Who is to Blame for Disruption of Care after Contract Disputes?
As contract disputes between hospital chains and insurers have forced patients to find new providers, San Jose Mercury News editorial writer Barbara Egbert says that an increasing number of patients are left wondering who is to blame for the disruption in their care. Egbert asserts that in the recent dispute between Sutter Health and Blue Cross of California there are "many villains to blame," including insurers that drive "payments below the actual cost of providing care"; the federal government, which "tore a gaping hole in Medicare" with the Balanced Budget Act of 1997 and pharmaceutical companies that charge high prices for drugs. Egbert asserts that everyone, including consumers demanding the most expensive care, can shoulder some of the blame for contract disputes. However, noting that "health care isn't something we can live without, even temporarily," Egbert maintains that it is "unfair to expect individuals to switch doctors and hospitals as casually as they switch brands." Egbert concludes, "The relationship between purchasers, payers and providers is out of whack and it will take years to get it back into equilibrium" (Egbert, San Jose Mercury News, 1/7).
An accompanying San Jose Mercury News editorial offers some solutions for California's health care problems. The editorial asserts that the main problem with the state's system is that it is "severely underfunded," but putting money back into health care "must be done carefully." To get the system back on track, the editorial maintains, the federal government needs to provide enough money through Medi-Cal and Medicare to cover the actual cost of care. In addition, the editorial urges employers to "make up their minds to pay" higher premiums. For their part, insurers should make sure they create "good, affordable packages for the small business market ... that address the needs of low- to middle-income families, rather than see millions more Californians become uninsured." Noting that "advances in technology and drug research" will continue to raise health care costs, the editorial asserts that the government, private industry and consumers all will have to pay more. However, pointing out that "not everyone" can afford rising health care costs, the editorial concludes, "As a humane society, we must ensure that adjustments in the health care system are not made at the expense of low-income workers who become uninsured as prices rise" (San Jose Mercury News, 1/7).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.