- [Narrator] Funding for this edition of State of Affairs with Steve Adubato has been provided by EJI, Excellence in Medicine Awards.

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[INSPRATIONAL MUSIC] - Hi, everyone.

Steve Adubato.

We kick off the program with Dr. Steven Brunnquell, who is the President of the Englewood Health Physician Network.

Doctor, good to see you.

- Nice to see you again, Steve.

- You told our producers something that we wanna share with everyone.

That there are keys to keeping out of the emergency room.

I go to the emergency room way more than I should, overreact to things.

What are some keys that we should be learning to avoid the emergency room, which only drives up healthcare costs?

- Well, particularly, this time of year, in the season that we're launching into right now, some of the ways to stay out of the emergency room is get a flu shot, get the latest COVID shot.

If you're over 75 or 80, you might consider an RSV vaccine as well.

And the second part is, you know, if you're not feeling well, get tested because we have medicines for influenza, we have medicines for COVID, and all of those things I just mentioned, the vaccines and those medications, they won't prevent illness, but they'll keep you out of the hospital.

I can't think of anybody who wants to be in a hospital.

- Doctor, let me ask you something.

I'm not gonna get into a whole political conversation about vaccines or what people believe or don't believe, but what do you say to folks, regardless of their, quote, "politics," "I am anti-vax.

I don't believe in vaccine."

Talk to them, from a medical, scientific, and clinical perspective.

Please, Doctor.

- I encounter these people all the time and I don't try to twist people's arms.

I say a couple of things.

I said there is plenty of scientific evidence that COVID vaccine in particular probably saves 3 million lives in this country.

It is true that influenza vaccine doesn't always prevent flu.

It is true that COVID vaccine doesn't prevent COVID, but it will keep you out of the hospital.

COVID is much less virulent than it was early on, clearly.

We're not seeing the death rates, and that's a good thing.

We'd like to keep it that way.

We also don't wanna transmit to your family members of loved ones.

And I say, I get a COVID shot and a flu shot every fall.

And if you don't wanna do that, that's your business.

But if you don't and you get sick, come and get tested because I can't tell the difference between flu and COVID these days.

They look identical and there are different treatments for each one.

- Doctor, talk to us about this.

This trend and the impact it potentially has on the delivery of healthcare.

Independent practices, dwindling, getting smaller as larger physician groups take over.

Large-scale mergers.

You got Walgreens through Village MD acquiring practices at Summit Health, all kinds of big mergers.

Bigger is better.

What do you believe all this means to the average citizen/patient who just wants to get healthcare, medical care?

Please.

- So it's getting harder and harder, I think, to be an independent practice.

The cost of overhead, the cost of insurance, the regulations, the billing.

Most of my colleagues really just wanna treat patients.

They really don't wanna run a business.

And so yes, we here at Englewood, we've grown to 700 providers, but we've also not wanted to become corporate medicine.

We want to provide the best care for people.

And so yes, we have a robust physician network with all the medical specialties you can think of.

And yes, we've organized them into some very large multi-specialty offices, which I think provided convenience for patients because we're all on the same insurances, we're all the same electronic medical record, it's all shared, but we've also kept the neighborhood field.

We've kept our local primary care offices.

- How?

How, Doctor?

- We keep them where they work, particularly in our urban neighborhoods where people don't have transportation, they walk to their doctor's offices.

We've kept those offices open and then we've located the multi-specialty office nearby so that when they need a specialist or they need a CAT scan, or they need a stress test, they can get it conveniently.

They don't have to come to campus to do those things.

- Let me ask you this.

There's clearly a shortage of physicians, particularly primary care physicians.

What do you see out there, Dr. Brunnquell, in terms of the physician market?

Who wants to go into it, who doesn't?

And how COVID and the experience of COVID for physicians has impact?

I know that's a loaded question.

- Yeah, I'll grant you, that's a loaded question, but you know, I love my job as much as I did when I started 32 years ago.

- COVID hasn't changed that.

- No, it hasn't changed that.

It was tough.

I'm not gonna kid you.

You know, the spring of 2020 was frightening.

It was terrifying because remember, this part of the world was the very beginning.

