The current healthcare system in California is in crisis, with many citizens uninsured, or underinsured, or living in constant fear of losing the coverage they have. In addition to the financial strain that the current system places on poor and middle class working families, all residents suffer because the crisis has resulted in a cutback of essential services, such as the closing of trauma centers. Moreover, lack of access to healthcare means that people often do not get preventive care, and illnesses that could be less expensively treated with early detection are allowed to progress to the point where they are much more expensive to treat and the prognosis is not so good. Another consideration is that people with infectious diseases such as tuberculosis pose a serious risk to all members of the community when a lack of access to affordable healthcare means that they go undiagnosed and untreated. As a result, there is growing consensus that the time has come to reform the system, as is evident in the three proposals that have recently been presented by California government officials.
After reading the three proposals to reform healthcare in California, I have concluded that Senate Bill 840, presented by Sheila Kuehl, has the greatest chance of long-term success because it is the only one of the three that provides universal care for all Californians. The Governor’s plan and AB 8 will insure most, but not all, Californians. Since every man, woman, and child needs health insurance, no one should be denied access. Thus, we should take advantage of the momentum for reform to be all-inclusive, since we might not get another chance. SB 840 sets up a single payer system, which could be the most cost effective approach if it simplifies the amount of bookkeeping and administration that are necessary to implement the plan. In fact, the plan anticipates a $29 billion saving in administrative costs. Those who object to a single payer system on the grounds that it removes choice can be reassured: SB 840 allows insurers to write supplemental plans for those who wish to purchase additional insurance, thus preserving freedom of choice for consumers and competition within the insurance industry. It also takes into account the rights of healthcare providers, and allows them to get together to negotiate fair fees for the services they offer. Basic coverage for all would be provided through taxes, but the poorest of our citizens would receive the assistance that they need. This is a much cheaper and humane solution than having poor people crowding emergency rooms to be treated for conditions that are not true emergencies, as they now do. Freeing emergency rooms to do what they are intended to do- that is, to treat trauma and other emergencies- would be a cost saving and a life saving benefit for all Californians. It will save the counties money. The SB 840 plan is appealing because it takes all of the health care dollars and puts them into one pool, and then allocates them more efficiently. This makes so much more sense than the patchwork system we have at the present time.
One of the most attractive aspects of SB 840 is that the cost of paying for healthcare is shared among the State, employers, and individuals. This sort of partnership is essential in order to make reform work. It is the only fair and practical way to provide coverage for everyone. By sharing the burden, all stakeholders participate in the program, and all will be invested in making the program work.
In my opinion, any reform of the healthcare system should include a strong focus on prevention and education. Giving people knowledge about nutrition and exercise and how these factors impact their health and quality of life is very important. A healthier population will be created if we collectively focus on health rather than disease. Although this might seem more expensive at first, in the long run it will save Californians a great deal of money.
The issue of healthcare reform is complicated, with a lot of money and the public health at stake. But surely we can work together to find a more efficient and more equitable way to use the $186 billion per year that we now spend in the broken healthcare system. A solution will require leadership, a commitment to the greater good of our society, and probably some sacrifice- but it is worth it.