California’s Managed Care System in ‘Crisis,’ Conference Panelists Say
California's managed care system faces problems that "loom as large as" the state's energy crisis, and reforms are necessary to prevent a breakdown, according to a panel of health care experts speaking at the California Health Care Symposium 2001 in San Francisco yesterday, the Santa Rosa Press Democrat reports. Noting that "financial pressures and nursing shortages" have led to the closure of roughly 50 emergency rooms statewide in the past decade, state Sen. Jackie Speier (D-Daly City) said, "We already have rolling medical blackouts in hospital emergency rooms across the state." Speier added that the current system of managed care plans contracting with numerous physician groups could "collapse" within five years. "The California model does not work; and the truth is, nobody is copying us," Speier told the audience of about 2,000. Jack Lewin, CEO of the California Medical Association, said that the capitation payment system has "fostered ... bad blood" between doctors and health plans and "needs to disappear in order for constructive solutions to occur." Noting that the managed care system has resulted in a "takeaway of what employees had before," health policy expert Alain Enthoven -- one of the early proponents of managed care -- suggested that employers look to create "large purchasing groups" to buy health care. Citing CalPERS and the Pacific Business Group on Health as examples, Enthoven said that purchasing alliances would allow employers to "offer wider and less expensive choices to employees" (Rose, Santa Rosa Press Democrat, 5/11).
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