As featured on p. 218 of "Bloggers on the Bus," under the name "a MyDD blogger."

Wednesday, January 07, 2009

Health Care Policy And California

One of the worst elements of the current budget crisis is that it crowds out all of the other urgent problems facing the state. Nowhere is this more true than in health care. When the Nunez/Schwarzenegger overhaul failed last year, the problem never went away. And there are a host of other issues with health care delivery that linger. Fortunately, we're seeing a little progress and a few good ideas that can set a course for the future.

First, the state reached an agreement with Blue Cross to reinstate 678 patients who were wrongly removed from their insurance plan in a practice known as "rescission". Basically, the insurer waits until a patient files a claim and then invents a reason to cancel their policy.

The insurer has agreed to reimburse the subscribers for any out-of-pocket medical expenses and create a third-party process to review policy cancellations.

Blue Shield faces up to a $5 million fine if it does not take corrective action, said Darrel Ng, insurance department spokesman.

Between Jan. 1, 2004, and May 31, 2008, Blue Shield improperly dropped 678 subscribers, the agency said.

Obviously, the state meeting its responsibilities to protect California consumers is helpful, but it doesn't solve the big problems of health care delivery. One of the most pressing concerns how to get quality care out to rural areas, where there is a dearth of doctors and facilities. Fortunately, John Garamendi has a plan to recruit new doctors to rural health centers.

State Lt. Governor John Garamendi is proposing an ambitious fast-track medical school at University of California-Merced in an effort to create more doctors for the San Joaquin Valley, one of the most physician-poor regions in the state [...]

Entering freshmen — recruited from San Joaquin Valley high schools, with family ties to the region — would study at UC-Merced and local community colleges, then train in existing medical centers and clinics, instead of at a pricey research-oriented hospital.

They would be encouraged to train as primary care physicians and learn the challenges of practicing medicine in this vast region, where 130 languages are spoken and many residents suffer from chronic ailments such as diabetes, heart disease and respiratory ailments from dust, diesel-burning farm equipment and wood-burning stoves.

And then there are the macro issues with rising costs and the uninsured in general. Recognizing the dire needs in this area, foundations and nonprofits are stepping up in this area with advocacy that will hopefully bring more attention to the issue.

Overall, while the budget is obviously the pressing concern, we cannot overlook these burgeoning crises throughout California public policy. There is sadly no magic fix for them, even if a budget is someday signed.

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