Emergency rooms bring equality to health care: equality of the queue.
Although originally established to treat trauma victims, emergency rooms today are increasingly becoming the health provider of last resort for the poor and uninsured.
Regardless of their ability to pay, patients are given a medical exam and are treated based on the severity of their medical condition.
In this mode, emergency rooms have indeed established an "equality of the queue" for those in need—and the needy. But it's not the kind of equality politicians speak of when they talk about creating a new health care policy for Californians.
"Sure, there's equality in the health care system," says Senator George Runner (R-Antelope Valley). "We're all equal in the bad access we have."
Runner and others believe reliance on emergency rooms as clinics for treating the uninsured is causing a breakdown in the health care system and costing the insured millions of dollars each year.
State senators and assembly members are clamoring to introduce health care reform bills for review this year. Some call for single-payer, universal health care, others seek to insure all Californians.
They may not agree on what the best solution is, but Democrats and Republicans agree a
sound policy should be patient-centered and should increase people's ability to get timely, affordable care.
A solution seemed within reach last year, when SB 840, a universal health care plan, cleared the state legislature. But Governor Arnold Schwarzenegger, who introduced his own plan earlier this year, vetoed it.
As chairwoman of the State Senate Health Committee, Sen. Sheila Kuehl (D-Los Angeles) plans to re-introduce SB 840 this year. The bill seeks to insure the 6.5 million uninsured Californians by creating a state-run insurance plan, which would reduce administrative costs and put health care options back where she says they belong—in the hands of patients and physicians.
But the health care debate in California may only end when the question of who pays is answered, says Assemblyman Alan Nakanishi (R-Lodi). In the current system health care costs are spread among taxpayers, businesses and insured citizens. Bills already proposed this year seek to either raise taxes or to move funds from other programs to pay for health care.
Nakanishi says he is struggling to find a solution with which he agrees. He worries requiring businesses to pay more for health care will make it difficult to keep companies in California. Meanwhile, he knows many Californians are already paying as much as they can, so additional taxes or increased premiums could result in additional uninsured residents.
Nakanishi says he thinks there are good proposals available, but each should be studied more closely. "We know we have a problem here," he says, "But how to fix it, we don't know right now."