Our patients can’t wait to fix our health care system
If there’s a lesson we should learn from the COVID-19 pandemic, it’s that it’s long past time to stop delaying a fundamental fix to our disjoined, dysfunctional and discriminatory health care system.
Californians have the opportunity to take those critical steps this year following the introduction of AB 1400, the California Guaranteed Health Care for All Act (CalCare) by San Jose Assemblyman Ash Kalra, D-San Jose, with 20 co-authors and sponsored by the California Nurses Association.
The Bay Area, site of the nation’s first COVID-19 deaths, could be a poster child for why CalCare is needed.
The pandemic tragedy is a tale of avoidable deaths, uncontrolled community spread, a lack of preparedness, inadequate hospital capacity and provision of supplies, and uncoordinated, uneven availability and distribution of tests, contact tracing and vaccines. All made worse by the consequences of long-standing racial disparities in health care that have led to Black, Latino, Indigenous hospitalization rates at as much as four times the rate for whites nationally.
Santa Clara County has endured all of that, as a longtime hot spot for the virus. It has recorded the most COVID-19 deaths of any Bay Area county, including a huge disparity for Latinos who have nearly four times the rate of infections than white county residents, exacerbated by a high concentration in medically underserved neighborhoods.
CalCare would tackle the problems and disparities exposed by the pandemic, as well as the deeply rooted shortcomings of a health care system driven by profits and ability to pay rather than a rational network premised on patient need and humane care.
Under AB 1400, every California resident would be guaranteed coverage at any hospital, clinic, with any provider of their choice, without the barrier of ever-escalating premiums, deductibles, copays, extra charges for being out of insurance network or other out-of-pocket costs.
Some 2.7 million Californians remain uninsured. Millions more have skeletal coverage that prompts them to delay or skip necessary medications or health care services due to cost. Since the onset of the pandemic, that number has grown as many workers have lost their employerbased coverage or were unable to afford the high cost of care due to economic constraints.
Nationally, a Commonwealth Fund survey found over 43% of adults not yet eligible for Medicare were inadequately insured during the first half of 2020 as the pandemic was establishing its chokehold. There are now reports insurers in California will seek premium hikes of 20% to, in select cases, up to 48% this year.
CalCare would provide comprehensive coverage, including primary and preventive care, hospitalization and outpatient care, prescription drugs, maternity, mental health and longterm care, dental, vision and hearing and much more.
It directly targets disparities that plague communities of color and other rural and underserved communities, ensuring rural and safety net hospitals have the resources they need to stay open to combat the cuts and closures we have seen too often.
Much of the cost would come from what we currently spend on health care, augmented by massive savings on the waste and inefficiencies that characterize the private system.
As Kalra emphasizes, we are already paying for it and too often not getting the care so many need. Nurses know he is not the typical politician; he is demonstrating bold leadership for all of us.
Some say let’s wait until the time is right — it seems to never be right — to assure health care is a right. Nurses are not willing to abandon our patients to the ongoing pain and suffering we see every day. We are mobilizing to pass CalCare, and we are not going to stop.