A symposium held at Western University of Health Sciences on Friday, Nov. 2, 2007 examined health care reforms, controlling skyrocketing costs and creating a safety net to warn of potential infectious diseases.
The symposium, the second organized by WesternU and Assemblyman Mervyn Dymally, D-Compton, focused on health care delivery. A symposium on Oct. 5 looked at health care financing.
Herb Schultz, senior health policy adviser for Gov. Arnold Schwarzenegger, gave an overview of the governor’s health care reform legislation. The Health Care Security and Cost Reduction Act, introduced in October, revises Schwarzenegger’s health care reform proposal announced in January 2007.
The core principles of the act include universal health coverage for all Californians, increasing affordability and guaranteed coverage. About 6.7 million Californians are uninsured, according to a recent U.S. Census Bureau report.
“The system is way out of control financially,” Schultz said. “If we are ever going to think about expanding coverage to the 6.7 million who are uninsured, we’re going to have to deal with cost containment and affordability.”
One of the biggest issues in getting support for the act is defining affordability and how much each stakeholder will pay, he said. But California is not far from making history and serving as the health care model for the rest of the country, Schultz said.
The state Legislature will consider the policy framework in the coming weeks, and the method of financing the proposal could potentially be placed on the November 2009 ballot, he said.
“We really are on the brink of history,” Schultz said.
Under the act, all Californians will be able to buy health insurance regardless of their medical history or age. The act would reduce the amount that low and moderate income individuals would pay for coverage in the state subsidized pool.
Universal health care is one of the keys to improving health care, according to Brad Gilbert, MD, executive officer of the Inland Empire Health Plan, who talked about “Solving the Cost vs. Quality Conundrum.”
National health care spending continues to increase at a faster pace than inflation, he said. The amount spent per person increased 77 percent between 1995 and 2005, from $3,783 to $7,498. U.S. health care spending far exceeds that of other developed countries, both in terms of per capita spending and percent of GDP.
But the rising costs are not reflected in the quality of care. In a 2006 Rand study, adults received half of the recommended acute, chronic or preventative care.
“Everyone was at risk for poor care,” Gilbert said.
But the system shouldn’t take all the blame. Obesity, heart disease, lung cancer and other leading causes of death are significantly impacted by personal behavior, he said. There must be changes in society, such as eliminating fast food, he said.
“I’m concerned we do a lot of it to ourselves,” Gilbert said. “It’s about helping people help themselves. We can’t solve everything in the health care system.”
WesternU Professor of Veterinary Medicine Tracey McNamara, DVM, Diplomate, ACVP, talked about continued gaps in bio-surveillance. She played a pivotal role in tracking and identifying West Nile virus in New York in 1999. Four hundred crows died from June to August 1999, but there was no system of communication between the various agencies that monitor potential health risks.
“As a veterinarian I had no way of knowing what was going on in the medical community,” McNamara said.
In the wake of West Nile virus, a nationwide network of zoos agreed to monitor West Nile virus, with information going into a central database.
WesternU veterinary medicine students could form a similar network, providing geographic coverage of Southern California, since fourth-year students are at 360 student rotation sites and growing, McNamara said.
“Our veterinary students spend a lot of time in the community,” she said. “They have access to urban biosentinels.”