Health System Solution Sought

California's health system is broken, say two state Assembly members who asked central San Joaquin Valley leaders for advice Thursday on ways to reduce costs and improve quality and availability of health care in the state.

"There are no simple solutions, or we would already have put them in place," said Assembly Member Keith S. Richman, R- Northridge.

But Richman and Assembly Member Joe Nation, D-San Rafael, said the information they received at a conference Thursday at Fresno State will help them craft nonpartisan health-care legislation.

The Fresno conference was the second of five being held statewide by the RAND Corp., a think tank, and The Communications Institute, a consortium of academic and research institutions and scholars. The conference drew about 150 health leaders from across the Valley.

Nation said the Valley's high unemployment rate, agricultural-based economy and large, diverse population pose challenges for health-care reform. "I think we need to be more attuned to those issues when we think about a health-care system for California," he said.

Conference participants said legislation needs to include higher reimbursements to doctors and other clinicians who accept Medi-Cal, the state-federal insurance program for the low-income. And they want a plan for providing universal coverage for those who have no insurance.

Allan G. Komarek, executive director at Delano Regional Medical Center, said his 156-bed hospital provided $2 million in charity care last year for those without health insurance.

"We need help," he said.

In Stanislaus County, 65% of patients seen in clinics operated by the Stanislaus Health Service rely on Medi-Cal, said Margaret Szczepaniak. But finding doctors willing to see them can be difficult, she said.

Richman said he agreed Medi-Cal rates need to be raised. But the problem will be finding money to pay for an increase. The state faces a $7 billion deficit, according to the state legislative analyst, he said.

Researchers from RAND outlined health-care problems, including double-digit increases in the costs of prescription drugs and health-insurance premiums.

California spends as much as many countries on health care, said Dr. Robert H. Brook, vice president and director of RAND Health and a professor of medicine and health services at the University of California at Los Angeles.

"We don't manufacture money," Brook said. "We have to pay for this, and the people who pay for this are workers."

Richman and Nation acknowledged getting a bipartisan health-care bill through the Legislature won't be easy. Many Republicans oppose increasing taxes and fees, and Democrats have balked at some spending cuts.

"But can we come up with something that's in the middle? Yes," Richman said.

Tim Curley, regional vice president of the Hospital Council of Northern and Central California, applauded the legislators' effort to get statewide input from health-care leaders.

Said Curley: "I think this is a good first step."

The reporter can be reached at banderson@fresnobee.com or (559) 441-6310