We were among the first to see these folks, but we chose this profession because we love taking care of people.

So if I can, like I said earlier, I can unload from doctors' busy days things like running the billing part and running a payroll and hiring staff.

If I can take that away from them and allow them just to see patients, and there's still lots of people who wanna care for folks.

I think that sometimes some of my colleagues have become sort of perhaps a little bitter and a little resentful of some of the things that they've been asked to do in the last 20 years and what medicine has become.

But what I do in the exam room, when I close the door and I ask you, "Mr. Adubato, how can I help you today?"

That has not changed.

Yes, I now document on a computer, which is the single biggest... (chuckles) - You gotta do electronic medical records in real time or no?

- I'm actually using an AI product at the moment to help me write my notes so I don't have to do that.

But we can do that another day.

But what I do in the exam room hasn't changed.

I listen to what the patient has to say, I do a physical exam and I share with them what our plan is.

That part has doesn't change.

Yes, we have to deal with insurance companies and we have to deal with the government and we have to deal with all sorts of other stuff, but I'm trying to take that away from the doc so they can focus just on caring for patients.

- Last question.

You mentioned government.

If state government were to take one action that would be helpful to help retain our much needed physicians, what would that be?

- We're having difficulty right now, Steve, getting our new doctors credentialed on insurance plans.

So when I hire a new doctor, and we take all insurances at Englewood, I want them on the insurance plans so that when people come to us, they can be insurance agnostic.

It doesn't matter the coverage you have, we'll take care of you.

We wanted to get rid of that barrier.

The insurance companies are dragging their feet and I would love to see the state do something to say, "Hey, listen, if there's an eligible, certified doctor who's capable, has the documents, and you have that documentation, here's the time limit.

You have to include them.

- Dr. Steven Brunnquell.

I wanna thank you so much, Doctor, for exploring a whole range of important issues that affect all of us, regardless of where we live or the issues we're dealing with medically, clinically.

Thank you, Doctor.

- It's been a pleasure.

Thank you, Steve.

- You got it.

Stay with us.

We'll be right back.

(grand music) - [Announcer] To see more State of Affairs with Steve Adubato programs, find us online and follow us on social media.

- We're joined once again by our good friend, Michele Siekerka, President and Chief Executive Officer, New Jersey Business and Industry Association.

Good to see you, Michele.

- Great to see you, Steve.

- And by the way, check out our interview with Michele and a whole series of other women business leaders that we're doing in partnership with the NJBIA, Business and Industry Association.

But today, on "State of Affairs," we talk policy.

So let's just say this, we're on the back end of 2024.

We're interviewing candidates for governor, 2025.

Top two business-related issues we should be talking to them about impacting the business community, Michele?

- Well, tax reform and regulatory reform.

You know, it's all about affordability and cost of doing business and being regionally competitive here in the state of New Jersey.

And we all know currently we are not.

- So let's be more specific, regulatory reform means different things to different people.

Name a regulation that is, in your view, in the view of the Business and Industry Association, hurting business that needs to be changed, and why?

- Well, it could be permitting, for example.

It takes our companies a significantly long time to get a new project online.

I heard recently a company who, yet again, has chosen to take a new project down south because the time to get that project up and built will be a fraction of the time it takes here in the state of New Jersey.

We need to look at the time sequence of getting shovels in the ground to finishing projects.

And a lot of that it has to do with permitting, licensing, inspection, et cetera.

- Michele, seriously, you and I have been having this conversation for years about government regulation.

Every time you're with us, there's another business leaving the state.

That can't be what the current governor and the current administration want, the Murphy administration, or the next one.

If that's a fact that we're losing business jobs- - Yes.

- tax revenue in the state, in part because of regulatory problems, why wouldn't it be a higher priority to make some of those changes?

It's not a rhetorical question, I really am curious about that.

- It's a great question.

Let me just say that I wanna do a shout out to the legislature who, in a bipartisan manner, did move a bill last year, the Government Efficiency and Regulatory Reform Act, or Review Commission.

What that would do is, it would set up a review board that businesses could come to with concerns about regulations, and then they could brainstorm around why is this getting stuck.

Bipartisan; passed the legislature.

