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Health Care Reform Initiative in California

Widespread dissatisfaction with the U.S. health care system has grown within the American population. Despite this, no consensus has been reached on the methods to be used in reforming it. According to Fuchs and Emanuel, Medicare, the means-tested insurance and the finance–employer–based insurance are all flawed (Fuchs & Emanuel, 2005). Health care is branded as one of the most expensive issues that it is faced by small business owners. This is affirmed by the fact that companies that have approximately 10 staff workers who are part of the 80% of employees of the U.S. population are shouldering the greatest burden arising from insurance premium increases (Wells Fargo Small Business round up, 2008)

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Health care reform initiatives

For a healthcare system to achieve financial sustainability, it should have incorporated certain goals in its design. These goals include affordability, access to quality health care, consumer choice, and predictability (Wells Fargo Small Business round up, 2008). These goals one way or the other are similar to the goals that the governor of California used in establishing the most comprehensive health care reform initiative in the United States (the State of California, Office of the Governor, 2009).

It is suggested that one out of six Californians are not insured, this translates to 6.5 million Californians that are not insured. The insured in turn pay a “hidden tax” in the name of higher premiums to subsidize the health care for those who cannot afford it. This in turn hurts the Californians who are already tired of the broken health care system (the State of California, Office of the Governor, 2009). As the health care costs are getting out of control, more and more people continue to lack insurance through their jobs. In addition to this, there is a decrease in employers that offer job based coverage (State of California, Office of the Governor, 2009, par 4)

According to the suggested California’s Governor’s health care initiative, the proposal will enhance a healthier California; reduce costs and lower hidden tax. In order to achieve these proposals every player must participate fully from the government, medical staff the individual people (State of California, Office of the Governor, 2009).

Implemented health care reform initiatives

  • Expand the use of Managed care: The aim of this initiative was to make enrollment in managed care mandatory in 13 additional counties of California. At the time, the Medi-Cal benefits through the Medicare were provided to 3.2 beneficiaries in 22 counties. This initiative was passed by the legislature in 2005, but it was not mandatory for the disabled and aged beneficiaries. A provision to impose a premium for specific beneficiaries and streamline eligibility process were rejected. The managed care improves quality and access and in addition to these, it controls cost (Health resources and human administration, 2006, p. 7&8).
  • Renew financing waiver for hospitals: In this initiative the state will continue to with the selective contracting with hospitals, a process that began in California in 1982.In the initiative California will stabilize funding for safety net hospitals and the same time try to preserve financing for those who cannot afford insurance. Safety Net Care Pool (SNCP) was established in order to fund health care services provided by public hospitals to the uninsured (Health resources and human administration, 2006, p 7).
  • Children’s Health initiative: In California, county coalitions have created insurance programs called Healthy kids that are used to cover uninsured kids who are not legible for public programs (Stevens, Rice and Cousineau, 2007). This insurance program has enrolled over 85,000 children in the various counties. The success of this program is attributed to high quality of leadership and stakeholders diverse coalitions (Stevens, Rice and Cousineau, 2007).

Conclusion

Over the past decade, United States has undergone major changes in its health care system. These changes are attributed to change in governance and specific initiatives undertaken at the various states level. California been one of the states in the U.S. has had its share of Health care reform initiative over the past decade. Captivating proposals have been suggested by the various sectors of the California states. Some of these Health care reform initiatives have been implemented and the results used as reference by other States in the U.S.

The main aim of these health care reform initiatives is to cut down the “hidden tax” lower the costs and make the health care services affordable to all. Some of these factors lie the hidden tax have resulted to reduction in number of employers offering job-based coverage. It has also been noted that some people are denied coverage due to their occupation e.g. fire fighters and migrant workers, despite been in a healthy condition. The uninsured on the other hand are compensated for by the high costs shouldered by the insured.

References

Fuchs, V. R. and Emanuel, E. J. (2005). Health Care reform: Why? What? When? Health Affairs, 24 (6), 1399. Web.

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Health resources and human administration. (2006). Medicaid Reform Initiatives and their Relationship to Health Centers. Web.

State of California, Office of the Governor. (2009). Health Care Reform Fact Sheet. Web.

Stevens, D. G., Rice, k. & Cousineau, R. M. (2007). Children’s Health Initiatives in California: The Experiences of Local Coalitions Pursuing Universal Coverage for Children. Web.

Wells Fargo Small Business Roundup. (2008). Reforming Health Care reform. Web.

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