Tuesday, October 28, 2003

HEALTH ACCESS UPDATE
Tuesday, November 18th, 2003

HEALTH CARE AT CROSSROADS
* Appointments from the Gubernatorial Transition: Health Care Hints
* Continued Work Needed to Expand Health Coverage: Nov 6th Advocates Mtg to Implement SB 2
* Medicare Debate Set for Showdown: Will Privatization Pass?


* GOVERNOR SCHWARZENEGGER'S APPOINTMENTS: HINTS OF A HEALTH AGENDA

Since Governor-elect Arnold Schwarzenegger rarely mentioned health care in his campaign, and he has no public record on the subject, very little is known about his positions on the key health policy issues of the day. His appointments have been scrutinized to figure out how he will deal with health care issues. His transition team of more than 60 people, while notable for the wide breadth of experience and diversity, was sorely lacking in major leaders from the health world, either from industry, academia, or advocacy circles. However, his two most important important appointments--transition finance director and chief of staff--raise serious concerns.

TRANSITION FINANCE DIRECTOR: Schwarzenegger asked Donna Arduin, on loan from Florida Governor Jeb Bush's finance staff, to conduct an overall audit of California's budget and make recommendations. According to Florida advocates, Ms. Arduin is known for advocating major cuts to health and social services.
* Under her direction, Florida has made cuts that have been rejected here in California, including lowering the eligibility for adults on Medicaid from 100% to 88% of the federal poverty level, and eliminating Medicaid coverage for adults for such benefits as dental care, vision care, and hearing aids.
* Other cuts made in Florida by Ms. Arduin have not even been proposed here in California. Florida has capped enrollment in their Child Health Insurance Program (called KidCare), which has so far denied coverage 60,000 children who are now on a waiting list; increased co-payments on prescription drugs, medical transportation, and non-emergency use of the emergency room; and increased premiums on families in KidCare. She also proposed to eliminate medically needy program in Medicaid, but this last suggestion was rejected.

CHIEF OF STAFF: Last week, the Governor-elect announced that HMO senior executive Patricia Clarey would be named as his chief of staff. Clarey worked in the first President Bush's Administration and then as deputy chief of staff in Governor Wilson's Administration. She then went off to Transamerica Insurance before becoming vice president for governmental affairs at Health Net, one of the large California HMOs. Her appointment, combined with the dominance of the Wilson team that opposed HMO reform, raises serious questions about the future of HMO reform and the Patients Bill of Rights, including the continued enforcement of these important consumer protections.


* HEALTH EXPANSIONS: DEFENSE AND OFFENSE

With the signing of SB 2 (Burton), to extend health coverage to over one million uninsured workers and their families, advocates for the uninsured have significant work to do in order to make the promise a reality. Here's some work to defend, implement, and expand SB 2.

* DEFEND: The Chamber of Commerce and a few other business organizations are beginning a petition drive to get a ballot referendum to repeal SB 2. They are paying $2 a signature to collect the more than 373,816 signatures needed to qualify the referendum for the ballot, either on the March or November 2004.

Most voters get their health coverage through their employer, and polls have shown that voters are strongly supportive of the concept of SB 2, even after opposition arguments are read. Especially with the increased coverage of health care labor disputes in Southern California, voters may very well want the protections in SB 2 to preserve the coverage they have. However, the campaign to repeal SB 2 is likely to rely on misinformation and scare tactics, as the name of the campaign--Californians Against Government Run Healthcare--suggests. More information on this effort will follow.

* IMPLEMENT: The bill has a two-year implementation process that includes multiple agencies. Last Wednesday, the Managed Risk Medical Insurance Board (MRMIB) started its deliberations on how to implement SB 2, including putting out a list of issues for consideration regarding implementation that they are seeking comment on. They will finalize the list of issues at their next meeting.

MEETING FOR ADVOCATES: Advocates for the uninsured are invited to a planning meeting on SB 2 implementation on Thursday, NOVEMBER 6th, 2003, at 2:00PM in SACRAMENTO. This "Faces of the Uninsured" convening will be a strategy session to plan and figure out all the ongoing work that will be needed to make the promise a reality, including the policy work of implementation at six agencies, especially given the new administration. Location to be announced. Please RSVP to Anthony Wright, Health Access, at awright@health-access.org. Transportation subsidies are available for those organizations who need them.

