HEALTH
Proposed Objectives
These objectives are subject to ongoing input from, and ratification by, our members. Finalized objectives will be substantiated by accompanying policy proposals in our upcoming Policy Agenda.
Strengthen and expand school and community-based health care services to be fully accessible to children
Increase access and practice of telemedicine in rural and underserved communities
End predatory pricing, untethered price inflation, and price discrimination
Context
If California’s diverse, creative, hardworking population is truly to flourish, policy makers must deliver access to affordable and effective healthcare for all, statewide, and ensure taxpayer dollars are managed responsibly toward this end.
There is a solid evidence base to guide policy makers in the right direction. We know preventing illness is often dramatically less expensive than treating it. Identifying and addressing children’s health-related needs while they are still very young is essential to ensuring kids can be successful in school, which in turn positions them to enjoy and serve critical roles in family, work, and community for the rest of their lives. Prenatal care and early home visits for mothers/families has a well-documented positive impact on the health, wellbeing and productivity of those parents and their kids – which benefits them as well as their respective employers and communities.1
To successfully implement these common sense policies and others like them, elected officials and policy makers must bring healthcare prices down2 and demand pricing be made substantially more transparent. In 2017, the U.S. spent about twice as much on healthcare as other high-income countries for the same level of outcomes and utilization, and $2000 more per capita than the next highest paying country (i.e. $79 billion in CA alone).3 Elected officials also need to be smarter about how they spend the dollars we have: 85% of health care spending goes to chronic disease, the vast majority of which is preventable.4,5
Additionally, while most Californians have access to some form of coverage (even if they don’t know it),6 many of them are underinsured. As costs continue to climb, employers increasingly move to high deductible plans, while also passing those costs on to employees, which holds down wage increases.7 Hence, having coverage is good, but access to the right array of affordable comprehensive health service is what really matters, whether through a health plan or the ‘safety net’ (via public hospital systems, emergency departments, primary care clinics and comprehensive health centers).
Last, insurance coverage is largely irrelevant if a person can’t access a professional to deliver needed care. Many Californians live in areas where seeing primary care providers, pediatric dentists, occupational therapists (to treat autism spectrum conditions for example), or mental health specialists, etc. requires long drives and missing many hours, if not days, from work. And, while only 16 of California’s 58 counties have sufficient numbers of primary care physicians, California continues to restrict who can deliver care, at the expense of patient health.8
California (and the nation) is spending too much on healthcare for what taxpayers are getting in return. Elected leaders are trying to address this, but haven’t yet had the impact taxpayers and patients should expect. Those funds must be redeployed for real results: Every infant deserves a chance to thrive and every child deserves to learn; every parent deserves a chance to nurture their family and every adult, including those with disabilities, deserves a chance to work and live independently whenever possible. Imagine the potential positive impact on communities statewide, on private sector productivity and on public sector spending if we/California can successfully meet this challenge.
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[3] https://www.businessinsider.com/cost-of-healthcare-countries-ranked-2019-3
[4] https://www.hsph.harvard.edu/nutritionsource/disease-prevention/diabetes-prevention/preventing-diabetes-full-story/; https://www.heart.org/en/get-involved/advocate/federal-priorities/cdc-prevention-programs
[5] The Governor included in the 2019-20 budget support for value-based payments that encourage more effective treatment of patients with chronic conditions. It will be important to monitor the impact of this step, and be prepared to expand it if it works.
[6] Nearly 93% of Californians qualify for some form of healthcare insurance/coverage. In the 2019-20 budget, the Governor expanded Medi-Cal to cover all income-eligible young Californians through the age of 25, has expended income-eligibility for older Californians, and increased Medi-Cal reimbursement rates.
[8] According to Jeannine English, former State and National AARP President, “California is 1 of 22 states that restricts nurse practitioners by requiring that they practice under physician oversight. Research has linked these restrictions to poorer access to care, lower use of primary care services and higher rates of hospitalization and emergency room visits. This means that increasingly more and more Californians will either go without care or visit emergency rooms for conditions like asthma or ear infections because of this lack of primary care.”
Indicative Resources
These links are included because the Collaborative considers some data or analysis in their body to be relevant, irrespective of the overall perspective or tone of the writing. They are far from exhaustive, and represent only a small fraction of the data and perspectives that shape our objectives.
It’s the prices, stupid: Why the US is so different from other countries
New iFHP Price Report highlights health care spending variations across the world
The Case for Single-Price Health Care
For Whom the Bill Tolls: Why Health Costs Are Too High, and What to Do About It
Governor Gavin Newsom to propose that California manufacture its own generic drugs
California’s Homecare Crisis: Raising Wages is Key to the Solution