Gary Passama

Gary Passama retired as president and CEO of NorthBay Healthcare on March 31, 2017. An active blogger since 2010, here’s a collection of his work.

Highway 12 of Health Insurance

March 21, 2017

California prides itself on being the vanguard of new thinking and progressive ways.  If you don’t believe me, just ask state politicians who tell us that all the time. 

That thought came to me recently as I traversed Highway 12, a key secondary route from the Bay Area to the Central Valley. Millions have been spent in recent years to improve this highway, which used to be one of the state’s “blood alleys” accounting for many highway deaths. I recall well one June evening when the parents of someone I knew were killed in a head-on collision on their way to a high school graduation in Fairfield.

Despite all the money spent on improving this road, recent heavy rains have made a mess of it. I recently dodged huge pot holes that seemed to grow before my very eyes. This can be typical of California’s government — amid progressive grand schemes lives the failure of getting the basics done right.

A new grand scheme is gaining currency among candidates for governor in next year’s election. They are beginning to engage in a bidding war to see who can devise the most impractical plan for a single-payer health care system in California.  This is a reaction – our leaders are world-class reactors – to the turmoil raging in Washington as attempts are being made to repeal, repair or replace Obamacare.

No one here in California seems willing to explore the failure of a recent similar scheme by elected leaders in Vermont. Economic realities there spurred an attempt at a single-payer system that crashed (or since it is Bernie’s state perhaps the crashed should be “berned”).

It would be nice if our state leaders would bring equal fervor to fixing our public pension system, which is deeply underwater due to other bidding wars they conducted in the past.

After studying the Republican proposal to repeal, repair or replace Obamacare, I find it far from ideal. But it has some potential.

As I soon exit my role as NorthBay Healthcare’s CEO, I don’t want to see anything done that would increase our bad debt. Fewer patients with insurance mean more non-paying patients and a rise in bad debt. As a private organization, NorthBay, unlike the state of California, must keep two feet firmly planted in real world economics.

I am intrigued by the proposed use of tax credits for employed people who seek health insurance from private companies. They would take the place of Obamacare subsidies. After all, that is in effect what people like me have now – health insurance provided by my employer. I am not taxed on the cost of the premium paid by NorthBay on my behalf. Why not do something similar for people who have to seek health insurance on their own?

The sometimes ferocious debate now going on in Washington is healthy. If there are no changes to Obamacare it will collapse within the next two to three years. Whether the process is called repeal or repair, there will be significant changes. 

The only question is whether the repairs will be permanent and lasting, or like Highway 12, temporary.



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