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I’m not quite sure when it started, but many observers knew something was wrong when the Orange County Board of Supervisors passed an ordinance making CalOptima the only Medi-Cal agency in California forbidden to participate in the California Health Benefits Exchange, the agency established to manage health insurance for newly insured individuals and small businesses under the 2010 federal health care reform law.  Shortly thereafter, a successful movement started to pass another ordinance to change CalOptima’s board of directors.  Then, the agency’s top managers started to leave in succession for other jobs, culminating with the recent resignation of Richard Chambers, its CEO.

Rising health insurance premiums are a concern for consumers and their medical care givers. Both want to preserve access to high quality, affordable health care. However, empowering a government agency to decide what health insurance premiums will be, as proposed by Assembly Bill 52, is the wrong solution to this very real problem.

There’s been a lot of grumbling from the hospital industry over the years about SB 1953 (1994) and regulations issued in the early 2000s mandating the state’s acute care facilities meet certain seismic standards between 2013 and 2030 or shut down.           

In slightly more than 7 years from the posting of this blog entry, the Hospital Insurance Fund (Part A) for Medicare will go bankrupt, according to the federal Centers for Medicare and Medicaid Services (CMS). Why, then, are the Democrats in the U.S. Senate proposing to expand the program by lowering the age of eligibility from 65 to 55 years as part of a compromise to secure passage of its health care reform bill?

Jim Lott’s recommended reading for understanding what’s happening in our economy, health care reform, organizational reform and more.

According to a recent report by PriceWaterhouseCoopers, few regions in the United States have the appropriate hospital surge capacity to cope with a major disaster. Funding on the national level has been relatively low: “The federal government spends less than $5 per person annually to pay for health systems and agencies to be prepared for a disaster. More money is now spent to stockpile drugs and supplies than to hire and train health providers to treat disaster victims,” the report states.

After only two weeks in limited release, Michael Moore’s Sicko achieved the rank of being in the top five documentaries of all time. That’s too bad, because a documentary it is not. Rather, it is one long campaign commercial for replacing our pluralistic, market-driven health care delivery system with a government-run, single-payer system. Once you understand that, any problems you might have with the film’s authenticity or integrity will seem less important.

In California, hospital construction is also being spurred by SB 1953, the mandated seismic upgrades to the state’s acute care facilities that could cost as much as $60 billion to complete. A recent report by RAND concluded that “only a fraction of California hospitals will be able to marshal the financial, organizational and logistical resources to carry out large-scale construction programs to meet the law’s deadlines.”

Scientists from all over the world came together earlier this month and in one powerful voice told us that we human beings broke our planet. They urged us to stop questioning the existence of global warming and to begin implementing known and proven strategies to mitigate the problems that a 4-to-5 point rise in worldwide climate temperatures in the near-term will cause. Hopefully, world leaders will listen and begin to do the real work needed to sustain life on earth.

We need a similar reality check with regard to reforming our health care delivery system in California and the U.S. Our system neither provides for the efficient access to health care that 6.5 million uninsured Californians or 47 million uninsured Americans need, nor is it able to sustain the twice-to-thrice annual health care cost growth to overall inflation ratio that will soon cripple our ability to do much about improving access for anybody.

The race is on! Not since 1992, when President Bill Clinton turned over the task of building a universal health plan for all Americans to Hillary, has anyone in the know felt that a major health care access and restructuring plan was forthcoming. Given the results of last month’s election, though, once again the pundits believe that real change is coming.

Though it is the association’s policy not to comment on criminal investigations, “we are dismayed by the City Attorney’s decision to use his prosecutorial authority against hospitals to address the problem of homelessness,” said Jim Lott, Executive Vice President. “It seems to be a rather excessive, pernicious approach to solving a problem that hospitals have agreed needs to be addressed and are addressing,” Lott continued.

Though no statistics are kept on the numbers of homeless treated by hospitals, 76 hospitals with emergency rooms are the medical safety net for the estimated 80,000 homeless residing in the county, including the almost 1,200 who congregate on the streets of Skid Row in downtown Los Angeles. In fact, these hospitals are required by law to receive, treat and stabilize any of the County’s almost 3 million uninsured residents who present with life-threatening illnesses or injuries, and they meet this obligation at a collective financial loss of approximately $1.6 billion annually.