Hospitals’ role crucial in expanded health care

An emergency room at a hospital in Palo Alto. (Photo: Jennie Book, via Shutterstock)

Today in California, the fifth largest economy in the world, we’ve made unparalleled progress toward our goal of health care coverage for all, but there are still roughly 2.8 million people without health care coverage.

Take a moment to let that number sink in: 2.8 million.

That’s 2.8 million children, grandparents, working moms and dads, retirees, veterans. Millions of lives without a safety net.

Second, we need to provide undocumented individuals with access to Medi-Cal. This is a critical head-start in the push to cover every Californian.”

They are our neighbors, our friends, our co-workers, many of whom face a grim choice when they get sick: pay out of pocket for their health care, or risk going without it entirely. For some, these are literally life-and-death decisions.

It doesn’t have to be this way.

Gov. Gavin Newsom and state lawmakers have laid out proposals to begin the work of extending insurance coverage to all Californians who need and deserve health care.

First, we must help working Californians afford health care. The proposals under consideration provide more subsidies to help middle-income families purchase insurance through the Covered California exchange.

Second, we need to provide undocumented individuals with access to Medi-Cal. This is a critical head-start in the push to cover every Californian, regardless of immigration status.

Finally, the requirement that every Californian have health insurance must be reinstated, incentivizing people to enroll in a health plan, and imposing a financial penalty on those who don’t. The revenues raised can be used to pay for coverage expansions in other ways.

Together, these proposals are important steps toward ensuring all Californians can access critical health care services. That’s a goal that is not only humane and worthy in and of itself, but also one that can help keep costs under control.

Here’s how it works: hospital emergency departments are the most expensive settings in health care – open 24/7/365 and staffed with specialized clinicians, equipment and technologies ready to save lives at a moment’s notice.

But when people forgo care due to a lack of insurance, emergency departments become the default provider, raising costs for everyone. And when people put off care until diseases and illnesses advance to more serious stages, treatment becomes far more expensive than it would have been if the conditions were addressed sooner.

Also, the more care that’s delivered to people without coverage, the more costs spike for everyone else. As hospitals and other medical providers increase the amount of charity care they deliver, costs for others rise to offset the gap.

Advancing these proposals means real savings for real people. The reduction in costs achieved when care is delivered earlier, rather than later, and when it is delivered in the most appropriate setting for a patient’s needs, will help keep health care costs down for millions of Californians.

Without a requirement for individuals to buy insurance, for example, there would be an estimated 400,000 fewer enrollees in California’s individual insurance market, resulting in increased premiums of as much as 9 percent for those remaining on the exchange.

Hospitals applaud Gov. Newsom’s and the Legislature’s pragmatic and budget-conscious ideas as a means to build on the impressive gains California has already made in securing coverage for 93 percent of its population.

For California’s more than 400 hospitals, there is no higher priority than ensuring the people and communities we serve receive the care they need, when they need it. But for 2.8 million of our fellow residents, the lack of an insurance card means they don’t have the keys to a healthy future. Supporting these ideas for expanding coverage will help ensure that all Californians have access to the care they need and deserve.

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