Posted on 05/02/2004 9:13:12 AM PDT by NormsRevenge
SACRAMENTO (AP) - With state health care costs soaring, Gov. Arnold Schwarzenegger has proposed more than $1 billion in spending cuts next year for public health programs along with caps in enrollments, new copayments for patients and lower reimbursements for providers.
But he appears to have far fewer ideas for reining in the billions spent on employee benefits - the fastest growing part of the state's medical bill.
Medi-Cal, the state's version of the federal Medicaid program, would lose about $900 million in funding next year. About half that money would come from a $454 million cut in support for in-home caregivers, although the administration is seeking additional federal money to replace the lost state dollars.
But Schwarzenegger also wants to overhaul the cumbersome Medi-Cal system. He has called for simplifying the eligibility process to make it easier to manage. He said he wants to "promote personal responsibility" among patients when they are deciding whether to seek care by imposing higher co-payments and limiting the choices of those who can pay the least.
The governor has proposed a more restrictive system for managing care of the blind and disabled and he wants to cap enrollments in the state's Healthy Families program, a subsidized health insurance plan to cover children in low- and moderate-income families.
Some health care advocates say it's not fair for the governor to ask low-income patients to pay more.
"Asking people to share costs doesn't work when you're talking about high-end users like the disabled and the elderly," said Kristen Testa, director of the California Health Program, a nonprofit advocate supporting children health care. "Even a $15 copay is a lot, some of these people have five or more prescriptions each month. You're asking them: Which drugs can I afford?"
Nicole Evans, spokeswoman for the Health and Human Services Agency, said Schwarzenegger's Medi-Cal reform plan is still evolving as the administration aims to be more efficient in providing care.
Meanwhile, the governor has made little progress in redoing union contracts to save the state money.
Although the cost of providing medical care through Medi-Cal, Healthy Families and other programs represents by far the largest slice of state health services spending - it is not growing as fast as employee insurance premiums. Worker health care costs have more than doubled in the past five years, costing the state nearly $2 billion annually.
Lowering health care costs is a key administration goal in the labor negotiations, said Lynelle Jolley, spokeswoman for the state's Department of Personnel Administration. She declined to cite specifics in order to protect negotiation strategy.
J.J. Jelincic, president of the California State Employees Association - the state's largest union representing more than 90,000 workers - said there are no specific talks scheduled to consider health care costs for any of the units he represents.
He pointed out that until January, the state paid a fixed portion of the health care premium and workers were required to make up the difference. That arrangement, which began several years before, meant that worker contributions varied year to year.
In some years - especially during the early 1990s, health care costs dropped and thus many workers had to pay little or nothing toward the premium. When costs began to rise, however, beginning in 1998 - workers had to shoulder a greater share.
The latest contact shares the costs, with the state paying 80 percent and workers paying 20 percent of health care premiums. That's an improvement for workers, Jelincic said, because health care costs are expected to keep rising.
This is the raising of an exception to defend the continuation of totally free service. The facts are that many people getting public health assistance can afford to pay something. And when they are required to pay, they use the service more judiciously.
-Little Johnny or Susie has the sniffles. Should we take them to the doctor? Why not, it's free.
- Little Johnny or Susie has the sniffles. Should we take them to the doctor? Why don't we wait, they started charging a co-pay of $20.00 a visit. Let's give it a day and see if thier common cold gets better.
The government certainly has no right to cut YOUR salary if you work in the private sector, but it certainly has the right to determine the salary of State of California workers. Either lower pay or lay off the unneeded.
Painfull, yes, but not a mess. Imagine your own family budget. Imagine if you simply didn't spend your discressionary income? Would you be in a huge financial mess? Or is it when you spend that money and MORE that the mess really happens?
You make a valid point, but I hardly think the level of state employment is going to effect you unless you actually live in the capitol area. Where do you think all that money is going to go if not to state government employees? It will stay in the pocket of the taxpayers - you, your friends and your neighbors. They'll spend it in a much more rational way than the government.
Think about it. California has 36 million people. There are 222,000 state employees. It's a drop in the bucket.
You've reached the threshold that I reached in 2000. I was watching small businesses close all over because of the cost of electricity. My company parking lot went from overflowing into two satellite lots to half full at the main building location. I wanted to get out while there was a sufficient number of qualified buyers in the marketplace.
My home in Mira Mesa was purchased for $105,000 in 1983. I sold it for $242,000 in Feb 2001. The going price would be in excess of $400,000 now. The equity that I extracted in 2001 allowed me to buy at the bottom of a glutted market in the Pocatello, ID area. There were 560 homes on the market. I picked off a 3900 sq ft house on 1/3 acre for $179,900. Property taxes are higher here. If you gross over $100,000, the state income tax is $7249 + 7.8% of the amount over $100,000. After factoring in the effect of federal taxes, the tax burden is pretty low. The cost of goods is much lower than San Diego. While we have a very severe drought going here, we don't have 1 million illegals spilling over the borders each month. The water supply in the southwest is dependent on the Colorado river. That source is heavily oversubscribed. Our population is Pocatello can manage just fine on the groundwater from our local snow pack.
I wish you success in moving the San Diego property. My son is selling 5 or more houses each month. His fluency in Spanish has doubled the access to potential buyers. I frankly think the real estate bubble is going to pop in California. Any rise in interest rates is going to reduce the number of qualified buyers in the marketplace. Even if that doesn't depress prices, it may leave you sitting on real estate that nobody can afford to purchase.
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