* EXPAND: Even as SB 2 is defended and implemented, the work toward universal coverage needs to continue. SB 921 (Kuehl), to establish a universal health care system, is currently awaiting a hearing in the Assembly Health Committee with a probable hearing date in March. Continued advocacy is needed to expand the organizations in support of universal health care, and to urge Assembly legislators to support this proposal.


* ADVOCATES MOBILIZE AGAINST MEDICARE BILL

The U.S. Congress continues to debate the particulars of a Medicare prescription drug bill, now pending in conference committee. Over 40 Democratic and Republican Senators have expressed serious concerns about the details of the final product, over a number of key issues. Health Access California has opposed both H.R. 1 and S. 1. Both bills provide little relief to many seniors, and actually would cost hundreds of thousands of seniors more than they pay today for prescription drugs. More disturbingly, the bills--particularly the House legislation--would lead to the privatization of Medicare. Several other issues and problems have been raised by senior and consumer advocates with the content of the bill.

It is likely that the Congress will make a decision and vote on a proposal in the next two weeks. Health advocates should contact Senator Barbara Boxer and Senator Diane Feinstein to urge them to OPPOSE any proposal that does not provide real relief to seniors, and that leads toward the privatization of Medicare.

For more information, see the following websites:
Campaign for America's Future:
http://www.ourfuture.org/issues_and_campaigns/medicare/index.cfm
Alliance for Retired Americans:
http://www.retiredamericans.org/rxbill/overview.htm
Families USA:
http://www.familiesusa.org/site/PageServer?pagename=Medicare_Index


--
Anthony E. Wright
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org

Labels: Updates

posted by Anthony Wright | Permalink | 7:40 PM


 

Thursday, October 09, 2003

HEALTH ACCESS UPDATE
Thursday, October 9th, 2003


NEW GOVERNOR NAMES NEW TRANSITION TEAM
Health Policy Views Still Hazy


Governor-elect Arnold Schwarzenegger has appointed a transtion team and a transition Director of Finance.

The transition team contains a mix of conservative Republicans, such as Congressmember David Drier and Sen. Jim Brulte; moderate Republicans such as former legislators Rebecca Morgan and Charlene Zettel, and Democrats such as San Francisco Mayor Willie Brown, LA Mayor Jimmy Hahn, former Speaker Bob Hertzberg, and CTA leader John Hein. Corporate leaders are well represented from Carly Fiorina (HP) to Eli Broad (major developer). Former Governor Wilson and former Republican candidates Bill Simon and Richard Riordan are included.

The transition team contains 65 members and is plainly intended to be broadly representative of the ethnic diversity of California. Latinos and Asian/Pacific Islanders are well represented. Several African Americans other than Willie Brown are included. Democrats look to be perhaps 15%-20% of the group. While conservative Republicans are well represented, probably better represented than Democrats, this is certainly not the dream team for far right. A McClintock transition team would have been very different.

We do not know what the role of this transition team will be: a group of this size is plainly not a working body. But it potentially creates a broad network for recruiting department directors and other political appointees and for shaping policy in the transition.

The 3,000 political appointees will be replaced at the time of the official transition in a few weeks: this will include staff down to the deputy director level in departments and in some cases below. We do not know who will take their places because no one knows this. We know from our experience with the Department of Managed Health Care what a huge difference a new team can make. We shall see what the new Administration brings.

The new director of finance is on loan from that position in Florida where she has served Governor Jeb Bush. In Florida, she has required departments to map out cost and demand for services, with five-year forecasts of need and performance goals that connect outcomes to budget dollars. Her view of what she has accomplished and that of the Republicans who lead the legislature seems to be at odds--she believes the budget has been balanced without tax increases. Legislators feel differently.

For a complete list of the transition team, go to www.latimes.com on October 9, 2003. For a description of the new director of finance, there is an interesting article at www.sacbee.com/weblog also for 10/9/03.

