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August 30, 2007
Los Angeles - Picking between expanding the safety net and expanding health coverage is a false choice that will not eliminate the barriers to health care for currently uninsured Californians, according to a new policy brief from the UCLA Center for Health Policy Research. The brief notes that improvements in access will require both expansion in health insurance coverage and expansion of primary care centers in order to be successful in eliminating barriers to using health care.
"Making access to health care services and health coverage an either/or proposition, especially for low-income individuals, does not guarantee access to health care," said co-author Dylan H. Roby, PhD, Research Scientist at the UCLA Center for Health Policy Research. "Access to care is more about the interplay between insurance coverage, having a medical home, and having facilities available that can provide appropriate care."
To draw their conclusions, the brief's authors reviewed existing literature on the expansion of primary health care centers versus the expansion of health insurance. Additionally, the authors analyzed data from the 2005 California Health Interview Survey to determine current levels of insurance, usual source of care, and how the two relate to each other.
Other findings in the brief include:-
Having health insurance is associated with better health status and improved access to care.
- Expanding the health care safety net has been shown to improve access to care by providing a usual source of care or "medical home", and providing enabling services such as child care, transportation, interpreter services, and case management.
- In order to significantly reduce or eliminate the barriers to health care access faced by Californians, the expansion of health insurance and the safety net should happen together.
"All Californians need both health coverage and a medical home - a health insurance card and a place to go to use that card - in order to maintain their health," said Robert K. Ross, M.D., president and CEO of The California Endowment, which provided funding for the policy brief. "California's safety net of community clinics outperforms many private practices when it comes to delivering culturally appropriate care to the state's diverse health care consumers. But we need to financially support these vital community assets if we want to ask them to take on an increasing demand for their services."
The UCLA Center for Health Policy Research was established in 1994 and is one of the nation's leading health policy research centers. It is also the premier source of health policy information for California. The Center is based in the UCLA School of Public Health and is affiliated with the UCLA School of Public Affairs.
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