Public Comment

Commentary: The Cost of Doing Nothing

By Dian J. Harrison
Friday June 22, 2007

In this, the “Year of Health Care Reform” in California, it’s ironic that the governor in his May Revise would fail to fund a reimbursement rate increase for providers of some of the most cost-effective preventive health care in the state. The cost of such an increase—$24 million—is just a speck of the overall $104 billion state budget—especially compared to the cost of doing nothing. 

Planned Parenthood clinics throughout California are in crisis. We are turning away more than 10,000 patients per month statewide because the reimbursement rates currently paid for services to our Medi-Cal patients have not increased in 20 years while our costs have skyrocketed 300 percent! Twenty years ago we could hire a clinician for $12 an hour. Today, the market rate for a clinician in the Bay Area is $50 an hour—add that to significant increases in prescription drugs, tests, medical supplies and clinic necessities like rent and utilities. 

Of course, we haven’t been sitting idly by. We’ve redoubled our efforts at private fundraising, pursued public and private grants, tried to use more volunteers and cut costs everywhere. But these efforts alone cannot close the gap between revenue and expenditures and the result leaves clinician positions vacant, forces reductions in services and cuts to prevention programs, and leaves our patients with no where else to turn. The safety net is tearing and it’s time for the state to step up to the plate and put a Medi-Cal reimbursement rate increase for family planning visits in the budget this year.  

Without an increase more patients will be turned away, years of advances in pregnancy and STI prevention will be rolled back, and the toll on taxpayers and the most underserved members of our community will be hefty. At Planned Parenthood Golden Gate, we have six clinics in Alameda, Marin, San Francisco, San Mateo, and Sonoma counties and serve 55,000 women, men, and teens each year. Since the last real rate increase back in the 1980’s, we have had to close multiple clinics, discontinue our pre-natal care services, and eliminate programs because we can no longer sustain them with current rates. We’re turning away more than 400 patients every month in our Oakland clinics alone which is particularly alarming considering the growing epidemic of chlamydia and ghonnorea rates in the city, particularly among young women 15-34, Planned Parenthood’s patient population. When we have to turn away thousands of patients who need access to time sensitive services like STI detection and treatment, family planning, breast and cervical cancer screening, that’s not just a reproductive health care crisis: it’s a public health crisis. 

Not only is a rate increase good public health policy, it’s sound fiscal policy as well. Family planning is one of the most cost-effective services in the state. For every $1 California spends on family planning, the federal government matches it with $9 in federal funds. And studies show that for every dollar the state spends on family planning and prevention, taxpayers save an additional $5.33 in future medical and social service costs. 

When the “Year of Health Care Reform” began, the Governor, Legislature and the State Department of Public Health all agreed that Medi-Cal reimbursement rates must be part of any final health care fix. But safety net providers like Planned Parenthood can’t wait. We need a reimbursement rate increase now.  

Thousands of women are counting on their legislators to put money in the State Budget for a rate increase and for the governor to sign that budget. As we told our lawmakers during Capitol Day this month, they can jump-start health care reform today by putting prevention first and granting safety-net providers like Planned Parenthood increases in Medi-Cal reimbursement rates.  

To take action on this issue, Berkeley residents can contact Senate Pro Tem Don Perata at (510) 286-1333 to urge him to take the lead and invest in family planning with a Medi-Cal reimbursement rate increase this year. It’s the right thing to do … and it makes a lot of cent$.  


Dian J. Harrison is president and CEO of Planned Parenthood Golden Gate.