of health and senior services she is a lawyer she has been a senior pharmaceutical executive and we've been talking about many different issues involving health at the national state and local scene this week will be focusing on what we're going to expect with our new governor phil murphy your new lieutenant governor she'll oliver and the state legislature in new jersey in two thousand and eighteen that will affect their daily lives and chris welcome back to the show it's great to be back i'm glad we're going to continue the conversation it's good have it was great conversation last week and we're really focusing this show on what's going to be emanating out of trenton in twenty eighty and it's been a lot of individuals who are going through the transition process right now and will be seeing who's going to be leading the various cabinet level agencies but there's a couple of issues that we want to talk about and that were made that were discussed on the campaign trail over the last couple of weeks and i think i'll start with the minimum hourly wage  so you think we can expect an immediate raise of the minimum wage up to the fifteen dollars target well let me back up a second and really do want to acknowledge you mentioned that not only do we have a new governor  murphy but we also have a new lieutenant governor senator sheila all of her and senator all over who has been a long time legislator in the state is now the first african american woman in the country to have served to be going to serve and will serve as we turn to governors so we wish i certainly wish her well congratulations a long overdue so the minimum wage i don't pretend to be an  expert that having been sort of on both sides of the issue both the wage earner and a wage payer we are currently at about eight dollars and forty cents i believe only thirty eight forty cents and so jumping directly to fifteen dollars may be a bit much to swallow but it is very likely that the legislature will want to have to go through this conversation and debate once so we may well see a bill which is progressive and either two or three steps to get to that level and then that will be very interesting it was brought to my attention just this week that as always there are some unintended consequences for example while certainly a living wage of fifteen dollars an hour maybe i'm viewed as a very important goal to many some of the consequences are we do have a title net programs so that you might have a family where mom and dad now get up to fifteen dollars an hour that before they know it it could take them above the level where they might be able to get what is known as medicaid insurance because new jersey has expanded medicaid coverage of we talked previously about we have to make sure that the governor may read up that medicaid expansion but my point is that just that it's never simple it's never likely to be a simple tomorrow the fifteen dollars there will be some implications in that issue and i remain a little thoughts as well since you are there is there  you know for help insurance she got a promotion her salary is raised due to the wage level it went up and also when she was no longer medicaid eligible she was chip eligible however chip has not through the parson wrangling going on right  now and maybe buy into the show when it airs the wrangling will be over but it has been refunded you know so the waiting for refunding which is a thirteen billion dollar program so right now those individuals are full on in between a gap right now so the question is as you said the minimum hourly wage has is a double edged sword both for employers and employees and i'm sure that i'm sure however that's been a focus of the governor as far as what he will be able to do and i'm sure that depends a lot on revenue too and i think one of the issues that he talked about was about revenue with the legalization of marijuana which we touched briefly on last week that you know governor murphy continue wants to legalize the casual recreational use of marijuana in private places by adults and tax the sale in regulated retail stores so let's talk a little bit about that what do you think well there are more such consequences to sure there are there are unintended consequences and in that issue as well there is a bill in the legislature it had been had one hearing in may of two thousand and seventeen it appears from newest news accounts that that  bill will continue to go through substantial revisions and there will be additional hearings it was with some surprise that many of us heard the governor us speak so favorably as to  supporting legalization of marijuana for as will use presumably in the bill limits this to over twenty one people over twenty one but there again is sort of a multipart issue on the one hand there are as there is a case to be made that this is also a civil justice issue in new jersey as in other states the pot the fines the penalties certainly the sentencing  mandated sentencing requirement for individuals who possess use or deal with relatively small amounts of marijuana have been found to be unusually disproportionately severe and apply to inner city minority populations disproportionately and in some people's view but you ask what i think i think that we need a serious conversation one can visualize d criminal or reducing making the more proportionate fines associated with particularly the dealing or selling of what is after all a still federally ban controlled substance as distinct from going all the way to legalizing it for casual use the bill is that's being considered is modeled on a couple of other states colorado within our bills primarily colorado california has been implemented yet they are there bill in turn has a number of issues but some of the fallout issues are these first of all there is i think we need to have much more clarity and input from public health people concerning the exposure of pregnant women and young children after all this bill would apply to the private use of marijuana presumably in your home or apartment so visualize mom and dad and the kid sitting there watching television or playing games while the adults are smoking and this is not farfetched we have numerous reports of parents using controlled substance in the presence of their children and it's not a joke it's not funny that's certainly not the goal of of  even a the most benign view of this the second issue it's not this is this is big business this is big business and as we all know new jersey is a very poor state it's not only the most densely populated the most diverse but we have tens of millions of people traveling the turnpike from the south into the north east west north south and it is perhaps naive to think that that will not be affected dramatically by people coming into the state since we're the only east coast state poised to consider this at this point and that will have some unintended consequence consequences as well as far as enforcement people coming here to buy to use and then there's the little thing called the internet which i don't think we've really thought through both anecdotal information is that well already a number of states can get access to controlled substances through the on the internet and then they come through the mail and so would be very very very difficult to think that we're going to have even with the regulated system the final point about marijuana that i think we're going to have to have a conversation about is having had the privilege of being