I’m Pat Powers.  I’m President and CEO of the Center for Health Improvement which is a nonprofit organization based here in Sacramento, and we do not take a particular position on any health reform proposal because we are nonpartisan.  However, we feel that it’s very important that we have some kind of health care reform this year, and that we have a vision for the state.  And we’re hoping the governor and the legislature will set that leadership for us.

I’ve had some personal experiences with health care that aren’t so good that illustrate some of the problems.  I’ve had foster children that have Medi-Cal coverage, and when I moved from Oakland to Sacramento, I tried calling a lot of physicians to get a TB shot for my daughter who needed it to get into school that year.  And I could not find a physician that would accept Medi-Cal coverage here, which is a real problem because the rates are so low.

So I was told to go to a clinic.  And when I went at 8:00 in the morning, the line was out the door and around the block, which was a problem.  So even people that have coverage, if they have a state program that pays too little, they can’t get in to see a physician.  And I wound up paying $150 for my daughter to get a TB shot to go to school when it should have been covered by Medi-Cal.

So this illustrates some of the access issues.  A lot of people have no coverage whatsoever and don’t get the preventive services that they need.  We’ve got one out of five Californians without any kind of coverage.  And even for those that have coverage, it’s so expensive, and they have probably a coin’s-toss chance of getting the recommended services they need, as we’ve learned from some studies that came out nationally.

So, hopefully this year, we will see something because no one is able to effect the change that’s needed—an employer, health plan, a provider—is unable to do that on their own.  So we’re hoping that it comes out of Sacramento this year.