California Health Care Bill Exposes Myths of Available Funds, Safety Net, Says Dr. Garson of UVAHS.

CHARLOTTESVILLE, Va. -- California's senate-pending health care bill that aims to provide universal coverage for millions of uninsured residents raises the truth about the actual lack of funding in the system--and the myth of a public safety net. With health care plans a top issue in early primaries, public health officials in California who provide most of millions of uninsured residents are increasingly concerned that the proposed system could leave big financial holes in the state's safety net.

"The fears about a lack of actual funding in California reflect one of the biggest myths on the uninsured crisis--that no additional funding is needed cover the uninsured, and that money is available in the system," said Arthur (Tim) Garson, Jr., M.D., M.P.H., former Dean of the University of Virginia School of Medicine and now university Provost, and co-author of "Health Care Half Truths: Too Many Myths, Not Enough Reality."

In an op-ed published in last Sunday's online edition of the Cedar Rapids, Iowa Gazette titled "How to Judge the Candidates on Health Care," Garson said that many plans, including those of current presidential candidates suggest unrealistic savings to pay for the uninsured.

"On a national level, the reality is that covering the uninsured would cost the United States about $90 billion a year above the current expense, even allowing for current cross-subsidies and payments," he said. "The money is in the system, but it is not available."

Garson said that prevention is essential, but doesn't necessarily save money. Modern information technology may save money for doctors, hospitals patients and insurers, but the government won't necessarily see those savings. He said that the cost of covering the uninsured, by most estimates, is between $80-$120 billion per year - this is new money that must be identified.

For universal coverage to work, said Garson--whether in California or at the national level--it has to be in effect by a certain date. "If we don't have a date, there is no accountability," he said.

He further defines "universal coverage" on the federal level, meaning that everyone is covered and every individual is required to be in the system. Garson says it does not mean that we need to adopt the approach taken by any particular country, such as Canada or England.

"There may be disagreement about how we should pay for universal coverage, but few would argue that anybody should be left out," he said. "Whatever the system--and it should be a distinctly American concept--coverage must be affordable, pay for a set of minimally acceptable services and be portable from job to job," he said.

Garson emphasized that learning from state programs such as California and Massachusetts is important, but eventually a single system must prevail.

"The California bill also exposes another, major myth that there is a federal safety net of government programs providing health care for the poor," said Garson. "The reality is that no matter how poor you are, if you're between 19 and 64 years old you're not covered for health care by federal statute unless you're pregnant, blind, disabled or have end-stage kidney disease," he said.

He said that any system must have a simple to understand, seamless, publicly funded safety net.