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California Health Care Reform Too Important to Diverse Communities to Waste Window of Opportunity

By Ninez Ponce, PhD
Associate Professor
Department of Health Services.
University of California Los Angeles

All Californians need the opportunity to achieve full health and live healthy lives. This is central to the vitality of our state, and to our ability to reach our full potential. We know our health care system is broken, and it is critical we take steps to fix it. Too many of California’s diverse communities have historically lacked health care coverage and have not been able to fully participate in the health care system. These inequalities and failures of our current system mean losses of time and money, and poor health. Fortunately, we have the solutions and can take the steps to begin to create a system that works for all of us.

This year, Governor Arnold Schwarzenegger and legislative leaders, including Assembly Speaker Fabian Núñez and Senate President Pro Tem Don Perata, have introduced proposals to increase the number of Californians covered by health insurance. These proposals join the reintroduction of Senator Sheila Kuehl’s proposal, Senate Bill 840, which would create a single-payer system that would provide health care coverage to all California residents, regardless of employment, immigration status, or income. With our state leaders prioritizing health care reform, we have a window of opportunity we cannot waste.

Health Care Reform Proposals Hold Promise for Diverse Communities: Getting California Ready analyzes the impact of these proposals on the uninsured in general and on communities of color in particular. By understanding the composition of the newly insured and their current regular source of care, we can better prepare our health care system to be responsive and accountable to meeting the needs of our multicultural state. The following is a summary of the key findings of the brief:

• All communities will experience an increase in coverage, and the insured population will begin to reflect California's diverse demographics.
• Communities of color will experience a significant increase in the number of insured, with an additional 2.4 – 3.1 million under the Núñez /Perata and Governor’s proposals respectively, and 3.4 million under Kuehl’s proposal.
• The number of insured people who are Limited English Proficient will increase by 28% under the Núñez/Perata proposal, 32% under the Governor’s proposal, and 38% under Kuehl’s proposal.
• The safety net will continue to be a source of care for many of the newly insured but private providers will also see communities of color increasingly utilize their practices.

These findings demonstrate that the health care reform proposals provide a positive step toward creating a stronger health care system. Addressing issues of coverage is just part of the equation as we seek to reform California’s health care system. We also need to make sure health coverage results in care that serves everyone and includes everyone, taking into account their cultural and linguistic backgrounds. The following recommendations by the Having Our Say coalition seek to provide viable solutions moving us closer to a healthier California.

1. Guarantee equal access for the people who do not speak English well. Adopt strong cultural and language access standards in the state purchasing pool and translate all information regarding eligibility, benefits, and services into multiple languages.

2. Health care reform must meet the needs of diverse communities. Establish mechanisms to identify and eliminate racial and ethnic health disparities and ensure communities of color have equal representation in the planning, development and oversight of the new program.

3. Health care must be equally accessible to all communities. Health care must be affordable and coverage must be comprehensive.

4. Adequately prepare public and private providers for the newly insured. Resources must be allocated for public hospitals and community clinics.

California’s future prosperity depends on the outcome of the current health care reform debate. We must seize this historic opportunity to create a health care system that works for everyone. This is the only way we can reach our full potential and achieve a healthy and prosperous California. The full brief can be found at www.cpehn.org.

Ninez Ponce (BS, UC Berkeley; MPP, Harvard University; PhD, UCLA) is an Associate Professor at UCLA's Department of Health Services. She is also Senior Research Scientist at the UCLA Center for Health Policy Research. Dr. Ponce's research focuses on understanding the intersection of race/ethnicity, immigration status, gender and SES to improve access to health insurance, and health care in the United States. Dr. Ponce serves on several state and national committees: the Cultural and Linguistics Work Group of California's Office of the Patient Advocate, the Policy Board of the California Pan Ethnic Health Network and the Executive Board of the National Health Law program.

Posted on August 28, 2007

Comments

The U.S. is not a socialist state (see http://tinyurl.com/2znnvl). No one is entitled to be given a house, car, food or health care, etc. If we want these things, we have to earn them. The government does not earn money. Perhaps some of us should take a civics class and learn about America. We all have to labor for what we want. For those who need help there are the charities and state programs. We need to fix the health care issue but we cannot fix it unless we know how it is broken. For the answer, please see http://www.InteliOrg.com/

Posted by: Dr Coles at August 28, 2007 09:12 AM

What makes you think people care about their health? There is more information available today then ever before on the dangers of obesity and yet an ever increasing percentage of people are obese. People have made the choice not to engage in good health practices.

The same applies to insurance, many of the people who are uninsured freely make that decision. Many people would rather have a big screen TV, a new car or an iPhone than pay a insurance premium.

