Monthly Archive for June, 2010

Health Reform for High-Risk Californians

Published on June 30, 2010 in Uncategorized. 2 Comments Tags: , , , , , .

On Tuesday, Governor Schwarzenegger signed the legislation to establish the high-risk insurance program for people with pre-existing conditions that have been without insurance for at least six-months. In theory, this high-risk insurance pool would cover Californians until the prohibition for insurers to deny coverage to people with pre-existing conditions comes to fruition in 2014.

The Managed Risk Medical Insurance Board of California has initiated the process to establish the high-risk pool by beginning to accept names of people that qualify. Apparently, the plan is to maintain a list of people who would like to be notified when the application forms become available (Dahlberg, Sacramento Bee, 6/30). There are not yet any insurance policies designed for this pool or applications for entrance.

According to the San Francisco Chronicle, the program itself would draw down about $761 million in federal funding and has the potential to extend coverage to 25,000 – 30,000 Californians, a positive step towards coverage and access (AP/San Francisco Chronicle, 6/29). It remains to be seen how this increase in insurance coverage will affect primary care providers and their abilities to serve this newly covered population.

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U.S. Health System Ranks Last

Published on June 24, 2010 in Uncategorized. 1 Comment Tags: , , , , , , , , , .

A recently released Commonwealth Fund report comparing the health systems of seven nations shows the United States consistently underperforms relative to other countries on most dimensions of performance, although the U.S. health system is the most expensive in the world. Obviously, we need significant changes and fast.

Among the seven nations studied—Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States—the U.S. ranks last overall, as it did in the 2007, 2006, and 2004 editions of Mirror, Mirror. Not only does the U.S. fail to achieve better health outcomes than the other countries, but the U.S. also ranks last on indicators of access, patient safety, coordination, efficiency, and equity.

The most glaring difference between the U.S. and the other countries studied is the lack of universal health insurance coverage. Universal access in the U.S. has the potential to significantly improve various access related indicators. When health reform is fully implemented in 2014, affordability of insurance and access to care should improve, but access and affordability are only the first step in improving our nations health. Primary care provider shortages and the obesity epidemic will test the bounds of current health system. It is not surprising that the U.S. currently under performs compared to other countries on measures of access to care and equity in health care between populations with above-average and below-average incomes.

But even when access and equity measures are not considered, the U.S. ranks behind most of the other countries on most measures. It is apparent that the U.S. is lagging in adoption of national policies that promote primary care, quality improvement, and information technology.

The report indicates areas for improvement for all countries. But, the other six countries spend considerably less on health care per person and as a percent of gross domestic product than does the United States. These findings indicate that, according to both physicians and patients, the U.S. health care system could and should do much better in achieving value for the nation’s substantial investment in health.

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