Much has been written about the new millennium and the promise it brings. In terms of health care, there is much to be encouraged about in San Diego County. We also have much to do.
An estimated 43 million Americans lack health insurance. Health care and insurance industry trade associations estimate the number of uninsured Americans could exceed 52 million people over the next decade, even if the economy remains strong.
In our own back yard, roughly 24 percent of San Diego County residents under age 65 have no health insurance. That’s about one in four individuals, and it is likely to be one of your friends, neighbors, family members, classmates or co-workers whom you see every day.
This rate is higher than all of California and the nation, putting the county on par with the uninsured in such states as Arizona, Texas and Louisiana.
Interestingly, most of the county’s uninsured adults work, but either are not offered health benefits by their employer or earn too much by federal, state or local standards to qualify for public benefits. An estimated 210,000 adults and children, for example, are eligible for public benefits, but are not enrolled, giving San Diego County one of the lowest Medi-Cal enrollment rates in California.
San Diego is a community rich in entrepreneurial spirit. The region’s economic base consists mostly of smaller businesses, such as restaurants, local “mom-and-pop” retailers and service stores, and many businesses in the tourist and service industries.
These small businesses bring diversity and energy to our region, but also produce larger numbers of working uninsured. It’s not for a lack of trying or caring on the part of these businesses. The financial burden of health coverage to these businesses’ employees often is cost-prohibitive.
In the end, we all pay the price for a large uninsured population. Those without a primary care physician turn to overcrowded emergency rooms for non-emergency treatment. Employees go to work sick because they don’t have coverage and cannot afford the time off. Children go to school without basic preventive and primary health care because their families cannot pay the additional burden of private health insurance coverage.
To better understand public perception and attitudes about health care issues in our region, the Alliance Healthcare Foundation commissioned an independent research firm to survey 1,000 San Diego County voters.
Voicing Concerns
Poll results reflected those of similar statewide and national polls. Clearly, voters are concerned about cost, availability and access to health care, and believe access to basic health care is a fundamental right. Most also support tax breaks for small businesses to encourage coverage.
While the challenges of increasing access to health care in San Diego County appear daunting, we can be encouraged by the way many diverse groups have come together over this issue in the past two years. The county Board of Supervisors, business and community leaders and grass-roots advocacy groups have pursued new, often innovative solutions for addressing the needs of the working uninsured.
For the first time in many years, the business community has rallied around the issue of the working uninsured. The San Diego Regional Chamber of Commerce has publicly recognized that a healthy work force is in the best interest of business and our community. The chamber’s board of directors declared health care is one of the organization’s priorities and is fully committed to working with the county’s health care providers to improve access to care for the working uninsured.
The Board of Supervisors took a true leadership role by committing all of its $30 million in tobacco settlement funds to health-related programs in 2000-01. With the promise of tobacco settlement funds for another 25 years, supervisors have actively pursued options to expand access to health care for its residents, worked to improve historically low reimbursement from the state and initiated significant outreach efforts to enroll uninsured children and families in public health programs.
Seeking Solutions
The supervisors brought together a diverse group of business, health and consumer representatives on the project management committee to oversee the county’s Improving Access to Healthcare project and use of the tobacco settlement funds. The project management committee developed practical and innovative solutions that will have far-reaching, ongoing benefits for workers, their families, employers and taxpayers.
Among the committee’s most innovative solutions is the creation of a business health access resource center to provide one-stop shopping and administrative services for small businesses seeking to insure low-income employees through available public programs and low-cost group insurance.
A number of legislators believe this approach to solving the problem of the uninsured facilitates a unique partnership between business, government and working individuals.
Assemblywoman Zettel will introduce legislation during this session to establish such a center for our region, and we are encouraging other state legislators from our region to join in this effort.
San Diegans for Health Coverage, a project of the Alliance Healthcare Foundation, is also educating and promoting the expansion of health coverage for the uninsured throughout San Diego County. This group of business, community and health care leaders seek to engage the community in solving a problem that affects our local economy, our health and our quality of life.
Outreach to small business owners and minority communities have been critical to their efforts. The group also is bringing together area legislators and policy makers to seek consensus on solutions that include local, state and federal funding opportunities.
As we begin the new millennium, we can celebrate the growing recognition that access to health care has become a fundamental issue of statewide and countywide importance.
Seeking To Make Change
These survey results reflect a citizenry that is compassionate and concerned about its neighbors, and the effect of this problem on our schools, workplaces and other institutions. We can make substantive changes in health policy that will improve access to health care for the working uninsured in the San Diego region, and continue to show much needed leadership.
In the words of Edmund Burke, “All that is necessary for the forces of evil to win in the world is for enough good (people) to do nothing.”
If you believe affordable health coverage should be accessible to everyone and a healthy community is important to our region, call, write or e-mail the Alliance Healthcare Foundation and your elected representatives to let them know.
Encourage the business community to find ways to improve access to health insurance for those who want it.
In San Diego County, we are a collective community, clearly committed to the unique quality of our lives, and the health of our community. We have a history of overcoming challenges, no matter how daunting. We have before us an opportunity to act collectively in this new millennium to protect and honor the basic human rights of our friends, our neighbors, our co-workers, our classmates, and ourselves.
Zettel represents the 75th District in the California state Assembly, and Riedel is president and CEO of Alliance Healthcare Foundation.