Issue of uninsured daunts task force 

Effort aims to help as many as 60,000 to 80,000 adults with $66K annual earnings

SAN MATEO — Members of a task force charged with expanding health care coverage to all low-income adults in the county met for the first time Thursday, setting a July 2007 deadline to come up with a plan.

The task force will focus on creating a program that reaches the 60,000 to 80,000 adults in the county estimated to be uninsured and who earn less than four times the federal poverty level — $66,400 a year for a family of three — Srija Srinivasan of the county Health Department said.

"The problem isn’t going to go away. The question is, how are we going to pay for it," said Board of Supervisors President Jerry Hill, who co-chairs the task force with Supervisor Adrienne Tissier.

A solution could range from expanding the county’s low-income managed care program, which serves 7,500 members, to a complete overhaul of how patients receive treatment in the county, officials said.

With the average emergency room visit at publicly funded San Mateo Medical Center costing about $700, patients without insurance are paying two to five times the cost of seeing a family physician for non-emergency problems, according to an Institute of Medicine study released last June.

In fact, the problem is getting worse, with the county forced this year to increase its subsidy for indigent care costs to the county medical center to $68 million from $54 million a year prior, medical center spokesman Dave Hook said. The committee, dubbed the San Mateo County Blue Ribbon Task Force on Adult Health Care Coverage Expansion, is among the first in the nation to tackle skyrocketing health and indigent care costs at the county level in response to what some perceive as a federal and state failure to address the issue, officials said.

"I think the issue of health care is one of the top priorities for the county," Srinivasan said. "Our current choices aren’t working, for the public, for the employers or for hospitals."

Among the factors contributing to exorbitant increases in health care costs that the task force will have to deal with are doctor and nurse shortages, increased pharmaceutical demand due to direct television marketing and the rising prevalence of chronic diseases — such as diabetes, high cholesterol and heart disease — that are a result of the public’s more sedentary lifestyle, according to Enriquie Martinez-Vidal, deputy director at the Robert Wood Johnson Foundation, the largest health care improvement granting foundation in the country.

ecarpenter@examiner.com

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