Does this mean that we will face the same budget fight that we faced this year? Or a different and more difficult one? The budget deficit was projected to be $8 billion or more---repealing the vehicle license fee ups that to $12 billion. If the new administration tosses out some of the various contrivances used to defer the pain until later, then the magnitude of the spending gap only grows. Cleaning house has consequences.

In his campaign, he has stated that there will be cuts, but he will not raise taxes, and education is not on the table. The next biggest item in the budget, by far, is health care.

Other than that hint, we do not yet have a clear sense of Schwarzenegger's health policy objectives. He did not answer the Health Access questionaire, as part of a general campaign policy to not answer any candidate surveys, and of course has no voting record. We will bring you further reports on his policy positions as we have more information.

--Beth Capell & Anthony Wright for Health Access California.
--

Labels: Updates

posted by Anthony Wright | Permalink | 8:47 PM


 

Tuesday, October 07, 2003

HEALTH ACCESS CALIFORNIA
Tuesday, October 7th, 2003

GOVERNOR DAVIS SIGNS SB 2 (BURTON), TO EXPAND COVERAGE TO A MILLION WORKERS

* Vote Today in an Election That Holds The Future of Health Care


SB 2 SIGNED!

On Sunday morning outside a hospital in West Los Angeles, Governor Gray Davis signed SB 2 (Burton), which would expand coverage to a million working Californians, by requiring medium and large employers to pay a fee to provide health insurance to their workers, or simply directly provide such coverage, as the vast majority of employers already do now.

This historic bill is the probably the biggest health expansion and most significant health policy shift since the creation of Medicare and Medicaid in 1965. Yet it is a modest version of many earlier proposals for health care reform, including those of two California Republicans: Governor Earl Warren and President Richard Nixon. The bill simply expands the current system where now 18 million Californians get their health coverage through their employer to cover another million, using existing agencies and expertise.

The event took on a surreal life of its own, with over 20 TV cameras set up to follow Governor Davis in the midst of his campaign against the recall. State Senator Sheila Kuehl moderated much of the program, where several elected officials spoke, leading up to actor Danny Glover and Rev. Jesse Jackson. Governor Davis then took the stage himself, where he looked on while supporters spoke, including Art Pulaski of the California Labor Federation, and Dr. Jack Lewin of the California Medical Association, the two organizational co-sponsors of SB 2.

Also speaking was Chris Mackin, of the garment company Team X, which already provides health coverage to their employees. As he said "As a businessman, I believe in competing on other things than the health care of my workers." Two uninsured people gave testimony, one in English, and one in Spanish, talking about the problems of working hard everyday, but not getting health coverage, and the health and financial consequences that result. Lee Gonzalez spoke about his experience working at a large department store but not getting health coverage, and the trouble this presents in trying to regulate his recently-diagnosed diabetes.

Key speakers included Assemblyman Dario Frommer as a co-author, Assembly Speaker Herb Wesson, and Senate President John Burton, who shepherded the measure through the legislative process. Senator Burton noted the history of the moment, indicating that he had gotten out of his sick bed to attend this signing of a health bill. Most speakers praised the Governor and his health record, including signing HMO reform and expanding coverage to a million children.

Governor Davis started that "today, California takes a bold and balanced step forward to reform health care." He spoke of the benefits of the bill, and made the case for why it was good for the economy. He pointed out that nearly half of all personal bankruptcies are because of medical problems and medical bills. He acknowledged many of the elected officials present, including Representative John Conyers, a longtime leader in Congress for the cause of universal health care who flew in for the event. Surrounded by elected leaders, doctors and nurses, uninsured families, and supporters, he signed the bill to cheers and applause.

Many community and constituent groups were present for the signing, including AARP, ACORN, Americans for Democratic Action, CA Pan-Ethnic Health Network, Congress of CA Seniors, Health Access, Human Services Alliance, MALDEF, and PICO California Project, in addition to representation from many provider and labor groups. But those present were only a fraction of the many people and organizations that made this major health reform possible, and congratulations are in order for everybody who has worked on these issues.

