California's 6.6 million uninsured residents could receive basic medical coverage if the state's total healthcare spending increased by $7.8 billion, according to a study released last week by Blue Shield of California, San Francisco.
The report was designed to put a price tag on the universal healthcare plan first proposed in December 2002 by Blue Shield Chairman and Chief Executive Officer Bruce Bodaken-now one of several proposals being debated at the state and federal levels as universal coverage has moved to the forefront of the political agenda (April 14, p. 26).
Bodaken's plan, hailed by many as a "middle ground" solution, would require all employers to provide an essential benefits package to their workers or pay into a pool that provides coverage. Outreach strategies would be developed to enroll every eligible resident in the state's public health programs. Residents who remain uninsured would have to buy private insurance, with the state subsidizing those who could not afford the full cost.
According to last week's analysis, the plan would cost the state government an additional $4.6 billion in expanded programs and family subsidies, and businesses and individuals would pay an extra $3.2 billion and $63 million, respectively. California spends about $125 billion on healthcare, the report said. When Blue Shield releases another report next month outlining which services should be covered, "the cost of the program may shift up or down by about 10%," said Kenneth Thorpe, an Emory University professor who conducted the analysis.
Bodaken said the report did not try to compute all the cost savings that better preventive care would be expected to provide. Still, current purchasers of private insurance would save a total of about $2.1 billion annually, the report estimated, because they would no longer be subsidizing care for those who aren't buying insurance.
While both the state's hospital and medical associations have backed the proposal, some employer groups said mandated coverage was financially onerous.