Health Care

The recently passed federal health care reform law will make significant changes in how health insurance and health care work for consumers, businesses, and local and state governments, as well as how insurers and providers operate.  But whether Americans experience improved care, lower costs and greater access depends largely on what happens next. This guide has been written to assist state policymakers and advocates as they engage with the numerous issues and opportunities presented by the new law. 

Of all the problems affecting California’s health care system, none is more immediate than the skyrocketing premiums consumers face year after year.  Understandably, then, Anthem Blue Cross of California’s recent proposal to hike rates on its customers by up to 39 percent galvanized an angry public.  A majority of states – at least 30 – have some form of protection, called “rate review.”  And their experience proves that giving regulators the power to reject proposed premium increases that cannot be justified on the facts helps police insurer behavior and lowers costs. 

This report explores the under-appreciated problems facing American youth in our health care system. It examines the status quo, looking particularly at the coverage crisis affecting young people, the consequences a lack of quality coverage can impose on their lives, and the inadequacy of the school-based policies many universities offer their students.

When it comes to health care, American small business owners are getting a raw deal. While the current insurance marketplace offers some options to larger employers, it too often leaves small business owners on the outside looking in. They face unpredictable changes in costs, and far too often they are forced to choose between covering employees and the very survival of their businesses.

California’s health care system is broken. Costs are rising faster than either inflation or wages, and wasteful spending is a major culprit. Inefficient and duplicative administrative systems force doctors and hospitals to spend more time and money on administrative support than is necessary, which increases costs to patients.

As Congressional and public debate over health care reform grows more intense, comparative effectiveness research (CER) has emerged as an unlikely flashpoint of controversy. Opponents’ claims that CER results in the rationing of health care or a government takeover are belied by the true nature of such research: it is simply fundamental scientific research of medical treatments aimed at determining the most effective ways to treat sickness and injury. It is the basis of all advancements in the field of medical science and has been used throughout history to improve medical treatment. The results of such research are used to create treatment guidelines, which are then incorporated by physicians in determining the best course of care for each individual patient.

As the national health reform debate begins in earnest, some pundits have suggested that America cannot afford to invest in health reform. The resounding response from political and thought leaders has been that America can't afford not to. 

The high cost of health care in California imposes an increasing burden on households, businesses, government, and the state’s economy – a burden made heavier by the current economic crisis.  The money that insurance companies spend on inefficient administration, billing and marketing – instead of medical care for their enrollees – contributes to the high health care costs Californians must endure.