David Gorn

Broader Enforcement Power for Insurance Commissioner?

A few hours after he was sworn in as the new commissioner of the California Department of Insurance, Dave Jones said he wanted the state to make sure PPO health insurers spend 80% of their revenue on health benefit payouts.

That 80% figure is the new federal mandate, and Jones wants to make it clear to insurers that the state is going to check up on them and enforce that law, according to Janice Rocco, deputy commissioner of health policy for the DOI.

“Historically, the department has reviewed for 70% medical loss ratios in the individual market,” Rocco said. “Now that federal law meets 80% individual standards, we feel it’s important that the federal law be enforced at the state and federal level.”

Third Time’s the Charm for Single Payer?

The megaphones and what-do-we-want cheers were in full force earlier this week on the steps of the Capitol building. It was all to support passage of a single-payer system in California, which  twice already has been passed by the Legislature and vetoed by the governor.

Amanda Foran, an occupational therapist at the California Hospital Medical Center in Los Angeles who attended the rally, said national reform will help ease some of the problems of health care, but doesn’t get to the root of what she sees every day at work.

“As a clinician, I see patients come into the ER all the time because that’s the only way they can see a doctor. And of course, it’s the most expensive.”

Deeper Cuts Won’t Come From Health Services

It was standing room only in the governor’s conference room yesterday, as reporters from around the state gathered to hear just how bad it was going to be.

Pretty bad, according to Jerry Brown.

“This is very difficult,” Brown said, as he announced his intention to cut about $6 billion from health-related services — everything from reducing child care subsidies to imposing co-payments for Medi-Cal services.

Health Insurance Regulation Proposal Is Back

This week’s large rate hike announcement by Blue Shield makes the perfect backdrop for debating an Assembly bill to regulate those kinds of rate increases, according to Assembly member Mike Feuer (D-Los Angeles), who introduced  AB 52 last month.

“It sure adds fuel to the significance of AB 52,” Feuer said. “I am optimistic that the day is coming when insurers will need to justify increases like this.”

Feuer’s bill was eligible to go to committee yesterday.

Researcher Paints Scary Picture of State’s Future

The Medi-Cal system in California is flawed in a basic way, according to researcher Stephen Moses of Pacific Research Institute, a California-based think tank.

“Instead of Medi-Cal being a safety net for the poor,” he said, “it provides very generous benefits to many in the middle class, far more than just the poor.”

The state provides long-term care to people who might have had the means to pay for some form of that care in their lifetimes, Moses contends.

State Gathering Info on Hospital-Acquired Infections

The state Department of Public Health recently released its first report on “healthcare-associated infections” (HAI) — those infections patients actually get while they’re in the hospital, such as surgical site infections or the antibiotic-resistant staph infection known as MRSA. (The full name of MRSA is the methicillin-resistant staphyloccocus aureus infection).

HAIs prompted some public outrage, both nationally and in California, and public health was charged doing something about it.

A year from now, state officials expect to have enough consistently compiled data to provide valid comparisons, officials said.

Brown Takes the Oath of Office, Again

In a way, you could say there were three former governors of California on hand for yesterday’s inauguration ceremony: Arnold Schwarzenegger, Gray Davis and… Jerry Brown.

It was the third time Brown has taken the oath to be the state’s governor. He mentioned that he was happy to be following in his father’s footsteps as governor “and, 36 years after my first inauguration as governor, even follow in my own,” he said.

At the end of his brief 17-minute speech, Brown summed it up this way: “Like our song says,” he said, “California, here I come, right back where I started from!”

Health Care Team Hits Ground Running

Long before today’s inauguration of Jerry Brown, the new governor’s interest in health care policy has been clear.

He appointed a new Secretary of Health and Human Services almost a month ago, back on Dec. 7, naming Diana Dooley for the job. Dooley also will serve on the new and powerful Health Benefits Exchange Board, along with two members appointed last week by outgoing Governor Schwarzenegger — including the woman Dooley replaced at HHS, Kim Belshé.

According to Dooley, there has been a high level of cooperation between the two administrations on health care reform and policy.