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Attention, Please: We Can Guarantee Healthcare for All Californians

By Deborah Burger writing for Common Dreams, 4/25/17

Hundreds of California nurses and healthcare and community activists joined with State Senators Ricardo Lara and Toni Atkins on Wednesday, February 22, 2017, in Sacramento to celebrate the introduction of legislation to ensure universal health coverage with effective cost controls — a Medicare for All style bill for all California residents. (Photo: California Nurses Association/flickr/cc)

It's time for a better plan. One that puts everybody in and leaves nobody out.

With continued uncertainty in Washington over the fate of the Affordable Care Act, California has a unique role to play in charting a new path on health care reform – legislation that would guarantee coverage for all Californians, at much lower cost.

SB 562, the Healthy California Act, introduced by state Senators Ricardo Lara and Toni Atkins, with the California Nurses Association as lead proponent, will receive its first legislative hearing Wednesday, April 26 before the Senate Health Committee.

Excitement over the proposed law is already escalating around the state. Scores of nurses and healthcare activists have held multiple town halls, rallies, marches, and engaged in conventional lobbying including neighborhood canvassing and calls to legislators.

The bill is certainly timely even with the ACA and the improvements it has achieved, especially in reducing the number of uninsured, still on the books.

A new series in the medical journal The Lancet offers reminders of what is an ongoing health crisis for many.

Nationally, the percentage of Americans without coverage has fallen from 16 percent of the population to 9 percent, mostly as a result of the expansion of Medicaid. But 28 million people are still insured, with ongoing racial disparities, 14 percent of African Americans and 28 percent of Latinos.

Big coverage disparities also continue based on income, 25 percent of the most low- income people compared to less than 8 percent of the “non-poor.”

That illustrates perhaps the biggest shortcoming of the ACA – the failure to adequately control out of pocket costs, from rising premiums to skyrocketing deductibles and co-pays.

Average deductibles for people in employer paid health plans averaged $1,478 in 2016, an increase of up to five times over 2006. In ACA exchanges, the deductibles are typically even higher, $3,064 in the most common, silver plans in 2016.

One-third of insured Americans who have difficulty paying medical bills are unable to pay for food, heat or housing; 15 percent took out high interest payday loans, 42 percent took on extra jobs or worked additional hours.

High costs also directly affect quality of care as well. The life expectancy gap between rich and poor Americans has been widening since the 1970s with the difference between the richest and poorest 1 percent now at 10.1 years for women and 14.6 years for men.

Children aged 5-18, whose parents had higher co-pays, have a 41 percent greater risk of asthma related hospital admissions than for children with lower co-pays.

Data from the Commonwealth Fund sheds some light on California as well. Nearly one-fifth of adult Californians aged 19-64 are financially distressed due to out-of-pocket medical expenses.

What happens after 64 is, of course, Medicare kicks in. Increasing numbers of people are rightfully asking, why shouldn’t that health security be available to everyone. There’s an answer for that, SB 562.

Under SB 562 everyone is covered, one medical card, good everywhere with real patient choice and no limited network choices. You, not your insurance company, pick your hospital or doctor.

SB 562 ensures comprehensive health coverage, including hospital and outpatient medical care, primary and preventive care, vision, dental, hearing, women’s reproductive health services, mental health, lab tests, rehab and other basic medical needs, with no insurance denials based on corporate profit goals.

And it ends the nightmare of going broke due to price gouging healthcare corporations or having to choose between feeding your family or going to the doctor when you are sick. SB 562 ends out of control co-pays and deductibles.

Who pays for it? We mostly already are. SB 562 starts by consolidating resources currently spent on health coverage, including federal payments for Medicare and Medicaid (Medi-Cal), children’s health, and federal tax subsidies to employers for health benefits, all of which comprise about 70 percent of current health spending.

Additionally, we’d see major savings from elimination of insurance waste, other bureaucracy, and profits with coordinated planning on health resources, and added revenues through a progressive tax mix.

Real healthcare reform through a coordinated system with public oversight, as exists in every other major country in the world, has been a dream and goal of policy makers in the U.S. for more than a century, blocked just by corporate lobbyists and others who profiteer off the sick.

It’s time to end that disgrace, and make healthcare a right, and a reality for all of us.

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