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HomeMy WebLinkAboutMINUTES - 10051993 - 2.3 r 2.3 THE BOARD OR SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Adopted this Order on October 5, 1993 by the following vote: AYES: Supervisors Powers, Bishop, McPeak and Torlakson NOES: None ABSENT: Supervisor Smith ABSTAIN: None SUBJECT: Relationship of the County's Health Plan to the Proposed National Health Plan and Analysis of the "Brady" (gun control) Bill. The Board received the oral report of the Health Services Director and his staff, including a slide presentation, with respect to the relationship of the County's Health Plan to the Proposed National Health Plan, and an oral analysis of the "Brady" (gun control) Bill. Supervisor McPeak complimented Milt Camhi on his explanation of the CCC Health Plan that he provided at the forum in San Pablo with Vice President Al Gore. Board members discussed with staff the impact of guns and violence on the health plan and health costs and determined to affirm support for the Brady Bill. IT IS BY THE BOARD ORDERED that the oral report of the Health Services Director is RECEIVED AND ACCEPTED. IT IS FURTHER ORDERED that the Board REAFFIRMS its support for the Brady Bill, and REQUESTS the Health Services Director to report further on the Brady Bill and Measure B. I hereby certify that this Is a true and correct COPY of an action taken and entered on the minutes of the Board of Supervisors n the date shown. ATTESTED: 9 y� PHIL BATCHELOR,Cierk of the Board of supervisors and County Administrator Oen+sty cc: County Administrator Health Services Director I I l SUNDAY SECTION ("* MAY 30, 1993 INSIDE V ...................... 13USINESSIo.�Jim Joigensen.�. ... Ia.Data bank 3 Stocks 4 c Coun takes _m__edi*ca1 nsk Contra Coslla F.A. ce fall ���'`�`�'� ' • insurance Seen as model - .�: .. . - , c Y+'�.:*':t~r•. .c i 3 for health ea care rg By JOYCE ROUTSCN Stan venter ARTINEZ — Talk r about your medical risk:How many health ' a' ►' insurers are wi31sng to cover low-income pregnant Women, AIDS patients, the t homeless—even bomb haulers at the Concord hbvat Weapons Station? r t. The Contra Costa Health Plan does —and crakes money at it. i For note than 20 years this county- a n. (..Y,,: a_ sponsored prepaid health insurance A •... 'fir: '. plan las been serving the people other healm insurers won't or can't afford to: the poor, the uninsured employed,the mediciallY indigent ent who make too � :.. much money to qualify for government - t• I assistance and the unhealthy.. in industry jargon, they are 11%nter- - abk populations,"and their precarious . fitancial situations can wreak havoc eoe UtiSonR mss With the typical health care provider's JAMES SiiARKE'!',67,of Richmond listens to Dr.Kimberly Duir at the Richmond Health Clinic. ►onom line. But for the last four years the Contra Costa Health Plan has i� }{. Members praise ! fumed a profit serving the underserved. Contra Costa Health Plan i I The pian, that is also open to any CC Health Plan co do good things in the county resident, last year netted #2.2 Not income Net revenues million on revenues of community,but 20 million. bIn thousands of dollars in millions of dollars but we do well financially,"said Executive $2.5m -- 530 hat do members and those fa- Director Milt Camhi. "We're really $2,200 miliar with the Contra Costa Studied unique bprepaid�healthaplans." 2,1X10 g18.3_=2--324.1 Health Plan think about it? ' - 25 •5 Brenda Hardeman,county employee y g 1,500 r 20 and single mother:"Why did I sign up? For that reason, the Contra Costa " 15 . In one word,money. It costs me#8 a plan is being looked to as a model by tAM =900 month for me and my two children, the state and federal governments that "r 10 -#7.8 whereas it would cost me#100 a month are wrestlingwith the problem of s �'t ! " ylt. at Kaiser.1 had to go a long time with-P sky- #460 r..� rocketing health care costs. 500'"--" �• „ ti''�, "#350- 5 - M1 � out any health insurance because I was t a tem before 1 of this 'ob.With two The President's Task Force on (i ,'� �, y � P g 1 Health Care Reform has been studying 0, 0 kids you -need insurance, but it's so how HMOs like Contra Costa's can de- 1989-'90 90.91 19V92 12-'93-, t995•'6s W-11 VV92 '92'93• hard to get." liver quality care with a tet monthly Fes?year Fiar:al year Lloyd Briley,former county employ premium rather than reimbursing doc- *Estimated ee, health plan member and advisory tors for every procedure — what is 8owca:corns C400 Hostm wan VAL HERNANDEZAHODES/Timeg board member: "I've been a member called managed care. It is one of a since 1984.1 can't speak highly enough handful of HMOs across the country be funneled into HMOs over the next Plan in the black by serving only low- about the medical capabilities. 