How SB921 (Kuehl) Reforms California's Health Care
FACT SHEET (PDF Doc)
FAQs: Frequently Asked Questions on SB921

How SB921 (Kuehl) Reforms California's Health Care
- printable version -

• State of California establishes benefit-rich health insurance plan to cover all residents.
• There are now 10,000-20,000 public and private health insurance plans in California. It's expensive to administer them. 25% to 40% of every dollar spent on healthcare goes to administration, which means there is less money for healthcare. In other countries 5%-10% goes to administration and 90%-95% goes to healthcare.

• All money to be spent on healthcare goes into a single state healthcare fund.
• All payments for healthcare are made from the state health fund through a centralized electronic claims and payment system.
• All Californians are in single health plan, spreading insurance risk across entire population.
• Consolidation of administration, finance, and risk saves California $14 billion in the first year. Savings go to healthcare services, provider reimbursement, research, investment and new technology.

• State becomes exclusive purchaser of pharmaceuticals and durable medical equipment and uses consolidated purchasing power to win price discounts of 40%-50%. Discounted prices available to all.
• $4 billion saved the first year, allowing all Californians to have a drug and durable medical equipment benefit without a co-payment or deductible.
• Revenue-neutral for the pharmaceutical industry. Under universal health insurance coverage market for drugs is expanded to 11 million Californians who now have no drug coverage. Sales to more people offset lower prices.
• California goes from "low volume/high price" policy to "high volume/low price policy." A "Win/Win" for all.

• All residents have a primary healthcare provider of their choice.
• Saves over $3 billion in unnecessary emergency room visits and preventable hospitalizations.
• Preventive care improves the health of the population.

• System wide health planning allows us to assess which new facilities and equipment are needed and to build and buy only what we need, instead of wasting billions on things that aren't used.

• Elected Commissioner of Health and appointed Chief Medical Officer, Consumer Advocate, Public Policy Board and Medical Expert Board develop statewide healthcare spending plan, including cost controls.
• Budget growth linked to population and demographic changes, new technology and other factors.
• Budget includes medical care for employees who are injured or become ill on the job, lowering the cost of Worker's Compensation for employers.

• Coordinated planning for health needs of the population.
• Integrated healthcare databases and research on development of electronic medical records.
• Needed improvements in quality of care addressed on a statewide basis.
• Public input into health policy.
• Transparent planning process, open to the public.

A. Our current system wastes between 20 and 30% of every health care dollar on administrative costs. Single payer systems around the world use only 3-5% of total health care dollars on administration. By creating a single insurance plan administered by a single entity, and by putting all health care dollars into one fund and making all payments out of that fund, calculations show that California saves about $14 billion per year -money that would be better used to provide direct health care. Additionally, the system uses California's purchasing power to negotiate substantial price discounts for pharmaceuticals and medical equipment. This increased efficiency allows us to provide a comprehensive benefits package to all California residents without increasing health care spending.

A. More than 6 million Californians lacked health insurance at some time in 200 I. That number has grown and it will continue to grow because insurance is becoming increasingly unaffordable and unemployment is rising.

A. 70% of Californians without health insurance are employed. Only 6% of the uninsured are immigrants.

A. We can't afford NOT to do this. Our plan protects our healthcare system against the ups and downs of our overall economy. SB921 (Kuehl) does not involve any new spending and controls the growth ofhealth care spending. Approximately 50% ofhealth care is already paid for by taxes and that money would come into the California Health Care System under SB921 (Kuehl). New taxes needed to fund the system would replace health insurance premiums, co-payments and deductibles. Reforms that seek to tinker with or slightly expand the present fractured system maintain our current expensive inefficiencies and would require that we spend more money to cover some additional people. That is what we cannot afford at a time of budget deficits.

A. All health care systems now ration care and consider it to be sensible health care planning. The question is: On what basis is care rationed and who makes the decisions? Today, insurance and pharmaceutical companies and HMOs ration care and medications to those who can afford them. Under SB921 (Kuehl) care will be affordable for every Californian, health system planning will be done by a public, representative Health Policy Board and care will only be "rationed" based on medical need as determined by your doctor.

A. No. A California single payer system will put medical decision making back in the hands of medical professionals and their patients, unlike today when doctors have to get permission to order a test or a treatment from an insurance administrator with little or no medical training. The bill creates a Medical Practice Standards Board made up of medical professionals and patients that will establish standards of care and an evidence-basedformulary. And isn't it interesting that in a country where people are so suspicious of government that some of our most popular health programs are government programs, like Medicare, Veteran's Health Programs and school nurse programs. What makes a government program unpopular is inadequate funding, complex eligibility rules, means testing, periodic eligibility lapses, poor provider participation, low provider reimbursement and the stigma ofbeing "on welfare". A California single payer system will not have these problems.