California Looks for Solutions to Growing Lack of Health Coverage

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Associated Press

With no work for nearly six months, electrician Michael Everett barely had money to survive, let alone supply medical coverage for his wife and daughter.

An injury or sudden illness would have plunged his family into insurmountable debt.

“We couldn’t afford to purchase most insurance plans,” Everett said. “So we signed on with the DGS system of health care. That stands for ‘Don’t Get Sick.”‘

With health care on the agenda of both presidential candidates, California, the nation’s most populous state, is struggling to address a growing problem that leaves one in five of the state’s 34 million people without health insurance, despite the healthiest economy in a generation.

California’s uninsured rate – growing by 23,000 each month – is about 33 percent higher than the rest of the country. Only Arizona and Texas have higher rates of uninsured, according to Census data.

The plight is blamed on the state’s high cost of living (the median home price in San Francisco, for instance, is $470,000), a low number of job-related insurance programs and a large population of illegal immigrants, said E. Richard Brown, director of the UCLA Center for Health Policy Research.

“Part of the reason we’re the poster child for the need for a universal health program is that food, shelter and transportation are so expensive,” said Jamie Court, an analyst with the Santa Monica-based Foundation for Taxpayer and Consumer Rights. “Families just can’t afford health insurance here.”

So far, efforts to reduce the uninsured have failed to take effect, which is bad news for other states studying California to see what kind of reform can work, said Nadereh Pourat, a senior researcher at UCLA.

“California could set an example,” she said.

A plan to extend coverage to nearly 600,000 poor parents whose children are covered by the state’s low-cost insurance program won general approval in the Legislature, but died Sept. 1 when the state Senate failed to vote on a separate bill to pay for it.

Gov. Gray Davis is considering whether to fund the program under his own authority. It would require allocating $128 million of the state’s annual $1 billion payment from a multistate tobacco settlement and another $128 million in matching federal money.

Brown also suggested shifting part of the cost of private insurance to the state, which would set premium costs for low-wage earners based on the family’s income.

Another solution – although controversial – would be to saddle California businesses with providing health care by imposing a new tax on employers that would fund a universal health care system, Brown said.

Such an alternative might make sense to employees who find job-related health plans too expensive but earn too much to qualify for Medi-Cal, the state’s low-income medical insurance program.

“The poor are priced out of employer plans, but even the middle-class is finding the costs more and more unaffordable,” Brown said. “They think, ‘I have no medical problems now – why spend all this money?”‘

Most of California’s uninsured are part of working families, and about half are headed by at least one full-time employee, Brown said, citing figures from UCLA studies released in May and August.

Margaret Prescod, a Los Angeles-based advocate for working mothers, said her elderly mother lacked medical coverage after being struck by a car.

Her family had little money, she said, and a lack of insurance translated into a lack of care.

Emergency room doctors delivered a cursory examination before setting her mother’s broken leg, Prescod said. Without therapy and repeat check-ups, the leg withered and the knee froze.

“Who gave a care about her?” the activist said. “She couldn’t pay so her level of treatment was terrible. Now she can’t get around.”

Everett, the electrician, still lacked insurance when he began suffering incapacitating headaches. The medication cost up to $75 a day, he said.

He finally found work in June as an electrician on the television show “NYPD Blue,” but said he’s still shaken by the experience – and he worries about the future.

“What if you need care someday and you can’t get it?” he asked. “What then?”

Consumer Watchdog
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