Dr. Malcolm John examines a patient at a UC San Francisco AIDS clinic.
UC plays vital role in health care reform
Recent state legislative activities, the presidential election focus, and new polling suggests that meaningful health care reform may become a mainstream imperative in 2008.
In a December Field Poll, more than 60 percent of all Californians, regardless of age, gender or income, supported the general principles underlying ABX 1 1 – the health care reform deal struck between Gov. Schwarzenegger and Speaker Nunez that died in the California Senate Health Committee on Jan. 28. Had that bill and its financing initiative passed, it would have provided public and private insurance coverage to nearly 4.5 million currently uninsured Californians.
Along with the coverage expansion, the reform package emphasized disease prevention, health care coordination, chronic disease management, and the use of technology as a means to improve the delivery of care.
The two remaining Democratic presidential candidates have health reform platforms similar to ABX1 1, and health care continues to poll as one of the top three issues of concern to all voters. Most health care analysts believe that health reform didn’t die in the California Senate. Rather, key components of the comprehensive package - including the levy of a hospital tax, and the emphasis on the role of primary care to lower overall health care expenditures - will likely be forthcoming from both state and national initiatives.
The UC Health System is deeply committed to ensuring the best possible health care for all Californians and is grateful for the efforts of policy-makers - the Schwarzenegger Administration and Legislature in particular - to improve health care delivery, expand insurance coverage and lower costs. While the underlying tenets of ABX 1 1 and some of the national proposals hold enormous promise to address these issues, it is essential that Californians really do get the health care they need, and not just an insurance card.
To that end, California's ability to improve health care under any of the health reform proposals depends on the fiscal soundness of our health care infrastructure, including the UC clinical enterprise.
The UC clinical enterprise provides an essential structure for much of the research and teaching that underpins the quality of, and the ability to provide, health care throughout the state. As the fifth largest health care delivery system in the state, UC serves a large fraction of California's population, including our most severely ill and medically vulnerable residents. UC also plays critical roles in serving low-income Californians. Today over 40 percent of UC’s total patient population is either covered by Medi-Cal or is uninsured.
Over the last months, UC faculty and representatives from the Office of the President have provided advice to various policy-makers working on health care reform to help ensure that proposals under consideration in Sacramento provide adequate funding for the unique and essential services that UC's academic medical centers perform for Californians. These services include patient care not often available elsewhere, such as trauma, burn and cancer centers, high-risk obstetric programs, neonatal intensive care units, cardiac care and organ transplant centers. UC inpatients have illnesses that are 63 percent more complex then the national average and are commensurately more expensive to provide.
As various stakeholders work on individual aspects of reform, it is imperative that we keep in mind the total financing picture. We must ensure that critical institutions such as the UC clinical enterprise maintain financial sustainability and the vital services that so effectively meet the health care needs of their communities.
Recognizing the inextricable link between reform and the financial viability of our hospitals and clinics will ensure that UC maintains the regional clinical services that support its education and research role.