Details of Health Care Reform Proposal Emerging
Officials of Gov. Arnold Schwarzenegger's (R) administration on Friday said that the governor's health care agenda for 2007 will include plans for reducing costs, expanding coverage and preventing disease, the San Francisco Chronicle reports (Chorneau, San Francisco Chronicle, 11/18).
Schwarzenegger's health care reform advisers are considering calling for a repeal of rules that require HMOs to cover treatments for mental illnesses, cancer screenings, contraception and other services. Employers say the mandates have contributed to a 55% rise in insurance premiums in the last five years (Rojas, Sacramento Bee, 11/19).
The governor wants to expand the number of health care clinics in public schools, especially in low-income neighborhoods. There are currently 119 clinics in California's 9,232 public schools.
The administration also plans to address the state's obesity rate and promote exercise, especially among children (Rau, Los Angeles Times, 11/19).
According to the Department of Health Services, physical inactivity and obesity last year cost the state $28 billion in health care expenses and lost productivity. An improvement among 10% of the people with obesity-related health problems could generate $13 billion in savings over five years (San Francisco Chronicle, 11/18).
The governor's health care agenda also will aim to reduce errors in surgeries, prescriptions and other treatments and encourage better technology in health care by using electronic records.
The governor has asked his advisers to focus on strategies based on "shared responsibility," the idea that insurers, consumers, government, employers and health care providers must contribute something to the plan.
Some advisers have looked to a Massachusetts law that requires residents to maintain health insurance coverage as a model for California, but others say it would be too costly to replicate the plan in California because of differences in demographics, insurance and employment conditions in the two states (Los Angeles Times, 11/19).
According to the Bee, a program in Illinois that requires doctors to use electronic prescribing is another potential model (Sacramento Bee, 11/19).
Although the governor has said he would not support tax increases, some in the health policy community have said that lawmakers might consider raising tobacco taxes to fund health care programs.
A proposal by Kaiser Permanente CEO George Halvorson calls for a tax on medical services and fees for employers that do not provide medical coverage to fund a health insurance coverage expansion (Los Angeles Times, 11/19).
Michael Shaw, assistant director for the National Federation of Independent Business, said that repealing treatment mandates would reduce premium costs for small-business employers and help provide more employees with coverage.
Sen. Sheila Kuehl (D-Santa Monica) said, "I think (eliminating mandates) is the least desirable way to lower the cost of health care for people in California because it does nothing to address the record profits of the for-profit insurance companies" (Sacramento Bee, 11/19).
E. Richard Brown, director of the UCLA Center for Health Policy Research, said that the proposed agenda measures are "not a substitute for providing coverage to people" (Los Angeles Times, 11/19).
"The quickest way the governor can substantially cut health care costs is by insisting the state" convert medical forms and documentation to an electronic system, according to an editorial in the San Jose Mercury News. The conversion to electronic records could cut costs by 25% to 30%, the editorial states.
According to the editorial, electronic health records also would:
- Reduce patient deaths caused by errors;
- Help physicians identify disease outbreaks earlier;
- Reduce repetitive medical tests; and
- Provide important information more efficiently to medical professionals in the event of a disaster (San Jose Mercury News, 11/20).