HEALTH ACCESS UPDATE
Wednesday, November 29th, 2006
HEALTH CARE DEBATE HEATS UP
* Schwarzenegger Reiterates Health Care Goals, But No Details Yet; Significant Press Focus
* New Web Debate on Health Care Hosted by the Sacramento Bee
* New on Health Access Weblog: Gossip on the Gov’s Plans; Congress on Drugs; Admin Staff Change
This weekend on NBC’s Meet the Press, Governor Arnold Schwarzenegger reiterated his goals for 2007 of covering all Californians, and reducing health care costs. Yesterday, the Administration held a press briefing reiterating these goals, and promising that the Governor would unveil his health care plan in 41 days–at the State of the State on January 9th, 2007.
These developments have led to more intense press scrutiny of the health care crisis, Governor Schwarzenegger’s record to date on health coverage issues, and speculation about his plans for next year. According to these statements, there are no announced details yet with regard to his plan–or even whether he will introduce a specific plan.
On the new Health Access Weblog, at http://www.health-access.org/blogger.html, we have spotlighted and commented on recent editorials and press accounts. BELOW is a catalog of recent articles in the last two weeks that report on what is known, and what is not known, about Schwarzenegger’s health care plans for 2007. For those wanting to track this renewed debate, they are worth reading:
Sacramento Bee 11/27: http://www.sacbee.com/111/story/83351.html
San Jose Mercury News 11/27: http://www.mercurynews.com/mld/mercurynews/news/16106382.htm
San Francisco Chronicle 11/27: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/11/27/BAGBPMKDT11.DTL&hw=health+schwarzenegger&sn=002&sc=831
California Healthline 11/27: http://www.californiahealthline.org/index.cfm?action=dspItem&itemid=127547
Los Angeles Times 11/25: http://www.latimes.com/news/health/la-fi-health25nov25,1,6558256.story
Sacramento Bee 11/19: http://www.sacbee.com/296/story/79527.html
Los Angeles Times 11/19: http://www.latimes.com/news/la-me-health19nov19,1,4969121.story
San Francisco Chronicle 11/18: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/11/18/BAGVAMFAO91.DTL&hw=health+schwarzenegger&sn=007&sc=337
Sacramento Bee 11/15: http://www.sacbee.com/111/story/77205.html
San Franscisco Chronicle: http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/11/28/EDGIHMKRSI1.DTL&hw=health+schwarzenegger&sn=001&sc=1000
San Jose Mercury News: http://www.mercurynews.com/mld/mercurynews/news/opinion/16088129.htm
Sacramento Bee: http://www.sacbee.com/110/story/83298.html
Contra Costa Times: http://www.contracostatimes.com/mld/cctimes/news/editorial/16101974.htm
The New Blog Debate:
The Sacramento Bee is hosting a new online forum, Crossroads, starting first with the renewed health care debate. Daniel Weintraub, the moderator and libertarian-leaning blog veteran, has invited various health care policy people to contribute initial op-ed style pieces, and then allow them, and the public, to comment and discuss health reform amongst one another.
Health Access California executive director Anthony Wright was invited to put the first article up, which already got a quick response from Dr. James Knight, a conservative proponent of Health Savings Accounts. You can read the debate and participate in it here, at:
BELOW is the full article posted, which provides a framework for thinking about the renewed debate this year. We invite your responses, both directly at firstname.lastname@example.org, and on the blog.
ANXIOUS FOR ACTION
Anthony Wright, executive director, Health Access California
Too often debates about health care in Sacramento or DC turn into fights among industries: hospitals vs. insurers, doctors vs. medical groups, HMOs vs. drug companies, etc. As the director of Health Access California, the statewide coalition representing health care consumers, I welcome broadening this debate to include those who our health care system is supposed to serve: the patient and the public. But it is no longer good enough to have the debate; it is time for action.
