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Comprehensive health reform cannot be abandoned

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Comprehensive health care reform is still a vision rather than a reality in California. But the reality is closer than ever before.

Rather than focus on the defeat of health care reform legislation in the state Senate, the Hospital Association of San Diego and Imperial Counties is encouraged by the ongoing dialogue and the progress that was achieved.

Last fall, California's community hospitals became the first major stakeholder group to embrace Gov. Arnold Schwarzenegger's health reform proposal, despite the fact that it came with a new 4 percent fee on hospital revenues. Most of the funds generated by this new fee would have been matched by the federal government and used to increase Medi-Cal payments and expand health care coverage to the uninsured.

Gov. Schwarzenegger and legislative leaders should be commended for their ongoing, bipartisan commitment toward achieving comprehensive health care reform. Much ground has been gained and we must keep the momentum moving forward.

California's health care system is near a financial meltdown. More than 6.8 million Californians are uninsured, including 19 percent of all San Diego County residents. Another 6.5 million people enrolled in the Medi-Cal program are finding it difficult to obtain care from doctors and hospitals because of inadequate reimbursement.

Nowhere is this felt more keenly than by hospitals in San Diego and Imperial counties, which rank among the lowest in the state for Medi-Cal and Medicaid reimbursements. On average, our hospitals lose 40 percent of every dollar of care they provide to Medi-Cal patients. Ask yourself if your business could continue to operate with losses of 40 percent.

Now a threat by the Bush administration to cut Medicare funding over the next five years will make an impossible situation even worse. This proposal works out to a potential additional revenue cut of $347 million to hospitals in San Diego and Imperial counties, according to the California Hospital Association.

During the past 25 years, nine hospitals and one emergency department have closed in San Diego County. More than 70 California hospitals have closed in the last 10 years. Over two dozen hospitals have been forced to cut their ties to the Medi-Cal program since 2000 because they couldn't otherwise afford to stay open. Will hospitals now be forced to stop treating Medicare patients too?

When hospital emergency rooms are clogged with Medi-Cal patients who can't find doctors to care for them, it doesn't matter how good your insurance coverage is. You'll wait to receive emergency care. When a hospital is forced to close its doors because it cannot sustain the financial losses, hospitals are lost to the entire community.

Tremendous momentum toward fixing our broken health care system was made this past year. A coalition of employers, labor, insurance companies, consumer groups and health care providers led by community hospitals came together to support comprehensive health care reform.

Despite the recent setback, it's imperative that members of the community and elected officials continue working together to ensure that comprehensive health care reform is achieved. It's the right thing to do for all San Diegans.

Submitted by Arthur A. Gonzalez, chairman of the board for Hospital Association of San Diego and Imperial Counties, and president and CEO of Tri-City Medical Center.

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