Schwarzenegger outlines reform plan to fix California's 'broken' health care
Speaking to the Association of Health Care Journalists, he outlined the plan, which emphasizes wellness and prevention, mandates that everyone have insurance and promises that it will be affordable.
"Everyone is assured coverage and everyone has to have coverage," he said. Requiring it removes a "hidden tax" in the form of higher costs levied on those who have insurance to pay for those who don't.
He said he took a nonpartisan approach and simply tried to gather the best minds from all areas, regardless of their political alliances. "I know we can fix this. The Democrats and Republicans want to do it. They're getting along now. They were just waiting for me," he quipped.
California is the nation's most populous and diverse state. It also has a particularly high rate of uninsured 6.5 million people, or 20 percent. He said that 84 percent of the state's uninsured are employed but cannot afford or cannot access coverage or choose not to. By creating a larger risk pool and providing subsidies for the poorest, everyone will be able to obtain a basic insurance package, he said.
Because of insurance premium increases 87 percent between 2000 and 2006 many companies are dropping the benefit, he said. "Then if you have to buy insurance, sometimes it's almost impossible to get it, and if you find it, it's outrageously expensive. So the whole thing is a vicious cycle," Schwarzenegger said.
As he looked at the issue, he visited hospital emergency rooms, including one that had billions of dollars in unpaid bills last year alone. Emergency rooms have become a default care provider for people without insurance, and emergency departments nationwide are stressed, with many closing down. In others, patients wait for hours to be seen.
Even some who have coverage through Medicaid programs find themselves using emergency departments instead of doctors because the payment physicians receive to care for them is low and many opt not to serve those patients. California will put an additional $4 billion to increase physician reimbursements for care of those patients.
The plan would extend Medicaid coverage, here called Medi-Cal, to all children in families making less than $61,950 a year and to adults in poverty. Coverage would be subsidized for families making between $20,650 and $51,625.
To help make it possible, the proposal calls for a 2 percent fee on physician revenues, 4 percent on hospital revenues. It also requires at least 85 percent of hospital payments and insurance premiums be spent on patient care.
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