SAN DIEGO: Votes To Pool Funds For Indigent Care

      The San Diego County Board of Supervisors voted unanimously yesterday to try to create a new program that would combine Medi-Cal with County Medical Service programs -- a plan they hope will save money and expand medical care for indigent patients. The move, an attempt to "gain more local control of spending for" health care for the poor, would create "a County Organized Health System, something that would be allowed in four California counties under a new bill making its way through Congress." The San Diego Union-Tribune reports that the most recent proposal is a step toward a long-term plan to "combine the county's $1 billion in health care purchasing power, using this clout to get a better price for care for the poor." Local officials hope the new program will "cut some of the layers ... out of the monetary loop," specifically for-profit HMOs based outside the county, to free up funds for local organizations. Medi-Cal and County Medical Service programs spend about $700 million a year, and Supervisor Dianne Jacob said "even a 1% savings could mean $7 million for expanded coverage for the poor."

Reaction
      Several health groups lauded the county's new proposal, but private insurance brokers were "nervous" about the long-term implications of the program. One broker warned the county not to "go too quickly," and expressed concern "about what may happen if the county is successful in pooling public funds." The Union-Tribune reports that the proposal's backers hope the county could someday create "an even larger health care purchasing pool by bringing their respective employees into the effort," which may cut insurance brokers out of the loop. Supervisors said, however, that private business are not involved in the plan at this time (Dalton, 6/10).