There is much more work to do, in the next few months and years, to defend, implement, and improve SB 2, and continue our work on behalf of the insured and uninsured. When we attain quality, affordable, health care for all Californians, we will look back on the signing of this bill as an important building block for reaching that necessary goal.

---

REMINDER: VOTE TODAY

The decisions made today at the ballot box will have major impacts on the future of health care and health policy in California. If you haven't already, please vote.

As a reminder, Health Access California has taken a "just say no" position on both Propositions 53 and 54. Health Access California has traditionally not made endorsements of candidates, and has not this year as well.
* NO on 53, which would fund infrastructure projects not by raising new revenues but possibly by diverting funds from health care and other priorities.
* NO on 54, which would ban the use of important information on race and ethnicity needed to appropriately learn about and address serious health care issues.


--
Anthony E. Wright
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org

Labels: Updates

posted by Anthony Wright | Permalink | 3:40 PM


 

HEALTH ACCESS ALERT
Saturday, September 27, 2003

HEALTH BILLS PENDING ON GOVERNOR'S DESK
* Governor to Decide on Bills to Expand Coverage, Enhance Language Access, Disclose Costs, and Preserve Continuity of Care
* ACTION NEEDED ON SB2.

Several bills are on the Governor's desk that have strong support by consumer, health, and community organizations. Advocates are urged to call and send letters to Governor Gray Davis to urge him to sign these bills. BELOW and ATTACHED are suggestions on advocacy. The bills include:

Health Access California STRONG SUPPORT

* SB2 (Burton, Speier): Expands coverage for up to a million California workers, by requiring employers with 50 or more employees to pay a fee to provide health insurance to their workers, or simply directly provide such coverage, as the vast majority of employers already do now.

* SB853 (Escutia): Requires Department of Managed Health Care to develop standards for linguistically competent care for commercially health insured plans.

Health Access California SUPPORT

* AB1528 (Cohn, Frommer, Pacheco): Creates a commission to study how to improve health quality while controlling costs. This is a companion measure to SB2.

* AB1627 (Frommer): Requires disclosure of hospital charges, including the entire list of charges plus those for the 25 most common services or procedures.

* SB244 (Speier) & AB1286 (Frommer): Expands existing law regarding continuity of care to protect consumers during contract disruptions between HMOs and hospitals or physician groups.

--
ACTION ALERT
WHAT CAN YOU DO TO SUPPORT EXPANDING HEALTH COVERAGE?

Any and all help is needed to make this major advance in health care. ATTACHED and BELOW is a one-page sheet of talking points on SB 2 (Burton), which would be a major step in confronting the growing health care crisis in California.

* PERSONAL LETTER: Send an individual letter to Governor Davis. ATTACHED is a sample individual letter that you can simply sign, with your address and contact information, and fax it to 916-445-4633. If that's busy, use the regional numbers below.

* ORGANIZATIONAL LETTER: Get your organization to send a letter on its letterhead in support of SB 2. These letters are counted differently from personal letters by the Governor's office, so do both.

* GET OTHERS TO WRITE: Get five friends, relatives, or colleagues to send a letter to the Governor, using the sample letter, or writing their own letter using one or two of the talking points.

* CALL: Call the Governor to urge him to sign SB 2. His office in Sacramento is: 916-445-2841. If that's busy, use the regional numbers below.

* GET OTHERS TO CALL: Pass your cell phone around to ten colleagues or friends, to simply leave the message to "sign SB 2" to Governor Davis.

* WRITE LETTER TO THE EDITOR: Write a letter to your local newspaper in support of SB 2. Use just one or two of the attached talking points. For a better chance of getting it printed, have the letter respond to a recent article or editorial on health care issues.

* PARTICIPATE IN EVENTS THIS WEEK: Events in support of SB2 are tentatively scheduled in the next week, including Wednesday in Los Angeles, and Thursday in Sacramento. For more information, contact Health Access: for Los Angeles, contact Idabelle Fosse (idabelle@health-access.org, 213-748-5287); for Sacramento, contact Anthony Wright (awright@health-access.org, 916-442-2308).