1 had that have experience providing univer. two Years. The Contra Costa Health income members. Although Medi-Cal, major surgery a year ago and I was ex. sal care—coverage to all regardless of Plan has been covering Medi-Cal pa. Medicare and other persons whose pre- tremley pleased with my treatment at income or pre-existing conditions. tients since its inception in 1973;they miums are subsidized in part or in full Merrithew, The facilities aren't the "We are a prototype," said Camhi. account for 44 percent of the 22,348 by the state and federal governments, prettiest,but they didn't want for quali- Under Clinton health care reform,"The members. make up the bulk of membership,the ty health care." many HMOs who have chosen not to Says Molly Joel Coye,director of the plan stays profitable by charging full Howard Mitchell, retired physician take bad risks are not going to be able California Department of Health Ser. freight elsewhere. P Y ician to cherry pick. They'll have to reflect vices:"The Contra Costa Health Plan is The "commercial" membership — and former health officer with Placer the community like we do." going to have the best chances of sur- individuals and businesses that com- County; advisory board member: "It's Adds Bill Hembree,a Walnut Creek vival in the future when we come to na. prises 28 percent of the total—is"our an extremely well-run program. By health benefits consultant:"In terms of tional health care reform because it al• cash cow," according to Camhi. The spreading the risks and with careful health reform,the Contra Costa Health ready incorporates the principles of plan also includes a substantial number management and cost controls they're Plan is really kind of leader in terms of primary care and service." of county employees, who pay a re- able to deliver a less-costly product. It how we go about bringing together duced rate. returns more money to the county cof- SO/tb pay in fers.I've met some of the providers and large,different groups of people." Sine outside when it opened the mem- they are very dedicated. They could The state of California has named Lest outsiders think Camhi is a coir- bershi outside of Medi-Cal, the coin- make much more money elsewhere." Contra Costa County one of 13 pilot acre worker, he is quick to say he counties where Medi-Cal recipients will doesn't keep the Contra Costa Health Please see HEALTH.Page 7C Please see PLAN.Pape 7C ra, _nwl OR 30. 1-01 r- C J-1 0 0. F.- Fro -0 M M 0 piaq 0 a- M > "o 07 "0 CD S- rj 5 M R. wcc O:j &n r'.;(A n CL 7-,— Ms3 s ow on -4 (0- �imm M r_E: a= -In g go 13 --i -rho = eoq F 0 ;'r 64 60% rL N; 0 C M W M aq im 7 -4 r--n A CL—_-7 M 0. 00 Z.,m w ty tA L7 o %eM= M, m Ix c WX rm, 1.7 MO- 0 =r M ro g _.x > -8 Wim"-1 r .— m ro M -=Om M C. K M OJT cc,— C . 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AFTERWORDS work welfare mother with five kids and an out-of- rk husband with a bad back doesn't know a primary- care physician. But she praises her little girl's pedia- trician. A young father-to-be, a limo driver without health care benefits, doesn't talk of managed care. But he doesn't know how his family could manage to get 'Model' through this pregnancy without the county hospital. Model health care The center staff, which sees about 200 people a day, doesn't think health care reform would change much at is already in' plaLrriew.e Me county hospital already runs on the soon-to-be- trendy primary care model,where patients are assigned Examining the nation's health care system is about one doctor to care for all their needs. as appealing as the stomach flu. The doctor who sees the pregnant woman could be The epidemic of inadequacy that plagues our i the same one who treats her cold symptoms and serves current system has been festering for years. It took a her baby and husband, and elderly parents as well. The middle-class recession to make us really care about family doctor decides if a patient needs to see a spe- changing it. Downsizing and bottom-line thinking have cialist. produced a record 37 million Americans without insur- This is how Merrithew runs the county's own em ance to pay for doctors, hospitals and medicine. Anoth- ployee health plan, a financially successful HMO open er 22 million Americans are underinsured. P to all county residents and businesses.About 44 percent The Task Force on National Health Care Reform, of the county plan members are state-supported Medi- headed by Hillary Rodham Clinton, has been working Cal patients. on