partisan anti tobacco activities about ten or fifteen years ago in new jersey we had the benefit of a very healthy financial trust fund dedicated to help educate children and young people middle school high school kids to wait if they were thinking of smoking to have the what were then sort of first generation quitting smoking programs and we had a very aggressive program because we've been through this for women and smoking women and crack cocaine women use of alcohol all issues that we could be funded through this trust fund that trust fund is long gone and we do not really see a source numerated in this proposed bill so i talked a bit on a non it's a something maybe we would want to have some people who who have different points of view about this on your show itself but it's not a simple it's not just so simple as as legislating recreational marijuana for those those voices hopefully would get them on and  you know get those points of view across one of the things also that was discussed along the campaign trail at the federal level the state level has been the implementation or not of a millionaire's tax and so maybe we could talk a little bit about what a millionaire's tax means when we refer to it and you know it's a special tax on millionaires only what does that mean because we have more millionaires now than ever this is an area i am not so i'm not  expert in and i think what we need to do is is in the wake of the now almost as as we are talking today and this will play out over the next few months is the federal tax reform act so i think that regardless we had we have not seen a specific proposal to my knowledge from from our incoming governor i did not yet i imagine we will so i'd phrase it more what are the questions we would ask  is this tax going to be additive to the federal the new federal scheme right is to what resources does this apply as a payroll tax  e it's interesting your perspective on more millionaires that millionaires sort of drop in and out of that last that lost the situation and we we have a continuing discussion people may differ that we are at a point in new jersey where we are seeing a net exodus individuals individuals who may not be making a million dollars in their pa but whose wealth is such that it's generating either through investments or perhaps property values and that wealth is something which they may well leave the state and not stay so it's a hard time in new jersey so whether that tax will generate i think the questions to ask are to make sure that we are very hard nosed about how it will be will we really realize it isn't worth the squeeze will we generate the revenues to what and will those revenues be dedicated we have some serious liabilities to be nice to think that it really would end up in some socially valuable and that's about all i have to say that that that issue today well i think the time that you were talking about the tax i think something will probably have to be done because the new federal the new federal tax plan and obviously that is going to affect northeast dates more than absolute more than most states because here in the northeast more than any other places we're used to itemizing our deductions on our tax returns and now we're just going to do the standard deduction we're talking about a potential impact on housing properties which they allow for values to fall you know by an excellent point did the people already have a high tax burden right and then have an additional tax maybe on on other sources of income so we're talking about  stay you know we're concerned about not just businesses but also individuals and if their property values are going down fortunately they have a lot of great schools new jersey jersey is one of the top you know top states i think the number three in the nation is force educating students but a lot of people feel the pinch in their pocketbook and people always vote their pocketbook and so if they're feeling that pinch in their pocketbook they may be looking to go elsewhere and that gap would leave new jersey looking for alternative sources of revenue you have to find there's a there's the pension that that may we can touch upon about how will unfunded pension liabilities be treated you know there's different pensions in the state of new jersey where the police whether it's the the public employees the teachers pension and everybody's looking to make sure that their pensions are fully funded when they want to retire at the something there so the question is how can we be doing all of this at the same time we're getting the revenue to to generate anough money defend punch pensions for employees who've worked their entire life for you know the state or local governments or schools or the really good to have some people who've lived in that world i know you you certainly know a lot about the educational system that i i have a lot more questions than answers right now my mind would welcome having guests that can can educate us like the news that the education caps you probably want to ask that question you know and see where that comes up whether or not we should  you haven't have a cap on the super ten salaries iverson believe we should and should not should not because what happened when the cap during the christie era was placed a lot of the superintendents who were excellent left the state  because they were limited in the amount that they could earn and a lot of taxpayers through that sack because then they realized they were getting new superintendents who didn't have the experience in the background to deal with the financial the legal implications or let alone the educational implications so we lost a lot of good superintendents to pennsylvania who lost luggage who attends delaware to new york and basically a lifting of that cap would attract the best and the brightest back into the state to help run our schools and maybe find ways to decrease costs to the average taxpayer so that we can meet the the burdens that taxpayers and the feeling when you look at tax bill what's the first thing that you say you see your school tax on there for those who have schools and you look at and say why do i pay so much and soon access especially for those who don't have you know students any longer in the system but i think one of the things that folks will need to do is look at the cap and say you know what maybe my way is right the right way or the go to the highway because there are unintended consequences we often don't think about ahead of time well you have you've dealt a lot with health issues over your career and i was hoping maybe we could just talk a little bit about some of the health issues that you feel will impact new jersey which we covered a little bit last week god and what we can look for in the upcoming year and years going forward and what might be good recommendations to the new governor and lieutenant governor coming in as to what they should look for to so that we could make it you know better for everyone as far as what to expect well it will be very interesting  probably the first time we're going to get a good look at this is in the budget and perhaps even before that in the governor's state of the state which will come after the verst of the year so we'll see what they have on the list but what i would be looking for is one of the few because it is a big budget issue in new jersey is that we have over the last twenty years have had a change in where the public insurance monies are going new jersey has been a state which