UNINSURED: Are Lawmakers Up to the Challenge?

      As the number of uninsured Californians tops 7.3 million, many in the health industry believe the only remedy to this "health care crisis" is a universal health plan, California Journal reports. "The health care system in California is on the brink of destruction. And we've got to get serious about repairing it and rehabilitating it," state Sen. Jackie Speier (D- Hillsborough), chair of the state Senate Insurance Committee, said. With the state's booming economy leading to a hefty budgetary surplus and the tobacco settlement trickling in, some wonder if lawmakers are the obstacle to change. E. Richard Brown, director of the UCLA Center for Health Policy Research said, "I think universal health care is a realistic goal in California. Whether there's political will to do it is another question." Brown believes the issue will remain off the radar screen of lawmakers as long as the ranks of the uninsured are confined to the indigent "who don't have strong political voices." Michael Dimmitt, a California Health Care Association lobbyist, agreed, saying, "Unfortunately, I think it has to become a middle-class issue." Part of the problem can be traced to the 1996 welfare reform which tightened eligibility requirements for public assistance programs, including Medi-Cal. Adding to the "epidemic," is the fact that relatively fewer California companies are offering employee benefits. In 1998, only 58% did versus 69% nationally.

Economic Impact
      "What's lacking is an understanding of how this crisis undermines the California economy," Beth Capell, chief lobbyist for Health Access California, said. While emergency rooms across the state have been closing due to financial strife, the number of visits by uninsured patients have continued to rise. One "conservative estimate" reports that between 840,000 to 1.8 million such patients visit ERs annually, at a cost between $500 million to $1 billion. Steve Thompson of the California Medical Association noted that lack of insurance has restricted many from accessible preventive and routine care. These patients "usually get care when they're really sick in emergency rooms, in the most expensive way," he said. State and federal laws mandate that doctors provide emergency services, but noting the burden on California's emergency rooms, Speier said, "It's an unmitigated disaster. 'ER' on TV is heaven. ER in California is hell." The state Legislature has proposed various bills to expand and reform Medi-Cal and Health Families, but Dimmitt said, "The question is what is the elective leadership of this state willing to do, when are they willing to do it and how much money are they willing to put into it" (Rodriguez, California Journal, May 2000 issue.)