Went to the governor's desk, and he outright vetoed it.

And we couldn't understand why.

- On what grounds?

- That's a great question.

We're still trying to figure that out.

And we're having that discussion yet again right now with the legislature so that they can engage the governor to understand why he vetoed that, so we can get it back on, because the legislature would like to bring that up again this fall.

- When we have the governor for his quote, unquote, "exit interview," because his term ends in 2025, We'll have that, well, it shouldn't be an exit interview, we'll probably have a couple of interviews, but that is one of the many questions we'll ask him.

So you and I have talked about this before, put it in context, the corporate transit fee-slash-tax, not only what is it, but what impact do you believe it's having on the business community?

- Well, significant impact.

So what it is, is it's the continuation of the corporate business tax surcharge that was supposed to end December 31st, 2023.

- Who's it on?

- By the governor, that it would sunset.

It's a surcharge on the corporate business tax.

- Translate that?

- 2.5% on top of already 9%, making New Jersey the largest corporate business tax yet again in the nation, by far, outlier, not just largest, but outlier.

- The governor has made the argument, some Democratic legislators have made the argument, Michele, that this corporate transit fee is money needed from businesses earning profits of more than $10 million to go to support a struggling, ailing New Jersey transit system, which commuters are struggling to have to deal with every day.

- So then, I would say, why is it sitting in surplus for a year?

You said you needed this $1 billion.

That's what it equates to.

But rather than turn it right over to New Jersey Transit to do something with, it's sitting in surplus for this year, right?

That causes us to be suspicious about whether it's going to make its way to New Jersey Transit next year.

You know, New Jersey Transit's having all these challenges.

We want a healthy New Jersey Transit, right?

We want people to get to where they need to be without having to get in their cars.

The problem with this is there's no nexus between putting that burden and that tax on New Jersey business and fixing what you're trying to fix by way of New Jersey Transit.

'Cause many of the companies that are subject to this aren't even near a rail line.

So it's not like their employees are getting the benefit.

And others have already told me that they supplement their employees' commuter costs.

- Let me disclose, before I ask this next question, that "New Jersey Business," which is the magazine of the New Jersey Business and Industry Association, is a media partner of ours.

Along those lines, let me follow up on this.

Unemployment rising in the state of New Jersey, A?

B, why?

- Well, you know, we're sitting here right now, yet again coming through what is an economically challenging time.

And we seem to be having, you know, a soft landing.

I think we've been in a soft landing for a few years now, you know, post COVID.

- What does a "soft landing" mean?

- A soft landing meaning that inflation is reducing.

People are feeling a little bit better about their economic situation.

However, prices are still too high.

And there's a lot of things that impact that.

Certainly, you know, COVID and post COVID did supply chain challenges and otherwise.

But when you increase the cost of doing business, you leave a business in no way other than to find how to make up that cost somewhere else.

And that either means cutting jobs, cutting benefits, or increasing the cost of their product and service.

And these businesses are doing all of the above.

So what we see right now in this settling out is the fact that they gotta balance their own sheet because of inflation.

And part of that is cutting jobs, right?

Increasing the cost of services.

And hopefully not cutting benefits.

- You told our producers that there is, and you've written about this in the magazine, I've seen it, that there's a skilled-labor shortage in the state.

What are we talking about?

- Well, every day, we know how dynamic it is relative to keeping your skills up in the workforce, particularly because of technology.

- That's right.

- Every single company, you know, Steve, you and I, we don't think of ourselves as running technology companies.

Of course we are, here we are right now, right?

Everybody needs to know the basics of technology.

But that technology changes each and every day.

And when it does, we need to make sure we're increasing our skills.

But I'll shift to manufacturing for a minute, right?

We still have, you know, tens of thousands of open opportunities in manufacturing that we can't fill because we need to educate the future workforce on the opportunities in these different fields, number one.

Number two, we need to continue to create, which we're doing, career pathways to in-demand jobs.

- Excuse me, sorry for interrupting, is that the New Jersey Pathways program?

