is running around as though nothing happened.

'Little kids are amazingly resilient,' she said. 'I hope some day when he's 20 years old that someone asks him, 'What are those scars on your foot?' and he says 'I don't know. When I was 2, I had this thing taken out,' and that he remembers it as no more of an ordeal than chickenpox.'


E-mail: groves@northjersey.com


Illustrations/Photos: PHOTO - HOWARD

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