Understand first that I write these blog posts between meetings and other business commitments as part of my day job, which is President and owner of a thriving insurance brokerage business. So let me apologize in advance for deficiencies in spelling and content. In my previous post on the Governor’s Health Insurance proposal, I pointed out the economic and legal reasons why its dead on arrival. At the end of the blog, I also point out why, if the Governor’s proposal were implemented and was successful, the health care system in California would collapse.
Health care affordability is at the core of what I help employers do every day.
So what steps should be taken now to make health insurance more accessible and affordable? Here are a few ideas:
1. Put the new money on the table first.
Increase reimbursement rates for government run health plans first. Cost shifting to private plans will end and health insurance rates paid by employers and employees should come down. When rates come down, access to plans goes up. Employer profits go up, taxes go up – helping to fund the increased reimbursement rates. How many more people will be insured by their employer once this change occurs? Probably tens of thousands.
2. Make the uninsured pay something.
Someone has to say it. I will. The uninsured are not destitute. They wait in line all night to get Play Station 3, they send their money back to Mexico, they eat out, they have TV’s, they go to County Fairs, they see movies, they go to concerts, they live life. When they go to the ER they plead poverty. There, I said it. Collect something, anything from them! ER Utilization rates will plummet if people know they have to pay – and many will pay if asked. We just don’t ask.
3. Bring the programs to the people.
How many of the 6.5 million uninsured are eligible for MediCal or MediCaid, or Healthy families? We don’t know. We can guess, but we don’t know. Put several kiosks in every Emergency Room in the State where those seeking care, but without insurance, can input their information to determine eligibility and even enroll, right then and there, in the appropriate program. Establish a 24 call center to handle the enrollments, in English and Spanish, so that by the time the patient is seen, often after a several hour wait, they will have insurance. This could virtually eliminate unreimbursed care in the State and give the patient something to do while they are waiting. There are already websites in place to help people research their options. www.coverageforall.org is one such website.
4. Fund this new effort by taking a new look at education spending.
Everything cannot be a priority, so let’s decide what the priorities are. We’ve more than doubled education spending in California since 1996 and enrollment is up less than 15%. Birthrates are at all time lows and enrollment trends are stagnant. Why, oh why, do we keep throwing money into this bucket when the true cost drivers, kids, are not increasing in any way commensurately with the increased spending? To fund the increased reimbursements for State funded health care, we are going to have to shift money away from other programs. Education should be number one on the list. Any politicos out there with the "nads" to take on the sacred cow of unlimited education spending?
These four ideas should be put into practice before any sweeping employer mandates or taxes are brought to a vote. Let’s be entrepreneurial first.