- Yeah, New Jersey Pathways is a partnership between NJBIA and the New Jersey Council of Community Colleges, with a state appropriation, thank you very much for that state appropriation, we're in our third year, to create these career ladders to in-demand jobs, like healthcare, like manufacturing, like logistics and distribution, like technology.

And the idea is earn and learn.

So you're stacking credentials, certificates.

It isn't just necessarily a K-16+, you know, academic trajectory.

Embedded in that, you have all these types of certification programs where you get a piece of paper that objectively says, "I can do this particular skill."

And with that, you can earn.

And then you can continue to stack those, and organically increase your career path and increase your salary along with it.

- And that is, in fact, the New Jersey Pathways program.

The website has been up of the Business and Industry Association in the state of New Jersey.

Go on there, check this out.

Michele Siekerka, thank you so much for joining us.

And make sure you check out our special on women business leaders that were doing in cooperation with BIA.

Thank you, Michele.

- Thanks, Steve.

- Stay with us, we'll be right back.

(grand music) - [Announcer] To see more State of Affairs with Steve Adubato programs, find us online and follow us on social media.

- We're now joined by Ray Zardetto, who's the editor and writer of ROI-NJ's "Military Matters" newsletter.

Ray, good to have you with us.

- Thank you, Steve.

I appreciate being here and having the time.

Thank you.

- You got it.

We're media partners with ROI-NJ.

Tell folks, and I get "Media Matters" on a regular basis, excuse me, "Military Matters" on a regular basis.

Tell everyone what it is and why they should check it out.

- Okay, well, "Military Matters" is one of the family publications from ROI.

ROI is, of course, a general business newspaper, but they have a number of what we call sector reports or newsletters on the most important areas of the state economy, including higher education, transportation, energy, finance.

And recently, they decided, because of the import of military activity in the state and the impact of it on the state economy, that having a newsletter and sector report on the Military was very important.

And so, back in May we launched "Military Matters".

- How'd you get into this?

- Well, when I was with the Chamber of Commerce, which was my last position before I was here, Chamber had a very close relationship with Joint Base McGuire-Dix-Lakehurst.

And we did a lot, we tried to do a lot.

- Go back for a second Joint Base McGuire-Dix-Lakehurst.

- [Ray] Lakehurst, yes.

- Explain to folks what military bases people were like, well, where are they?

What are they?

Please Ray.

- Okay, all right.

The Joint Base McGuire-Dix-Lakehurst is actually, a combination of what were three separate military bases at one time.

There was the McGuire Air Force Base, there was Fort Dix, which was an army training center base, and there was the Lakehurst Naval Center, which was for the Navy.

And in 2009, they decided to combine the three of them into one joint base.

- Excuse me, Ray, was that because there was a commission, a federal commission that was established- - Yes.

- at the time to try to save money and merge or close military bases across the country?

- Yeah, it's called BRAC, B-R-A-C, which the Base Realignment And Closing.

- That's right.

- And that's a function of congress and they're constantly looking at, you know, different bases across the country.

And what they decided was, when they decided to close Fort Monmouth, which they made the decision to do that 2005, and it took 'em four or five years to actually close it, one of the things they also decided to do was to bring together these three bases into one, because a lot of what the three bases do really in many ways overlap and interact with each other.

So, it's no longer just one service branch.

Usually, what they talk about now is the joint force.

- Got it.

- You have more interaction between the different service branches.

- Ray, what are the most pressing issues that our veterans we're literally taping this program after, right after Veterans Day.

Question.

- Yes.

- What are the most pressing issues and challenges facing our veterans?

- Well, I'll mention two.

One, is something that is called a food insecurity issue.

Ran corporate study two years ago said, there's about 25% of military families that are dealing with food insecurity issues.

Food insecurity defined as not getting enough food or not getting the right amount of types of food that they need for families.

- Is it that these families don't know what their next meal's gonna be?

Is that what we're talking about?

- Yeah, we're talking about them having to decide many times between paying the rent or having enough food put on the table on a regular basis.

And this is mostly because the spending power in a military family is eroded because of inflation.

That's number one, but number two- - Because it's a fixed amount the government provides.

- Yes, and you know, and they have raised the salary to some degree, but it hasn't kept up with inflation, especially at the lower levels of military service.

