The Assembly Health Committee is holding a hearing on Governor Arnold Schwarzenegger’s health care reform package tomorrow, October 31st (yes, on Halloween, go figure). I’ll be there testifying on behalf of the California Association of Health Underwriters and the California chapter of the National Association of Insurance and Financial Advisors. I’ve got my formal statement ready, but now I’m wondering. Perhaps I should just read an opinion piece from today’s San Francisco Chronicle by Spyros Andreopoulos, director emeritus of the Office of Communication and Public Affairs at Stanford University Medical Center. Mr. Andreopoulos makes the point that the focus of reform should be on constraining health care costs. Nothing new there.
However, Mr. Andreopoulos goes on to cite three causes of skyrocketing medical costs:
“– 75 percent of health-care spending is associated with chronically ill patients – those with predictable and long-standing medical problems, according to “Chronic Disease Overview,” published in Nov. 18, 2005 by the Centers for Disease Control and Prevention.
— Chronically ill patients only receive 56 percent of the clinically recommended preventive care, according to an article in the June 26, 2003, issues of the New England Journal of Medicine. Nearly two-thirds of the rise in health care spending is associated with rising rates of patients treated for largely chronic diseases.”
— Nearly 30 percent of the growth of health spending is associated with the doubling of obesity over the past 20 years – a chief contributor to chronic illness, according to an article in the Oct. 20, 2004 issues of Health Affairs.”
He then describes what’s required to address these cost drivers and points out how Vermont effectively addressed them in developing its health care reform plan. Notably, Vermont’s reforms were passed by a Democrat-controlled Legislature and signed into law by a Republican Governor. Apparently there’s more to the place than fall foliage, maple syrup and ice cream with weird names from two guys named Ben and Jerry. There’s a lot of common sense, too. Lawmakers there reached agreement on their reform package by first negotiating reforms aimed at tackling health care costs.Then it focused on how to assure access to care. Which makes sense. Requiring consumers to pay for health care coverage (whether through premiums or taxes) is a lot easier — and more fair — once they’re convinced the coverage will be affordable. Without that assurance the result will be what’s happening in California: competing plans focused on coverage being sniped at from every direction by every stakeholder.
As Mr. Andreopoulos puts it, California lawmakers “must take Vermont’s example and redefine the discussion to the issue of rising costs as the first priority. The focus must be how to cut costs and streamline the system, and what will the end product look like, and most important persuading Californians that health insurance will be affordable.” If he’s available, I’m more than happy to give up my time at tomorrow’s hearing for Mr. Andreopoulos to make his point to the Committee.