Senate Health Committee Moves Single-Payer Bill and GAO Looks at Ways to Reduce, Divert ED Use

CAL/AAEM News Service calaaem.news.service1 at gmail.com
Thu May 19 16:32:56 PDT 2011



May 6, 2011
Senate Health Committee Moves Single-Payer Bill
CaliforniaHealthline
 
By David Gorn

Many dozens of single-payer supporters crammed the Senate Committee on Health chambers on Wednesday for hearing on a bill that would set up a single-payer health system in California.

The supporters were respectful and emphatic as they all stepped, one by one, up to the microphone to voice their support for such a model. After all of the advocates took their turn and returned to their seats, Senate Health Committee Chair Ed Hernandez (D-West Covina) wanted to know if there were any more speakers, so he politely asked if there was anyone else in the audience who was in favor of the bill.

And a sea of hands went up, as nearly everyone in the audience spontaneously and quietly raised their hands.

That has been the history of single-payer legislation in California, with enthusiastic, almost fervid, support of it by many citizens and organizations in the state, but a tepid, almost embarrassed, reception by many lawmakers.
Single-payer legislation passed the Legislature twice before, but then Gov. Arnold Schwarzenegger (R) vetoed both of the bills. Last year, it didn't fare as well, when it languished without a vote on the last day of legislative session, despite being on the floor agenda.

This year it's back as SB 810, by Sen. Mark Leno (D-San Francisco).
"This is a system that will provide California with the best health care in the nation," Leno said, adding, "It will lower premiums, thereby attracting employers. It will simplify paperwork, and that will attract providers."
The state Legislative Analyst's Office estimated that setting up a single-payer system could cost about $200 billion. "But that's the money we're already spending now," Leno said.

Dan Hodges of California Health Care for All said he's been advocating in Sacramento for single-payer health care system for about a decade now, and he has seen a big change occur in the Capitol on his watch.

"The basic argument for single payer has gone from how it might solve the health care problem in California to now being the way to solve the fiscal crisis in California," Hodges said. "That just shows how health costs have gone up so dramatically. So now [single payer] has the chance to solve two of the greatest crises in California -- the health care crisis and the whole financial crisis."

Opposition came, in part, from John Lovell of the California Association of Health Underwriters.

"However interesting this debate is, it is a diversion from making the Affordable Care Act work in this state," Lovell said. "We have to deal with on-the-ground realities of single payer."

That was the sentiment echoed by most of the opposition -- that California is in the middle of a vast health care reform undertaking right now.

Marti Fisher of the California Chamber of Commerce said, "We are opposed to a government-run health care system," adding, "The Legislature is already busy with this. We don't want to be derailed by implementing a new system."
DeAnn McEwen of the California Nurses Association pointed out that Medicare is a government-run health care program that many people seem happy to have. She added that a new single-payer health care system could mesh easily with health care reform tenets since they're so similar.

"Look," McEwen said, "It's not socialized medicine. It is civilized medicine."

The Senate Committee on Health voted 5-3 to pass SB 810 out of committee.


 
 
May 11, 2011
GAO looks at ways to reduce, divert ED use

Fierce Healthcare

By Janice Simmons

Three strategies--focusing on emergency department (ED) diversion, care coordination and accessibility of services--could help reduce ED use, according to a new Government Accountability Office (GAO) report.

GAO interviewed officials from nine health centers, and conducted group interviews with officials from multiple health centers operating in three states about their strategies. The findings were released today by GAO's director of healthcare, Debra Draper, at Senate subcommittee hearing on diverting nonurgent ED use.

Some health centers collaborated with hospitals to divert emergency department patients by educating them on the appropriate use of the ED--and the services offered at the health centers, the report said. Also, by improving care coordination for patients, health centers may help reduce ED visits by encouraging patients to first seek care at a health center and then reducing--if not preventing--disease-related emergencies from occurring.

Also, the health centers used various tactics to increase the accessibility of their services--such as offering evening and weekend hours and providing same-day or walk-in appointments. This helped position the health center as a "convenient and viable alternative" to the ED, GAO noted.

Health center officials told GAO that they experienced several challenges in implementing strategies that could help reduce ED use. For example, some officials indicated that various services--such as those provided by case managers who may help coordinate care--generally are not reimbursed by third-party payers.
 

 
 
Anna Parks &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service

 
 
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