But secondly, also, military families are nomadic by nature.

Most military families will move on average once every two to three years.

And then they may go across the state, they may go across the globe.

- Why?

- Just because they moved to different, you know, different expertises.

They're moved around to different parts of the world where they're needed.

So, it happens frequently to them.

And a Blue Star family study says that although the military picks up most of the costs of the move, families' usually stuck with spending 2,500, $5,000 out of pocket for whatever moves they make.

So, that erodes the family finances too.

And the third reason is a lot of military spouses can't find jobs in, you know, not just New Jersey, but otherwise, because the transient nature of military life makes a lot of companies reluctant to hire spouses knowing they're likely to move on after a year or two.

- Ray, the other issue that you talk about in "Military Matters", by the way, check out the website will put up.

Is the website the ROI website or our media partner and then they could find "Military Matters", Ray, is that how it works?

- Yes.

Yeah, they'll find it right on the front page there.

Yes.

- Team, let's put it right up there so people can check out "Military Matters".

Talk to me about the issue of mental health for our veterans.

- Yes, that's the second major issue I think that is being dealt with that needs to be dealt with more.

For any number of reasons, mental health issues permeate the service branches.

There's no one service branch that isn't dealing with it.

There's a number of reasons for it.

And you know, the biggest eye opener for me is the Defense Department number that on average 22 active military or veterans commit suicide every day.

And there's a lot of military and a lot of veterans organizations that will tell you that number underestimates how many are actually committing suicide every day, because we can't keep track of where all the veterans are.

And so, the Military is trying to do a lot of things about it, but it's an overwhelming issue.

- So, for the average person, sorry, for interrupting, Ray.

- That's all right.

- For the average person who says, "I want to be helpful, I want to go beyond saying, 'Thank you for your service.'"

Which has value, but only so much.

- Right.

- What can people do?

- There's a few things they can do that they consider.

First of all, because as I mentioned before, military families' are transient.

They move around a lot.

If a military family moves into your neighborhood, you know, do anything and everything you can to welcome them, because otherwise they can feel very isolated.

They don't feel like they have any place to go.

And that's one of the key factors they find when they do the studies is this sense of isolation either in the community or on the base where they work.

That's one of the key problems.

Another problem is a lot of the kids who come into the military have come from tough backgrounds.

And this is their first time away from home.

It's the first time they're really having responsibilities put on them.

And sometimes that's a bit of a burden too.

So, another thing you can do is there are a number of organizations you can support, either with resources or money.

American Legion, the VFW, you know, Military Support Alliance of New Jersey, which is an organization I do some volunteer work for.

We all are trying to get as many resources to the kinds of institutions that are addressing mental health issues as we can.

- Ray Zardetto is doing important work.

He's the editor and writer of ROI-NJs "Military Matters" newsletter.

Ray, thank you for your work.

Thank you for the impact that you're making every day.

Appreciate it, Ray.

- Thank you, Steve.

Thank you.

- I'm Steve Adubato.

We thank you for watching and let's go beyond simply saying thank you for your service and ask what we can actually do for a veteran or that veteran's family.

See you next time.

- [Narrator] State of Affairs with Steve Adubato is a production of the Caucus Educational Corporation.

Celebrating 30 years in public broadcasting.

Funding has been provided by EJI, Excellence in Medicine Awards.

The New Jersey Economic Development Authority.

The Russell Berrie Foundation.

IBEW Local 102.

New Jersey Children’s Foundation.

Seton Hall University.

The Adler Aphasia Center.

Delta Dental of New Jersey.

And by The Port Authority of New York and New Jersey.

Promotional support provided by BestofNJ.com.

And by NJ.Com.

- I'm Tim Sullivan, CEO of the New Jersey Economic Development Authority.

Since joining the NJEDA, I've been struck by the incredible assets and resources that New Jersey has to offer.

The NJEDA is working every day to grow New Jersey's economy in a way that maximizes the values of those assets to benefit every single New Jersey resident.

This includes more support for small businesses and a focus on reclaiming New Jersey's position as a leader in the innovation economy.

Visit njeda.com to learn more about how NJEDA is building a stronger and fairer New Jersey economy.