Expanding coverage while containing costs is a concern for many
in the health care industry. Read about the challenging path to
health care reform in these blog entries from Jim Lott.
Jim Lott is the executive vice president of the Hospital
Association of Southern California where he is responsible for
health care policy development, advocacy, and association
communications for hospitals serving Los Angeles, Orange, San
Bernardino, Riverside, Santa Barbara and Ventura counties.
I’m not quite sure when it started, but many observers knew
something was wrong when the Orange County Board of Supervisors
passed an ordinance making CalOptima the only Medi-Cal agency in
California forbidden to participate in the California Health
Benefits Exchange, the agency established to manage health
insurance for newly insured individuals and small businesses
under the 2010 federal health care reform law. Shortly
thereafter, a successful movement started to pass another
ordinance to change CalOptima’s board of directors. Then,
the agency’s top managers started to leave in succession for
other jobs, culminating with the recent resignation of Richard
Chambers, its CEO.
In new health care landscape where inpatient volumes are falling
and Medicare, Medi-Cal and commercial payments to hospitals are
flattening and/or decreasing, radical change and major financial
investment are required by hospitals while facing the most
problematic economic outlook in 20 years.
Last November, the director of the state Department of Health
Care Services was “pleased to announce” that the federal
government had approved a new five-year Medicaid Section 1115
waiver for California.
Congress may have rejected a public plan option for private
health insurance coverage, but the California Legislature gave it
new life with its passage of legislation to implement the federal
health care reform laws.
Make no mistake about it; the Obama Administration gets it!
Without reform, including cost containment, health care will grow
from 16 percent of our nation’s gross domestic product to 25
percent over the next 15 years.
After only two weeks in limited release, Michael Moore’s Sicko
achieved the rank of being in the top five documentaries of all
time. That’s too bad, because a documentary it is not. Rather, it
is one long campaign commercial for replacing our pluralistic,
market-driven health care delivery system with a government-run,
single-payer system.
Scientists from all over the world came together earlier this
month and in one powerful voice told us that we human beings
broke our planet. They urged us to stop questioning the existence
of global warming and to begin implementing known and proven
strategies to mitigate the problems that a 4-to-5 point rise in
worldwide climate temperatures in the near-term will cause.
Hopefully, world leaders will listen and begin to do the real
work needed to sustain life on earth.
We need a similar reality check with regard to reforming our
health care delivery system in California and the U.S. Our system
neither provides for the efficient access to health care that 6.5
million uninsured Californians or 47 million uninsured Americans
need, nor is it able to sustain the twice-to-thrice annual health
care cost growth to overall inflation ratio that will soon
cripple our ability to do much about improving access for
anybody.
Legislators and governors in many states intend to shepherd some
form of health coverage expansion along in the next year. In
California, Governor Schwarzenegger has introduced an ambitious
plan that would make insurance coverage mandatory. Fees would be
imposed on physicians, hospitals and businesses to help expand
coverage, while low-income and uninsured individuals would
receive subsidies to purchase insurance.
The race is on! Not since 1992, when President Bill Clinton
turned over the task of building a universal health plan for all
Americans to Hillary, has anyone in the know felt that a major
health care access and restructuring plan was forthcoming. Given
the results of last month’s election, though, once again the
pundits believe that real change is coming.
In most economic markets, supply and demand are the principle
economic forces at play. This is a bit more complex in the U.S.
health care market, where the economic forces driving health care
are supply, demand, fear and greed.
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