SAN DIEGO COUNTY: Health Reform Plan Outlined
An advisory council yesterday formally proposed an "an ambitious reorganization" of San Diego's health care system designed to "improve quality and access to care," the San Diego Union-Tribune reports. Among the many suggestions, the 23-member Regional Healthcare Advisory Council, formed last year at the behest of county Supervisor Dianne Jacob, recommended: "[e]xpanding care for the poor"; [c]onsolidating services to eliminate duplication"; [c]ombining programs for the medically indigent to save administrative costs"; and "[d]eveloping an information system to monitor care and quality." While the county hopes to begin implementing the changes in June, they "may be some time in coming," the Union-Tribune reports, and there still remains the dilemma of where the funds will come from to implement the reorganization. County Supervisor Ron Roberts, who co-chaired the panel with Jacob, noted "it may take 'divine intervention' to accomplish what is proposed for the 2.7 million people who live in San Diego County."
The panel noted that 25% of the population in San Diego County is uninsured, well above the national average of one in six people having no health insurance. And even those who do have health insurance are not guaranteed adequate health care quality and access. The Union-Tribune reports that "[t]o address these inequities and broaden health care coverage to more working people, the panel is proposing efficiencies that it believes would free up money that could be plowed back into services." One such proposal, submitted by Texas Tech University's Dr. David Smith, a consultant who worked with the panel, recommends consolidating the county's six trauma centers into fewer centers so "staff at the remaining facilities would have higher skills." However, the Union-Tribune notes that "concentrating trauma cases at fewer centers could also mean concentrating the economic burden of indigent care at those hospitals, since many trauma victims are uninsured."
Because of the complexity of the changes recommended, consultant Dr. Brant Miller "said the panel was recommending 'small pilot projects to develop the ability to work together.'" As a next step, the 18 members of the committee will "form about a half dozen subcommittees to draw up plans for reorganizing the system." The panel's report will be presented to the county Board of Supervisors March 17, with May as the target date for completing planning and June as the target to begin implementation (Dalton, 2/27).