George C. Halvorson: It's time to give health care to all

Minority families across California know what is truly at stake in the special legislative session on health care reform: They live with the consequences of our broken system every day.

African American parents know that their children are far more likely to have asthma, lack treatment and die from this chronic condition. Hispanic children know that more of their parents will get diabetes, miss out on treatment and die early.

Why are these sad realities true? The fact that the United States does not have universal health coverage for all Americans is a major reason for these disparities. For starters, 75 percent of the uninsured people of California are minority. Uninsured people are less likely to receive needed primary care and far more likely to suffer the dire consequences of untreated diseases.

There really are two Americas when it comes to health care -- the fully insured, primarily white America and the disproportionately uninsured minority America. More than half of the total uninsured people in this country are minority. That fact alone should make the need to cover everyone in America a pure ethical imperative. This issue is not about economics -- it is about equality. Universal coverage should be the next major civil rights issue for this country to face.

The uninsured of America do receive care. Emergency rooms take the place of primary care clinics for high percentages of uninsured people. Thirty-five percent of uninsured adults with a chronic condition went to an emergency room and were hospitalized for that condition -- more than double the percentage of insured people who needed that same care. Economists estimate that about 10 percent of the total premiums paid today by insured Californians are spent as a "hidden tax" to offset the needed uncompensated care costs of the uninsured.

That 10 percent should be very nearly enough money to cover everyone in California if the program to do that is both well designed and well implemented.

A key point to keep in mind when you think about total health care reform is that most health care costs in America result from only a very few chronic health care conditions. Highly visible "acute" care conditions -- cancer, for example -- are important areas of care delivery, but they are actually not the main cost drivers.

Chronic conditions, such as diabetes, congestive heart failure and asthma, drive 75 percent of our health care costs. That is particularly relevant to the issue of universal health coverage for minorities because all of the data show that our minority populations have highly disproportionate levels of diabetes, asthma and heart disease.

That gives us an excellent opportunity to improve care if everyone has coverage. Each of these very expensive chronic conditions requires and benefits hugely from early interventions and accessible primary care. Up to half of all hospital admissions for asthma could be eliminated with better primary care and patient education. Half of the kidney failures could be prevented.

Major answers to health care costs are sitting right in front of us. Universal coverage combined with basic data support tools to help caregivers keep track of each child with asthma could improve care and significantly reduce the cost of care.

It's time to do the right thing. It's time to give all Americans, regardless of race, ethnicity, or income level, health care coverage -- in ways that will both finance care and improve it. If we don't step up to that challenge now in California when we have a real chance to do it, shame on us all.

About the writer:

• George C. Halvorson is chairman and CEO of Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals.