California's health care system in 'death spiral,' commissioner says

Californian legislators are trying to bring in universal government health care in their State yet this guy is bitching about too many people depending on California's existing government health care. California logic, I guess

With 6.6 million Californians uninsured and costs soaring, state Insurance Commissioner John Garamendi called Wednesday for a series of reforms to save the health care system from what he called a "death spiral." Garamendi released a 73-page report entitled "Priced Out: Health Care in California" that, among other things, showed the average health insurance premium in the state increased 61 percent between 2000 and 2004. He said Californians are paying more for health insurance but getting less as employers offer fewer benefits or pass on a greater share of costs to workers. The increasing cost "is simply placing every Californian at risk," Garamendi said at a news conference outside a closed hospital in North Hollywood. "I believe the California health care system is in a death spiral," he said.

In his introduction to the report, Garamendi, who regulates insurers operating in California, decried the health care system for the poor. "We are already well on our way to having an inequitable health care system where the wealthy live and prosper while others are priced out," he said. "Forty-five million Americans and 6.6 million Californians can already attest to this." Garamendi, a Democrat who has announced he will run for lieutenant governor in 2006, proposed reforms that could eventually ensure every state resident has basic health coverage, either through the government or the private sector. However, he acknowledged that the political climate for such coverage was poor. Californians have repeatedly rejected such proposals in ballot initiatives. In addition, the federal government has legislative control over many of the medical issues involved. Garamendi said it was unlikely the United States would have universal coverage "until we get a different administration in Washington."

He was also critical of health savings accounts, including some plans backed by the White House. The White House referred questions on the issue to the Department of Health and Human Services, which in turn deferred comment to the Treasury Department, which oversees the accounts Garamendi has criticized. No one answered a call at the Treasury Department after hours Wednesday.

Garamendi referred to reduced benefit plans as "skeletal policies" that offer less coverage as a way to reduce costs when major illnesses strike. He specifically pointed to a Blue Cross plan known as Tonik that he said is being marketed to young adults for about $70 a month but doesn't include maternity care or catastrophic illness coverage. Garamendi asked what would happen if a young woman with the policy got pregnant or had a major illness that wasn't covered. "They're going to wind up, probably, on the government dole in the Medi-Cal program," he said.

Blue Cross of California spokesman Michael Chee said Garamendi was misinterpreting the Tonik plan, which provides coverage for everything except maternity. "It's absolutely false to say it doesn't cover catastrophic" care, Chee said. "This is full insurance coverage." The company used focus groups and other research to tailor the plan's cost and coverage for people 18 to 30 years old who represent the largest portion of the state's uninsured, Chee said. "This program was designed with this age group in mind," he said. "We looked at the same uninsured data that Mr. Garamendi sees and determined there was a need for this product for this particular segment."

Joining Garamendi at the news conference was Alicia Ayala, 75, of East Los Angeles, who serves as a board member of a not-for-profit chain of clinics called AltaMed Health Services Corp. Ayala said she has a lower back problem that used to be fully covered by her insurance. Increasing premiums caused her to change coverage, and now she must pay $15 for each visit to physical therapy and $200 for more serious care when the ailment flares up, she said. "We are living longer," Ayala said. "You need to take care of us."

Richard Brown, director of the UCLA Center for Health Policy Research, said many people are being forced into "medical bankruptcy" by increasing premiums, deductibles and copayments, even though they have health insurance. In California, an individual can pay as much as a $10,000 a year for health coverage when all those costs are included, while families can pay as much as $16,000 a year, Brown said. Garamendi has planned a hearing next month in San Francisco on the policies detailed in his report. In October, he plans a hearing on the profits of health insurers.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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