Californiaâ€™s largest health care system is a single-payer system (â€śMedi-Calâ€ť) that covers the stateâ€™s 13 million poorest residents, a population greater than all but four states. Service is terrible. Despite spending of $100 billion per year, appointments are hard to get, emergency room visits are up, thereâ€™s little indication of greater healthiness, and thereâ€™s even evidence than uninsured patients do better than Medi-Cal insured patients in some cases. Yet the California Legislature has not seriously tried to fix it.
Indeed, in a twist worthy of George Orwell, a Select Committee in the legislature recently proposed reforms to other parts of the health care system but, with a single exception, not to Medi-Cal! Meanwhile, excessive Medi-Cal spending is also crowding out funding for the needy, courts, parks, the University of California and California State University.
Itâ€™s not as is there arenâ€™t plenty of reforms for the legislature to consider and adopt. To boost customer convenience the legislature could change scope of practice laws and establish co-locations at fire stations and schools. To reduce visits to expensive hospitals the legislature could adopt a â€ścap-and-tradeâ€ť type approach that employs sticks-and-carrots to encourage customer treatment at lower cost locations. To reduce super-use of expensive hospitals and to improve lives for patients with chronic conditions the legislature could utilize less expensive social programs to reach cost-emergent users in advance.View Article