a new and improved system. The final plan, which Dedicated staff was expected to be unveiled this month, has been put on hold while the president and Congress deal Saddled with an aging campus of leaking buildings, with the national budget. shrinking public funding and a patient population from We may not see the conclusions for several months. the poorest neighborhoods and the county jail, the But pieces of the new health care puzzle keep popping county hospital has learned to make ends meet. At the up in the news. The previews, so far, have infected same time,this public institution has coupled cost-effec- many with bouts of premature skepticism and fear. tiveness with heavy doses of caring from a dedicated, Managing care almost zealous, staff of doctors, nurses and administra- tors.Their definition of preventative care includes mak- For starters, providing health care to the uninsured ing sure an elderly patient who lives in his car gets and underinsured will cost $30 billion to $100 billion a clean clothes and a shower when he comes for an ap- year. We don't know exactly how that will be raised. pointment. People who are hungry get fed, sometimes A national sales tax? Not likely. Sin taxes on booze with money out of a doctor's own pocket. and tobacco? Still possible. New payroll deductions of 2 Once the Clinton administration releases the task to 3 percent for workers, with a 7 percent employer- force findings, the promised health care overhaul will paid tax? A bitter pill to swallow. likely go through many incarnations.The biggest obsta- Aside from the wicked question of who should pay cles to reform are clearly the attitudes of doctors and how much, the reform debate has conjured up images patients and the willingness of government to mandate of a whole new breed of health care. change of the ailing system. Most likely the new system will rely on some version . Transfusing a little bit of the county hospital's know- of managed care, an HMO-arrangement in which con- how and attitude into the nation's $900 billion a year sumers pay a set monthly fee but are restricted to a cer- health care industry could be part of the cure. tain group of doctors and hospitals. Primary-care physicians— reincarnations of the old Donna Hemmila's Afterwords appears every other Tues- family doctor—will replace expensive specialists as the day to take another look at the people, places and is- doc-of-first-resort to cure what ails us. Preventative sues in the news. If you have a suggestion on where we medicine will play a new important cost-saving role. should focus, write Afterwords, P.O. Box 5088, Walnut Oddly enough, these innovative, miracle-working ( Creek 94596 or fax your ideas to 5101933-0239. concepts have been in practice for years at Merrithew Memorial Hospital, the ramshackle county hospital in Martinez. Garamendi touts managed Richmond forum addressesconcernshealth plans - By DONNA WASICZKO John employers, but it is still linked to Staff writer Ga�m�mm�N employment, with jobs will be able to afford it." RICHMOND -- West County The state Washington was one of many folks disgusted with the health care insurance who expressed concerns about system greeted California Insurance commissioner w6anc the bomneieys, the mentally Commissioner John Gurumendi en' proposed a 8{. the disabled and undocumented xhusiustico||y Tueoduy, but some health plan that immigrants fit into Gwrumeodi's said even his reforms might not go may become o plan. far enough tnhelp them. model for the Those who are not covered by About 50 people -- many of nation the plan will fall into a "safety net." them senior citizens -- attended u Gurmmendi assured them, but pro- community forum led by Gdi commissioner. 8eproposed the Cal- vided little elaboration. at the Richmond City Cuund|chan' ifonniu health plan that will likely Under the new proposal,all legal bemTuesday night. The^/o,kmhall" serve as a oudonm| model. At the citizens of the country would bec|i' type meuinA, similar to those held heart of the questions was the fear gibic for coverare undercnm pf- �' � Prc,kkoi Clinton, asn�no. was designed that some p� be left out of the fective, managed care health plan. to uUm, infvnnm| give-and-take be health care program that is The plan woulddnaway with costly r*'een the policy-makers and the posed toprovide treatment for all. duplications of insurance coverage. general public. ''l think, if this goes into effect, like worker's compensation and After Oarumendi's lnihu| o'er- there's going to be people thrown auto injury coverage. view and co/'````rnmfrom apanel of out of the system just like they are The federal government would local heu|th, u/':./'ymcnt andcom' oow." said Belinda VVashington, define e guaranteed benefits puck' � mu i experts, wily a handful of who advocates for Medicare po' � p*. -,|e had ti,^ � ��eshon the beo�- "This �|ao is not linked mn p|ap` �& eseeARA&8END|. bmcxpage _ r v � � mpumeUe04i}/ La�hi executive Six 25 m ofCal- Ga �' � �.