| Public administration |
Requires that the State of California
LifeTime Care Health Act system be
administered on a non-profit basis by
a public authority responsible to the
state government with a unified
funding mechanism provided by taxes
and funds including those gathered
from existing federal health programs,
state appropriations, and any
philanthropic contributions. The public
administration criterion only applies to
the administration of the system and
the financing; it does not mean that
health care services cannot be
delivered by private entities as long
as insured persons are not charged for
services defined as benefits in
(CALTCHA). This system-wide public
funding shall also include the training
of health professionals in public
institutions and the regulation of health
professions, clinics, hospitals, and
public health care.
|
| Comprehensiveness |
Requires that all “insured health
services, benefits, and supplies”
(as defined in the CALTCHA legislation)
be available and covered at a high
standard.
|
| Universality |
Requires that all “CA residents' ' (as
defined by CALTCHA) be entitled to all covered services, benefits, and supplies
on uniform terms and conditions.
|
| Portability |
Any CA resident may seek and obtain
needed health care services and
CALTCHA benefits from any CA
licensed health care provider without
limiting professional networks or
geographic location, inside or outside
the state of CA, out-o- state or out-of
-country
|
| Accessibility |
Requires that the State provides
reasonable access to publicly-insured
health services on uniform terms and
conditions without any financial or
other barriers and eliminates all
administrative intermediary or prior
approval processes for prescribed
covered care.
|
| Accountability/ Efficacy/ Efficiency |
CALTCHA provides accountability for
funds and effective use of them by
centering public health assessments
of local community health needs as
the basis for resource allocation. It also
uses the tools of an invigorated public
health system, informed by a network
of community/neighborhood inputs, as
well as data derived from the provider
reporting and the unified electronic
record system to assess outcomes and
metrics of social wellbeing and health.
By replacing profit data with
neighborhood/individual and
community health data as the
Requires that the State provides
reasonable access to publicly-insured
health services on uniform terms and
conditions without any financial or
other barriers and eliminates all
administrative intermediary or prior
approval processes for prescribed
covered care.
Affordability/ Value
determiner of resource allocation,
CALTCHA achieves optimal system
efficiency.
|
| Affordability/ Value |
Universal, first-dollar coverage of all
medically necessary hospital and
physician services, prescription drugs,
dental care, mental health services,
rehabilitative care, and lifetime care
will be guaranteed – all free at the
point of care. The system realizes
enormous savings and health benefits
by eliminating costly administrative
structures inherent to the current
system, by empowering state
negotiation of pharmaceutical and
equipment prices, and by shifting
care paradigms toward prevention
and primary care and away from
specialty driven sick-care of a
population currently deprived of
primary and preventive care.
|