Healthcare for All? 

By Gary Lauer

 

Proponents of universal healthcare see a single-payer system as the only way to cover the millions of uninsured in California.  But clearly, universal healthcare is an unrealistic solution in a state that can barely keep libraries and schools open. 

 

Governor Schwarzenegger’s insistence on a special election to promote his agenda has created an uproar among Democrats regarding the omission of healthcare in the governor’s top-3 initiatives. The healthcare issue needs to be --and can be-- addressed today, even if it’s not on the top of the governor’s list of priorities. Democrats and Republicans should work together now to insure more Californians through existing programs, both public assistance and the private insurance market. 

 

The California healthcare system isn’t as broken as many portray it.  The truth is that despite the high cost of other necessities like housing, California has some of the most affordable health insurance in the country.  Our strong, competitive health insurance market has provided Californians with dozens of plans from a number of major companies.  Recent research on the affordability of health insurance in the 50 largest cities in the country ranks seven California cities in the top ten.  San Francisco ranks as the 7^th most affordable city in the nation, with health insurance for 30-year-olds available for as little as $58.00 a month.   

 

The real question is: Why do so many Californians go without health insurance when it’s so easily within reach?  It’s true that a certain percentage cannot be insured in the private market due to pre-existing health problems, and there are people for whom even $58 a month is more than they can afford. But there are surely many thousands of individuals here in the Bay Area who are both insurable and could afford an individual or family health insurance plan in the private market.

 

The Employee Benefit Research Institute recently released a report indicating that much of the increase in the uninsured in the United States may be attributed to recent immigrants who may have a cultural bias against health insurance or are restricted from applying for public assistance for their first five years in the country.  Certainly this accounts for a percentage of the uninsured here in California. 

 

But immigration is not the whole problem.  Young adults between the ages of 24 and 35 comprise the largest segment of the uninsured.  People in this age group often fall into a coverage gap upon leaving their parents’ health plan.  As employers are becoming less likely to offer health benefits due to rising costs, many new workers lack the access to group coverage they might have had ten years ago.  Typically young and healthy, these people are more likely to hold onto their money and forego health insurance entirely, hoping their good health continues.   

 

Understanding that the uninsured is a mix of those who are either too sick to get private health insurance, those who may have a cultural bias against health insurance or are unable to apply for public assistance options, and those who think they’re too young and healthy to need it, what can we do to reach out to the people who can qualify for affordable private insurance? 

 

First we need to educate those who can afford health insurance. There’s a lot of discussion about universal health care, but before we decide we need a new approach, there are things we can do in the current environment to help the community discover and utilize all public and private options that are available. Secondly, we have a very robust system in California to support people who cannot afford health insurance. For example, the needy in our state have access to many state-sponsored programs including the Healthy Families program, Healthy Kids plans, MediCal and the Major Risk Medical Insurance Program. Mr. Mayor, we need to get the word out to the community so people know how to get access to these programs.

 

Joint action between local leaders and state government could identify ways to remove barriers to health insurance and provide access to health care.  Mayor Newsom should take a leadership role and create a task force comprised of public policy officials, community leaders and health insurance industry experts to determine and address the barriers facing those who can qualify for health insurance.  Others who can qualify for private coverage should be given incentives to purchase health insurance on their own.  This will help keep our emergency rooms open and preserve public assistance for those who truly need it. 

 

It’s crucial that local and state governments work together to address the problem of the uninsured in San Francisco and the rest of California.  This issue is not going to go away and universal health coverage is only a distant possibility.  Let’s make an effort now to help those who can be insured under our current system. 

 

Gary Lauer is the CEO of eHealthInsurance, an online marketplace for individual and family health insurance.