CALIFORNIANS MORE LIKELY TO BE UNINSURED: For California patients and families, health care is a deeply personal and important issue, that goes directly to one’s life and livelihood. Californians are more likely to be uninsured than those in 45 other states. Over six million Californians are uninsured—80% are workers or their family members—and many more are underinsured. Many with insurance at the moment fear that it won’t be there for them when they need it.
THE CONSEQUENCES OF UNINSURANCE: Why should we care? Those who are uninsured live sicker, die younger, and are one emergency away from financial ruin. They don’t get needed care, including preventative screenings, ongoing treatment for chronic conditions, and emergency care, resulting in worse health outcomes, for them and the community at large. The uninsured are more likely to die prematurely than insured patients with similar problems. Financially, nearly half of the uninsured reported having unpaid bills or being in debt to a health provider. In fact, medical problems and bills are a leading cause of personal bankruptcy.
A MANDATE FOR CHANGE: So it is good news that both major gubernatorial candidates made health care affordability and coverage expansion a major priority for next year, and that the re-elected Governor Schwarzenegger stated that 2007 will be the year of “health care, health care, health care.”
Our health system is at a crossroads, and action is needed just to preserve the level of health security we have today.
TWO PILLARS OF OUR HEALTH SYSTEM: Of 36 million Californians, 19 million get health coverage through employers, and another 10 million get coverage through public insurance programs like Medicaid (Medi-Cal in California) and Medicare. The common theme is that we come together to share the risk and cost of health care, either at the worksite, or through a public program.
WHAT DOESN’T WORK: In contrast, relatively few Californians—1-2 million—get coverage in the private marketplace, because it is either unaffordable, or unavailable, due to so-called “pre-existing conditions.” As individuals, consumers don’t have a chance against big insurance companies, who actively try to avoid covering those who actually need care. Together, we know it is more affordable and efficient to get insurance in a larger group—and the larger the group, the more effectively we can spread risk, and the better we can bargain for fair rates.
THE CHALLENGE: Yet the two key pillars of our health system on which most of us rely, employer-based coverage and public insurance programs, are under attack. Employers are scaling back health benefits or dropping them altogether—which places an additional burden on public programs. Yet some politicians have proposed cuts or caps on Medicaid and Medicare coverage, even though they have proven more cost-effective than the private insurance-even at taking care of the oldest, sickest, and frailest amongst us.
THE POLITICAL WILL: The best solutions are to fortify these key pillars, building on what works to both protect the coverage that people have and extend coverage further. In the past four years, the California legislature has tried to do just that. To bolster private coverage, it set a standard for employers to provide health benefits to their workers, much like the minimum wage does for pay (SB2 in 2003); it passed an expansion of public insurance programs to cover all California children (AB772 in 2005); and this year, it passed a reform that would bring all Californians together under a universal health care system (SB840 in 2006). Each of these efforts were opposed by Governor Schwarzenegger, either in ballot campaign or by a veto.
FIFTH YEAR’S THE CHARM?: So 2007 should not be seen as the beginning of a health care debate in California, but the culmination. We’ve been having this debate in our state for four years; it’s now time for action.
THE RISKS OF INACTION: Without positive action, the health care system is deteriorating, and individual patients and families are being forced to take on the risk, burden, and cost of health care.
What’s worse, some so-called policy solutions actually encourage this trend, toward what economist Jared Bernstein calls YOYO, or “you’re on your own.” Such YOYO ideas include using the tax system (through so-called Health Savings Accounts) to encourage underinsurance and high-deductible plans, where consumers bear the risk for most medical expenses; and imposing an “individual mandate,” forcing consumers to purchase unaffordable coverage in the broken individual insurance market.
THE CHOICE: That’s the choice we have. If the health care system continues down the current path, you’re on your own to deal with your next major medical emergency. But the Governor and the Legislature can actually come together, to bring Californians together, we all will be healthier for it.
We look forward to the debate, but we are anxious for some action.