Posted by: sean at August 28, 2007 09:54 AM

Puh-leeze Dr. Cole, not the 'socialist state' card again! Who cares what the U.S. is or isn't when I and millions of others pay too much for health care just to receive poor quality service?? Free market competition doesn't improve the quality of health care I and millions of Californians receive, instead it makes it worse! Reform for our health care system in California is necessary and of the 'lesser of the two evils' between what we have now and single payer, I'd rather put my money where everyone gets covered and no one gets left behind. To think that a free-market system has taken us to where we are today and believing that where we are at is so much better than the oh-so-scary 'socialistic' system is complete nonsense.

Posted by: Jed Cruz at August 28, 2007 09:57 AM

Ms. Ponce and Mr.s Nunez and Perata (who are all long on policy and politics, but short on medicine and science) put forward a shining vision of California's health care future that cares for all according to their needs ("...to each according to their needs; from each according to their abilities."), accessible to all, able to overcome all barriers of ethnicity and "diversity", with no one left behind.
The "single payer" will be the government of California, with their power to pick the pockets of workers and redistribute the wealth of its citizens to pay for the scheme; and of course the single payer will ration the health care among the diverse consumers as it sees fit. Sounds wonderful, in the abstract. It should be as successful as California's system of public education, which consumes more than half the state taxes and produces education all smart people avoid like the plague. (This should consume the other half easily.)
"Yo!! Citizens of the World! Free health care here. Just come in on any kind of visa, or creep across the border illegally. Bring all your diseases, your parasites, your vices, your near birth fetuses, your birth defects, and any bad residuals of your native lands -- they can't say, NO!"
But all of the above is no worse than the mess the HMOs have gotten us into. We workers pay them to deny us health care, and the bean-counting managers make the profits, based on how much health care they can deny or avoid paying for. In my area (Antelope Valley), one private and two public hospitals have closed since 1975, while the population quadrupled.
So there's the choice, so far: a government health system that will give it away free, run by Liberal Arts majors; or a corrupted private system run by MBAs, that has us paying the most in the World for about the fourteenth best care.
Stay healthy, All!

Posted by: vern at August 29, 2007 04:03 AM

fully how the minds of the educated work in CA. multilanguages for healthcare .. healthcare for all including illegal alleigns. who come across the border 38 wks pregnant and go to hospitals for free and have american born citizens with all rights! Bilingual/trilingual etc education in Ca. don't refuse anyone health care for sure illegals while I took care of an american citizen whose face had almost
rotted off because she could not afford health care. now we are cutting to the bone healthcare care workers to keep hospitals open no free ride the tax payers will foot the bill and I will be happy to leave this country in which I have always lived as it is NO LONGER america but a melting pot where everyone wants their rights but NO ONE wants to adhere to the laws of the land or take responsibility for their own selves. Illegals are savve about our system. Here are no waiting lines in Mexican ER's they are all here while our citizens who have given their life paying taxes suffer in silence. wake up Professors??? who financed your education anyway??? who pays for all the language translations are you thinking about finances or just apple pie in the sky???

Posted by: anna at August 31, 2007 10:22 PM

To Dr. Coles, I go to bed every night just praying that people like you get seriously hurt or sick, just so you will know what it's like to suffer, yes suffer. If you get seriously injured in this country, you are treated like trash, no one gives a shit about you. You will lose all the money you own, your house, cars, etc., you will lose friends who don't understand what you are going through, and you might lose your family, because you cannot support them anymore. Then to top it off, no insurance company will sell you health insurance, they will hang up on you, and if you're lucky to get any kind of insurance it will be so expensive you won't able to afford it. This is what you have to look forward too in this so called " Compassionate ", " civilized " country. This is what we have become, because of people like you! This isn't in any civics lesson, it's about greed, there are plenty of people like me, willing to pay a reasonable amount for health care, but if you have any kind of injury or condition, they (the Insurance Companies) will not sell you anything, because it is more important for them to make profit, instead of helping people. Maybe you are right, look for civics courses that pertain to the treatment of slaves!

Also concerning your comment about state programs, there are none, unless you are completely broke, no assets, and you can't make more than $900 a month. That is too much to qualify, even if you live in an expensive city. If you do ( make more than $900) you don't qualify for Medicare, and then you are shut out of the Health Insurance market. Charities, I would like for you to name me one, that will help you get health care, they are not out there, of course you would only know that if you were injured.

Posted by: Joe at September 2, 2007 03:22 AM

California needs basic health care for all of its citizens. It's up to the governor and the state legislature to find a way to accomplish this. The people of California are most urgently waiting.

Posted by: Mary Anne Cooper at September 11, 2007 12:14 AM

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