SAN DIEGO: Supervisors Solicit Opinions on Co-op for Uninsured
San Diego County supervisors will hold public hearings this afternoon to solicit opinions on funding a proposed independent health care cooperative that would provide coverage for nearly a quarter of the region's uninsured population. The plan to expand health coverage came in a recently released report, "Improving Access to Health Coverage," also known as the "Options Report" (Yphantides, San Diego Union-Tribune, 10/25). Prepared this summer by the Pacific Health Policy Group, the plan would offer "one comprehensive health benefits package to everyone in the county with an income that is less than twice the federal poverty level," the San Diego Union-Tribune reports. In addition, enrollment would be open to employees of small businesses that do not provide coverage. The cooperative, designed to insure up to 170,000 of the county's 600,000 uninsured, would be financed primarily through federal, state and county Medi-Cal funds and would include "subsidies to help low-wage workers buy into the system." Sylvia Hampton of the Coalition for Quality Health Care said it is about time the county addresses the problem, which affects all residents. "I don't want somebody making my hamburger -- or taking care of children in daycare -- who hasn't gotten a TB test or a flu shot and doesn't get regular check-ups. It's an outrage that in a community as wealthy as this, this has gone on so long." Dr. Robert Hertzka, president of the San Diego County Medical Society, added that the timing for action is fortuitous. "We're at a window of time, where the federal government is, no question, interested in the uninsured and the state government is clearly listening. There's some genuine interest in the issue," he said. The plan will be submitted for vote to the county supervisors after it is revised by local health care interest groups.
General Acceptance
"Key players from several sides [of the health care debate have] expressed enthusiasm" for the plan, the Union- Tribune reports. Gary Stephany, president of the Healthcare Association of San Diego and Imperial Counties, said, "The hospitals are willing to look at this. It's the most optimistic thing I've seen in some time. If we can leverage some more money out of the feds and get our fair share, that's great." County HHS director Dr. Robert Ross added that while he hasn't "yet bought off on the cooperative ... it's an intriguing idea" that would help "reduce some of the fragmentation and confusion for working families that are uninsured." But, Richard Ledford of the Chamber of Commerce expressed hesitation over the plan, saying he is "'very uneasy' discussing a cooperative at this point" and that the "county should first commit to the specific coverage expansions, then debate how best to implement them." But Greg Knoll, executive director of the Legal Aid Society of San Diego, said a solution will require daring action. "Our hope is the county will have the political will and courage it's going to take to do something bold and different," he said, adding that the proposed cooperative is "one heck of away to start" (Duerksen, San Diego Union-Tribune, 10/24).
Preserving Care for the Remaining Uninsured
Calling the plan a "good first step in addressing the grave issue of health care for the uninsured," Medical director of Escondido Community Health Center Dr. Nicholas Yphantides said the proposal signals a "real commitment [by the county] to mending the health care safety net ... offer[ing] a real benefit to some of the working uninsured." But in his San Diego Union-Tribune op-ed today, he warns that because 425,000 residents would remain uninsured under the proposal, the "county must work carefully to keep intact the financial underpinnings of the community clinic safety net. Othwerwise, access to health care for the remaining uninsured population could be jeopardized" (10/25).