Los Angeles County this week announced that it was slashing by another third the already meager compensation provided to hospitals for emergency room care for the uninsured. Reimbursement will now cover less than one-fifth of the cost of providing urgent and life-saving care to these individuals, mostly childless men between the ages of 18 and 50.
The LA Times quotes Jim Lott, executive vice president of the Hospital Association of Southern California, who warns that, “some hospitals could be pushed over the edge by this.” He raises the crucial question of whether further cuts to reimbursements -- both in this case and through the larger Medi-Cal cuts that will be necessary to balance the state budget -- will cause hospital failures both in southern California and throughout the state.
According to one poll, a majority of the public, fed up with the lack of federal action, now claims to support either a new approach to reform that involves a number of smaller steps or no healthcare reform at all. What they may have understandably forgotten over the course of a very long year of policymaking, was the reason that we tackled this problem in the first place: changes to our healthcare system are not occurring in small steps but in huge blows. This is brought home in California through skyrocketing premiums on the individual market as well as by plummeting reimbursement rates.
The question is not whether there is going to be major change to our healthcare system but whether we will have a strategy to deal with it. The bills pending before Congress that may be merged before Obama’s healthcare summit next week represent one strategy. Though there are other comprehensive strategies such as the Wyden-Bennett bill, the chances are nil that they would be passed instead at any point in the near future. Therefore if we do not pass federal healthcare reform, instead of taking control of the changes to the system it appears that we are going to simply let them happen to us. And, presumably, hope for the best.
Predicting the future is a tricky thing. The sky may not fall if we don’t pass federal reform. But, particularly, if you live in California, I would recommend purchasing a very sturdy umbrella.
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