State Medi-Cal pays 7 cents on the dollar in some cases, hospital officials said, one of the lowest rates in the nation. On top of that, hospitals see rising ranks of the uninsured who by law are ensured access to care, often leaving hospitals to pick up the tab. Some hospitals have been able to rely on corporate parents to help make ends meet, while others have borrowed money to until the bottom line stabilizes or leaned on wealthy patrons for more donations. To many in the health care industry, HMOs are the bad guys. But HMO officials say they're just filling a consumer demand and doing it by negotiating contracts with doctors, hospitals and pharmaceutical companies.
Health plans point out they've kept down premiums for businesses and patients alike.
For example, statewide premiums in California are 30 percent lower than in Massachusetts despite the Golden State's large number of small businesses, a segment of the economy that usually pays more for health care insurance. Pena said that with average profit margins of 2 percent at most, health plans are not the ones enjoying great financial gain. But McVay from the nurses' association says it's not the patients fault they want the best care available. If we're able to do something to save somebody's life, that's a gift. We should use it,'' she said.