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November 2006
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A periodic update on Sacramento Healthcare Decisions community-based projects on
society′s use of healthcare resources.
For general information about SHD, visit
www.sachealthdecisions.org.
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SHD′s flagship project in 2005-06 was Just Coverage, an intensive effort to identify what
the public regards as the minimum coverage that everyone should have. The concept of basic
healthcare stems from growing interest throughout the country in bringing coverage to the uninsured,
but doing so at a lower cost than current employer-based coverage.
Nearly 800 residents of Northern California participated in 71 Just Coverage group sessions.
Using a computer-based simulation program called CHAT, participants, as individuals and groups,
balanced cost-sharing, provider network and meeting a variety of healthcare needs.
To receive the 16-page report on the Just Coverage results,
contact SHD.
Multiple copies can be provided upon request. You can also view or download the pdf version
at: www.sachealthdecisions.org.
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"Everyone needs some kind of coverage. You know, something to just get by until
they hit the lottery."
uninsured Just Coverage participant
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Since 2002, SHD has created three different versions of the CHAT computer program for grant-funded
projects; worked with four other organizations to help create new versions for their communities;
and led more than 200 CHAT sessions.
SHD is now spearheading a new use of CHAT as an exercise for leadership groups
that are exploring their own values and priorities about healthcare costs and coverage.
With intensified statewide interest in expanding coverage and reducing costs, healthcare,
business and policy groups are asking SHD to facilitate Just Coverage Leadership Sessions.
Using the CHAT model developed for the Just Coverage project, these sessions are tailored to
groups that want a hands-on, interactive, nonpartisan exercise to expose leaders to the challenges
of making trade-offs in healthcare today.
If your organization wants a process that engages, educates and motivates, learn more about the
Just Coverage Leadership Session by contacting SHD Executive Director
Marge Ginsburg.
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The subject of value in healthcare - deciding if the benefit of a medical treatment is
worth its high price tag - is getting increased attention as medical technology has burgeoned,
often with a price tag to match. Policy makers are faced with such questions as, should health
insurance pay $100,000 for a cancer drug that extends a patient′s life for a few months?
While this subject is being debated at the national level, there have been few efforts to
understand how the public views the concept of weighing cost with benefit in deciding coverage
policy.
Using a scenario-based approach, nearly 300 community residents participated in 27 discussion groups
in 2005-06. The results may surprise you.
The 10-page Getting Good Value report can be read or downloaded at:
www.sachealthdecisions.org.
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Getting Good Value session participant
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SHD Executive Director Marge Ginsburg, with co-authors Drs. Susan Goold and Marion Danis, describes
the key findings of the Just Coverage project in the article, "(De)constructing
′Basic′ Benefits:
Citizens Define the Limits of Coverage," published in the November-December 2006 issue of the
national policy journal Health Affairs. The article is available through the website of
the California HealthCare Foundation. Visit www.chcf.org
and scroll down to the article title. A reprint of the article can also be mailed on request by contacting SHD.
Ginsburg wrote another article for Health Affairs for its web-based version October 24, 2006.
Titled "Rearranging the Deck Chairs," this article responds to the growing interest in consumer-directed
health care with a critique based in part on observations from Just Coverage. This article
is also available on the CHCF website at: www.chcf.org.
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