Working Together Towards a Healthier Community

San Diegans for Healthcare Coverage (SDHCC) and its subsidiary, the San Diego Business Healthcare Connection (BHC), were founded in 2001 with a mission of improving access to health care through the expansion of healthcare coverage.  SDHCC was formed out of the Improving Access to Healthcare (IAH) project, initiated by the County of San Diego to focus on a federal demonstration waiver to expand healthcare coverage in the region.  IAH efforts were stymied by State waivers and budget issues and the not-for-profit SDHCC was created to continue the collaborative and efforts begun through the IAH project.  The BHC was the initial project undertaken by the SDHCC.  Over the years, the BHC has successfully developed partnerships and relationships with significant sectors within the business community, providing outreach, education and assistance with health coverage.  The BHC has simultaneously worked to elevate health reform as a priority issue with its business partners. 

A series of business and labor roundtable forums were conducted from 2003 – 2005 and the results of these forums established the basis for the San Diego Healthcare Connection (SDHC) as a three-share pilot demonstration project to expand coverage through the workplace.  The SDHC was introduced as legislation but has been overtaken by comprehensive reform proposals by the Governor and Assembly.  While SDHC pilot legislation (SB51) remains in suspense, the governor remains wedded to statewide, comprehensive health reform.  SB51 was sponsored by SDHCC and the San Diego Regional Chamber and, through its collaborative and BHC relationships, demonstrated significant support of diverse constituencies through the region.

Ultimately, meaningful health reform and health coverage are essential to improving the health of our communities.  The San Diego and California uninsured rate is again growing (19.3%) and the issue of underinsurance -- the insured with high deductibles and copayments – is becoming more acute, especially for those of low to modest income.  Among both the uninsured and the insured, there are those at risk for, or with, chronic conditions that have gone undetected or untreated.  According to the UCLA Center on Health Policy, the most prevalent chronic conditions, heart disease, asthma, diabetes, and depression, are among the leading causes of death, the most costly, and often preventable.  In the United States, asthma and related allergies strike one out of every four individuals, fully one-third of all first graders are at risk for diabetes which affects 7% of our population today (1/3 of all cases remain undiagnosed), 29% of all deaths are caused by heart disease, and 19 million people are affected by depression every year.

There is a growing need to maintain awareness and education regarding issues surrounding the uninsured and under-insured, and the various proposals for health reform being developed nationally and in many states.  To meet this need, we must maintain and strengthen our local SDHCC coalition and mobilize members to encourage and help shape health reform and health coverage expansion. 

The Problems
The uninsured live sicker and die younger. An estimated 137,000 adults died between 2000-2006 because they lacked health insurance, including 22,000 in 2006. Compared with the insured, those without healthcare coverage are:

• Approximately 50% more likely to be admitted to a hospital for conditions which could have been avoided with regular access to medical care
• Significantly more likely to die when admitted to a hospital
• Significantly more likely to be diagnosed with more advanced stages of cancer.  Uninsured women who develop breast cancer have a 30-50% higher risk of dying than women with insurance.
• More likely to file bankruptcy due to medical bills.  Approximately 50% of California bankruptcies are due to medical costs.

• In 2007, there were 45.7 million uninsured individuals nationwide, and 511,000 uninsured in San Diego County.   
• The uninsured are increasingly older:  between 2001 and 2207, there was a 60% increase in the uninsured ages 40-64.   
• A greater percentage of the uninsured now earn more than 300% of the federal poverty level.  From 2001 – 2007, this category saw an increase of almost 50%.
• Most (70-80%) of the uninsured are in working families with at least one adult working full or part time; the number of workers with employment-based insurance has been declining, especially for those under 300% of the Federal Poverty Level

• In higher premiums as providers must charge more for to the privately insured to cover the costs of uncompensated care provided to the uninsured and under-insured;  the New America Foundation estimates that employers and individuals pay an average of 17% more in premiums due to this shift.
• In higher taxes to fund public coverage programs and for government subsidies to healthcare providers for uncompensated care; recent reports clearly indicate that when they become eligible for Medicare, the uninsured have significantly higher medical costs than those who were insured before enrollment.
• In fewer Emergency Departments and hospitals to serve the community due to closures brought about primarily due to uncompensated care
• In long wait times for Emergency Department services as the only medical care option available for many of the uninsured.
• In a less productive, less healthy workforce now and in the future