Stem an Unhealthy Tide
What’s the impact of 7.3 million Californians uninsured for health care? Aside from the suffering of those who go untreated, there is this: Relatively minor illnesses often develop into major problems that require far more costly treatment; emergency rooms become increasingly overcrowded for insured and uninsured alike; students and working parents must stay at home to care for ailing relatives, and infectious diseases are more apt to spread untreated.
California’s uninsured are growing by a nearly unmanageable 70,000 a month, bringing county health facilities in Los Angeles and other large counties close to collapse in the midst of an economic boom. The counties are legally obliged to serve as health care providers of last resort, but they can’t bear the current rate of growth.
Local groups and governments are trying to meet some of the need, but the effort is piecemeal at best. Tuesday, QueensCare, a nonprofit foundation, announced an $8.5-million grant to provide health coverage to working poor people in central Los Angeles. Health experts say the effort is laudable but will barely dent L.A. County’s shortage of treatment for the poor.
Meanwhile, the San Jose City Council came close to approving a revolutionary plan that would have made wealthy Silicon Valley the first locality to provide universal health insurance for children. Unfortunately, the council sent it back for more study.
Ventura County will put to a vote in November a plan to use $261 million in tobacco settlement money to broaden its health care for the poor, but the initiative, which ties care to a private hospital, has run into strong objections from nonprofit providers.
In his new budget Gov. Gray Davis reduces some of the pressure on counties by allocating $174 million to expand enrollment in two federal-state health insurance programs for the poor, Healthy Families and Medi-Cal.
These are promising steps but do not go nearly far enough to meet the needs of the one in four Californians who are without insurance. The politically risk-averse Davis will have to face some difficult choices.
Liberal Democrats want Davis to approve $600,000 to fund a study of universal health care and to claim $1 million that the Clinton administration is offering to the first 12 states to initiate such studies. It’s a worthy project, but since universal coverage is at best a distant political goal, Davis also needs to focus on more pragmatic solutions like making health insurance more affordable to families and small and medium-sized employers.
A new Kaiser Family Foundation study cites costs as the key reason why small employers have been dropping health coverage. The problems are particularly pronounced in California, whose companies offer fewer health benefits to workers than the national average.
Here are two other ways the state can make private health insurance more affordable:
* Extend a 50%-of-premium tax credit to small, low-wage employers, at a cost of about $200 million. There is support for this in the Legislature but no strong concentration on passing the relevant legislation.
* Allow health insurers to offer more modest benefit packages to low-income Californians. In recent years, legislators have required health insurers in the state to offer a wide range of specific health services--for example, mental health care at the same benefit levels as physical health care.
In a recent Field Poll, Californians listed health care as their No. 2 concern--just after education--in this November’s election. Davis and legislators in Sacramento should recognize that doing more to reduce the numbers of uninsured in the state is not only in the best interest of counties but in their political self-interest as well.