����x����&������ ' —' - percent, ������ �����������K rector o� the b�hh plan. "In the ifomians do not have medical cover- past, I've described your organiza- and employers who do provide FROM PAGE .A tion asa model for things that niU benefits are spending about 15to28 bmdone across the nation." percent of their personnel budge age that is standard for all. and u Carol Kiecker,vice presidentund on /hero. Gurumeodi said. But the federal health board would muni/or regional administration for the Kai' new plan would cost participants quality of oenices. ser Foundution, said her company just about 7.5 percent nytheir pay. Participants could choose their learned years ago that managed ''That'omoney that m/oya in our own plan and would have aye^dT cun: makes good health and fiscal pockem.^ besaid. "We can gnand option /o change to another. Cover' sense. buy a new American-made car." age would not he obtained through "The more wckeep the patients employers but would bcaccessible weU. the beneroff wcare§nunciu|' di,eo|y by iodiddua/s through the }y,'' KJecbmr said. government, which would contract Guramendi began the forum with private health cure facilities. Tuesday bj di mem- The commissioner credited Kai- beo to give one or two word de- ser Permanente and the Contra Cos- eserPcrmanen,eandtheContra [ns' noiptions of their major concerns. mCounty health plan with recogniz' They responded with u laundry hst, mg the drawbacks offee'fopoendce cjdng--urnnngc$her ills - lack of health care and becoming pioneers access, exclusion from coverage of in ,he field of managed cure. those with pre-existing conditions, "Thr Contra Costa Health Plan escalating cn*s, pour quohry con- ha,; been way out in front on'ha" bprnv,o?nu/ inhnnt ...for the um|, unfair billing and inadequate Iasi n`o decmdes." n»'p="''.4' --'^ provisions for long-term care. oti m y3 Sd � � G �$ �� c'S �'O .'p $ 0 i0 R� m � om� e3:;;�� m aGcp ` e�� � saCO cogar Eun Tj ECgU v a o:D m� - S •�� m.G ffi� mcg "cc ' e= .°�O a a o °U °Zfi O 3�..r� Tu) E •� mN� ype Gd� 2 $ „ Cr.S3� m'T' �mGY �m.S'.SGo ? v.S' � � GYU >+ 3 `0' $ mo �� '=D �.aQg ,E,3 � 3 AUS` � 5 ai � � m m 3,$ u m qp $s• ems' U o m m a $ eog ? ° ° ❑ g �`o S '4 �� a' �� o r� r�-swU�U �� m� � go' � m3�,g".�$+.per bE a � m ���4 s E �]j e T 8 ;•� M m ,E c G� �� °°;8:3 '�$ � �'d 3 E d�•ti m o�c 9 � �';'"g aCi .y.s m �+ aQi a O •Sb c v m Q + m E: 3 v $ m o m m m S m �, Y a m m •- 6 c� Emu �s ?3 ,o ap n m qmF� U 8.S 'm0�. _ s� Ia �'� > E m•°� ami $3 .S$ m.° �'G '°-. �, 7GU�•S, 'u = 3:s. .. 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She said such an the Clinton plan for health insur- incentive could slash the cost of ance should include discounts for medical care because about half of workers and employers who follow expenditures are related to smok- or promote healthy lifestyles. ing, drug abuse,:YNproper diet and McPeak plans to ask fellow su- lack of exercise. pervisors Tuesday to adopt a recom- Richard HarrisoA, director of mendation to Clinton and Congress provider affairs for the Contra Costa for a "wellness incentive"to reduce .Health Plan, said the county-run in- health-plan rates for workers who Durance program offers lower rates exercise, eat right and don't smoke. to employees and other worker The rate break also would be ex- groups whose overall percentage of tended to employers who provide sdwkers is lower than average. SOME HIGHLIGHTS OF THE PRESIDENT'S SPEECH • "Despite the dedication of literally millions of talented healthcare professionals, our healthcare system is too uncertain and too expensive, too bureaucratic and too wasteful. It has too much fraud and too much greed. At long last, after decades of false starts, we must make this our most urgent priority, giving every American health security - healthcare that can never be taken away, healthcare that is always there." • "For the first time in this century, leaders of both political parties have joined together around the principle of providing universal, comprehensive healthcare. It is a magic moment, and we must seize it." • "So let us agree on this: Whatever else we disagree on, before this Congress finishes its work next year, you will pass, and I will sign, legislation to guarantee this (healthcare) security to every citizen of this country."