In America’s fragmented health care system, too many individuals and families lack continuous access to health insurance. Overwhelming evidence shows that lacking health insurance leads to decreased access to quality care and reduces health status. The widely shared social and economic losses from these problems compound the cost of thousands of lives lost every year due to lack of health insurance and consequently access to care. In this context, health reform that ensures every individual and family seamless health insurance is more a matter of stewardship than of charity.
The goal of California health reform should be seamless, universal coverage, achieved by sharing responsibility among government, businesses, and taxpayers. This goal is achievable if we develop a system that encourages people to enroll by removing barriers and making insurance affordable. While all individuals must participate, seamless coverage should focus on ensuring that no individual or family is allowed to fall through the cracks, not just enforcement. Financial risk should be fairly shared by government, business, and households.
This paper develops operational principles and techniques to help California (and any system, by extension) create a culture of coverage where having health insurance is the norm and lacking insurance is the rare exception.
Both the full paper and an executive summary are available below in PDF format.