has expanded its medicaid coverage and medicaid is aid to the poor however in that is a bit you know how you see  the income levels actually now we new jersey have expanded medicaid to make it accessible to sam lees of four who are a couple times the poverty level so it's become a very important source of insurance and we talked about possibly the minimum wage if we don't continue that expansion and under the affordable care act states which chose to expand which new jersey did five years ago new that five years out and now the chickens have come home to roost this year our incoming governors and legislature are going to have to decide whether to maintain medicaid expansion so it would be somewhat poignant if at the same time we're talking about increasing the minimum wage we are taking away an important source of insurance covers so i look forward to the discussion about medicaid expansion and i think the other thing and i realize that haven't really talked about risks to medicare and it's sometimes important to say what we don't have to to think too much about both in the affordable care act discussions and more recently in the income the the tax reform discussions at the federal level while there was a lot of noise and claims the reality is that medicare is intact and this point now some people may have hoped for some changes some additional changes be made but at least the good news is that new jerseyans don't have to expect much change in medicare nor does our state system have to explicitly address that on the other hand at the state level we have to make sure that we still have a robust state level program that monitors and maintains the quality of the licensure services the inspection of services increasingly our residents in new jersey are moving into assisted living facilities they are making more use more greater use of hospice than ever before that for end of life issues which is an important issue and we have to end these and these programs while they are they have their own requirements to be monitored and national programs that accredit them are not that we need to maintain in my view an adequate although lean and mean  regulatory framework and we've gotten a little out of whack in the last year so i'm looking to whether the governor will be addressing that health issue as well so we're talking about medicaid expansion will it be maintained  are looking at maintaining an infrastructure for seniors you mentioned the chip program for children if that is not refunded that has been a very important program the children's health insurance program on the national level the federal government has given us some resources to maintain that that would be very sad in my view if that were to go away we have a continuing opioid epidemic and while the incoming administration has we've talked about  possibly a marijuana legalization discussion i think we may need to hit the ground running and be very clear as to their view on helping to maintain what has been a growing behavioral health system in new jersey and behavioral health is is a perk programs these are programs that not only help prevent by educating the public about the risks associated by using controlled substance drugs but they also make sure that we have enough facilities to offer outpatient an inpatient treatment and that's always a question for an incoming administration these are not inexpensive programs  the affordable care act has made some progress in insisting that some behavioral health care be covered in insurance policies but that that is a risk that i'll be looking looking at as as the years u big piece of this issue and how they think about coverage how they think about a state like new jersey and as we mentioned that there is consult it consolidation in the wind among insurers so that in my experience i have remember having a number of conversations just face to face with the c e o s of companies who often are asked you know what what they think should be done and so maybe we can have them as well maybe one of things that i get asked occasionally is a lot of members of the public come up to me and say how can they register their concerns you know who should they go to have can they get there with local and state officials and maybe you know we can talk just a little bit about that before we wrap up the well at the state and local level we still have the opportunity to right to call i mean i am always amazed at all they won't listen to me i'm just one voice your state and local elected officials keep very close tabs they look at two things they look at the morning headlines on the papers of interest and they ask their staff what we get in terms of calls what are the leading issues but you have to pick up the phone and call and it's just say i'm concerned about this i hope you're addressing this i have a family member i i want to make sure that this program stays in place and that is that's very important just just to put your money where your mouth this to do that and i think it's also if was we think about what's happened in the last couple years in the good news is think about all the people who came out of the various town meetings and had concerns they registered with their feet and they showed up at meetings and it i have been speaking with some senior groups and particularly seniors because they bit been interested in this but have pointed out yes you can't go to all these meetings but you have friends why don't you make sure that somebody goes to your local council meeting why don't they ask about these issues that we've been talking about today not only at the local level but the state level you have your trade associations you have your consumer associations that that you certainly should be reading  or asking how does that affect new jersey just take an article send it to your representatives say is this a fact does this affect us to have to worry about this so it's just a matter of going to these later years particularly for seniors are not a time to slow down if anything you need to spend a little more time asking your officials what have they done for you lately and what are they doing for your your neighbors and you that's true and you have to be your own advocate out there and you have to advocate for those who can advocate for themselves and for those of you who watch two weeks i hope you've enjoyed the the conversation and we look forward to bringing you more individuals who can address many of the important issues that will be challenges to new jersey and the other states and the federal government in the in the years days months and years to come but one of these one of things i'd like to do is offer you the opportunity to converse with us and basically if you have any questions please feel free to write princeton t v at monument way in princeton new jersey and we'll be happy to get back to you and maybe a fist is destined for shows we'll be happy to try and get those guests lined up so that you get to hear people that you want to answer your questions with and find out what they're thinking and where will be going in the future if you have any health questions just around the chris grant because believe me she is the consult of the every look for everybody wants to talk to and everybody wants to hear her  so anything that you'd like to ask us please do i'm lugol's seen with chris grant thank you for watching tonight and we want you to stay focused they active stay healthy and we'll see you next week on another edition of open source