[courtesy of California Progress Report]

By Hanh Kim Quach
Health Care Policy Coordinator
Health Access California

The most exciting thing this week (other than Health Access' report release) was the release of the California Medical Association's annual "Knox-Keene Health Plan Expenditures Report,'' which replaces my old dog-eared copy from a couple years ago.

The report gathers data reported by health plans to the Department of Managed Health Care to show which ones spend the most on medical services for their enrollees (and which ones spend the most on administration and profit). This is called the "Medical Loss Ratio,'' you know, because plans ''lose'' money when they spend it on health care for you. The percentage of premium dollars spent on patient care is an important (though not the only) measure of a plan’s value.

[courtesy of California Progress Report]

By David Dayen
d-day

There's a confluence of high-profile lawsuits against the state today, on big topics with far-reaching consequences. First, the medical community is suing over Medi-Cal payments:

“Doctors, hospitals and health care providers filed a class-action lawsuit Monday seeking to block the state from cutting payments to them for treating the poor.

“The lawsuit argues that an upcoming 10 percent rate cut to Medi-Cal -- the state-run health insurance program serving 6.5 million low-income residents -- will exacerbate a shortage of doctors, dentists and pharmacists willing to treat poor patients because payments are so low.

"Medi-Cal already doesn't cover the cost of providing care," said Dr. Richard Frankenstein, president of the California Medical Association, which led the lawsuit. "If these cuts take effect, Medi-Cal patients will be forced to seek care in already overcrowded hospital emergency rooms, which undermines access to care for all Californians."

“The suit, filed in Los Angeles Superior Court on Monday, seeks an immediate injunction to block the reduction from taking effect July 1.”

by David Dayen [courtesy of Calitics - Front Page]

by David Dayen [courtesy of Calitics - Front Page]

[courtesy of California Progress Report]

* Insurers would face restrictions in cancelling coverage retroactively
* Patients would be better able to assess hospital cost and quality data
* Other bills on hospital community benefits and "boutique hospitals"

By Hanh Kim Quach
Health Care Policy Coordinator
Health Access California

The Assembly Health Committee on Tuesday approved a smattering of bills that would begin to set the foundation for health care reform, providing security to health consumers – both for their coverage and choice of provider.

Two of the bills deal with the insurer practice of retroactively canceling policies after patients become sick and need expensive treatments. These rescissions leave patients tens of thousands – if not hundreds of thousands in debt. Another bill would require medical providers to disclose cost and quality information in order to give purchasers more power in selecting the highest quality and most efficient care.

RESCISSIONS

[courtesy of California Progress Report]

CMA ignores evidence, experts, and physicians’ views

By Richard Ikeda, M.D.

When cure is no longer possible, the majority of Californians, and the majority of California physicians, want dying patients to have the right to make end of life choices in accord with their own values and beliefs. I am disappointed that my own professional organization, the California Medical Association (CMA), continues to oppose terminal patients’ end of life choices. As a physician caring for the poor and vulnerable elderly, I can tell you cancer and other terminal patients need better end of life care and choices. This week completed ten years’ experience with Oregon’s death with dignity law, and all studies show end of life care has improved for all Oregonians.

[courtesy of The California Majority Report]

Ned Wigglesworth, the quotable policy advocate for Common Cause, is moving to the California Medical Association as director of communications.
 
Wigglesworth made his mark in Sacramento when he was working for therestofus.org, which called Gov. Schwarzenegger on the carpet during the 2005 election for numerous campaign contribution conflicts. Lately he's been involved in the redistricting talks in the Capitol. Should be interesting to see his quotes when CMA is grilled about contributions to legislators involved in shaping health care policy!

Image courtesy Common Cause.