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By Jim Barber
With President Clinton now focusing on education, discussions of major health care reform issues may fall off the political agenda.
This lack of attention may create a false sense of security regarding access to health care services throughout the country and particularly in Los Angeles County, but don’t be fooled by appearances. The growing problem of the working uninsured is quietly undermining the resources of all health care providers in the region.
To attack this problem, a unique coalition called “4 the Health of L.A.” was formed a year ago to renew efforts for a grassroots agenda that advocates incremental health reform. The coalition comprises area executives from the business, entertainment and health care communities, as well as charitable organizations.
It came together during the county’s fiscal crisis last year, when closures threatened county hospitals and clinics that traditionally assisted the uninsured. Though the county system temporarily averted a meltdown, large numbers of people without health insurance remained.
In fact, the uninsured population continues to grow, and we’re starting to see the return of some basic ailments like measles, polio and tuberculosis.
In fact, tuberculosis is two-and-a-half times more common in L.A. than in other parts of the country. We’re also seeing increased uses of emergency rooms for routine primary care, because people don’t have access to a doctor anywhere else.
Currently, more than 2.6 million people in the Los Angeles area or 31 percent of the population are uninsured, which is more than any other metropolitan area in the country and well above the national average of 18 percent. The Hispanic population is hardest hit, with an uninsured rate of more than 46 percent.
Typically, those who fall into the uninsured category are working people and their dependents. The working uninsured are in a Catch-22 situation: They earn too much money to qualify for Medi-Cal, but can’t afford conventional insurance.
More than 80 percent of the uninsured are workers and their families, and nearly nine of 10 uninsured Hispanics in the state are part of a family in which the head of the household works. Usually, companies employing these workers either offer no insurance or offer coverage only for employees without covering their dependents, because the premiums for a full-benefit health plan are so expensive.
With so many people having no access to physicians for preventive care, and the fact that many are forced to wait until illnesses become serious before seeking care at a clinic or emergency room, the efficiency of the health care system decreases for us all.
An already difficult situation may be exacerbated by the recently enacted federal welfare reform legislation, which could mean the estimated 200,903 legal immigrants in L.A. County may lose their health care benefits.
I serve as chair of a 4 the Health of L.A. subcommittee exploring how the private sector might contribute to easing this problem. Our current efforts focus on development of new low-cost insurance products that would be more affordable for uninsured individuals, families and employers.
For this program to achieve a meaningful impact, the business community must become a big player by helping to subsidize employees and their dependents with this lower-cost insurance. The 4 the Health of L.A. insurance products aren’t available yet, but a positive signal from the business community indicating that we’re on the right track would expedite needed approvals from the state Department of Corporations.
The time for us to act is now. Business leaders are encouraged to join the efforts of 4 the Health of L.A., because without the business community’s commitment to solving the problem of the uninsured, the health status of the county’s entire population remains at risk.
Jim Barber is president and CEO of the Healthcare Association of Southern California.