GOVERNOR'S REGIONAL CONTACT NUMBERS:
Offices: Phone: Fax:
Sacramento: (916)445-2841 (916)445-4633
San Diego: (619)525-4641 (619)525-4640
Los Angeles: (213)897-0322 (213)897-0319
Riverside: (909)680-6860 (909)680-6863
Fresno: (559)445-5295 (559)445-5328
San Francisco: (415)703-2218 (415)703-2803

---

TALKING POINTS:
SB 2 (Burton), Health Insurance for Working Californians

SB 2 (Burton) would extend health coverage to up to a million uninsured California workers, and provide security to millions more families that get coverage through their employer, but are scared about losing it. The bill is broadly supported by groups representing doctors, workers, consumers, seniors, people of faith, communities of color, hospital, insurers, and some employers. Surveys of both voters and employers indicate broad support.

Starting in 2006, the bill gradually builds upon the current health system, by which 18 million Californians get health coverage through their employer. Employers of 50 or more workers would pay a fee into a state purchasing pool to provide health coverage to their workers. They would have the fee waived if (as over 90% of such employers now do) they already provide coverage to their workers—and, in the case of employers over 200 workers, their families. Small businesses are exempt.

SB 2 provides health coverage to working families that play by the rules, pay their taxes, work hard, but don’t get health coverage.

· Almost 80% of people without health insurance are in working families.
· SB 2 focuses on the significant number of uninsured working at large corporations that do well but don’t offer health benefits.
· SB 2 would cover working families--as many as one million of 4.5 million uninsured Californians would get health insurance through their job, including 200,000 children.

SB 2 provides relief to up to a million uninsured working Californians—that now live sicker, die younger and are one emergency away from financial ruin.

· The uninsured often delay or avoid getting the care they need, including screenings and preventative care, ongoing treatments for chronic conditions, and even emergency care. The uninsured are more likely to die prematurely than the insured with similar problems, for every type of ailment or problem.
· Nearly half of all uninsured reported having unpaid bills or being in debt to a hospital or health provider. In fact, nearly half of all personal bankruptcies are the result of health problems or large medical bills.

SB 2 provides security to millions who already get health insurance through their employer, but are scared about rising costs or losing coverage altogether.

· Over 18 million Californians get their health coverage through their employer; half of them would be more secure in keeping their health coverage under SB 2.
· SB2 limits the share paid by workers to 20% of the premium, or for low- and moderate-income workers, 5% of their wages.
· SB2 tightens regulation of co-pays and deductibles by requiring the responsible agencies (DOI, DMHC, MRMIB) to review copays and deductibles for affordability for workers and employers.

SB 2 provides a boost for the economy, ensuring a healthier, more productive, more economically secure workforce and customer base, and fairness for the majority of employers that provide coverage.

· SB 2 would prevent many personal bankruptcies due to medical bills; Nearly half of the uninsured face “life altering” medical debt, so they are unable to be good customers.
· Uninsured workers are sicker and thus less productive, missing work due to illness. They also are more transient, imposing significant training costs on employers.
· SB 2 provides savings to the state budget, since taxpayers foot some of the cost for those whose employers don’t provide coverage. Most on Medi-Cal and Healthy Families are in working families.
· More people will be enrolled in Medi-Cal and Healthy Families, and this will bring in considerable new federal matching funds that will create jobs in California.
· The employers that already provide health benefits to their workers—over 90% of those with over 50 workers—will benefit from not being undercut by competitors that don’t.
· Affected employers will now have a new option of paying into a state purchasing pool, that will administer the benefits and be able to bargain for better rates.
· A companion bill, AB1528, creates a commission to explore controlling overall health care costs while improving quality---before SB2 even goes into effect in 2006

--
Anthony E. Wright
Executive Director
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org

Labels: Updates

posted by Anthony Wright | Permalink | 3:36 PM


 

Reserving my right to critique coverage later...

 

From small changes to BIG changes...

 

The view from 10,000 feet.

 

A Zen Sen

 

Bush Whacking Kids

 

A San Francisco treat

 

Fireworks of a different kind...

 

Building a fence at the border for whom...

 

International House of Health Care

 

Dept. of Insurance