Facts

Over the past 20 years, the percent of uninsured Californians under age 65 has continued to rise as employer-sponsored health insurance has declined. Although Medicaid and individually purchased coverage partially offset that decline, more than 20% of Californians remain uninsured.

The problem, though national, is more prominent in California, which has a lower percentage of individuals with employer-sponsored coverage and a higher proportion of uninsured. And because of California's large population, the number of people without insurance — 6.6 million (as of 2007 estimated to be over 7 million at end of 2008) — is the highest of any state.

Some findings from this year's snapshot include:

• Workers at private sector businesses of all sizes are experiencing an increased likelihood of being uninsured, although it is most pronounced in businesses with fewer than ten employees.
• More than a third of the uninsured have family incomes of more than $50,000 per year.
• Twenty-seven percent of families with incomes between $25,000 and $50,000 are uninsured.
• Seventy percent of uninsured children are in families where the head of the household has a year round, full-time job.
• Nearly 60% of the state's uninsured are Latino.

With the exception of the public sector, employees in businesses of all sizes, including the self-employed, are more likely to be uninsured in California than in the United States.

Uninsured sectors
Self Employed	33.3%

Private sector
Less than 10 employees	40.9%
10-24 employees	31.5%
25-99 employees	24.8%
100-499 employees	19.5%
500+ employees	15.4%

Source: California Healthcare Foundation

Likelihood of being uninsured by family income
Total	20.2%
<$25,000	37.1%
$25,000-$49,999	27.3%
$50,000-$74,999	16.6%
$75,000+	8.5%

Source: California Healthcare Foundation

Approximately three-fifths of California’s uninsured children are eligible for public programs, but less than 10 percent of adults are eligible. Seventy percent of California’s uninsured children are in families where the head of household works full-time, all year.

From 2000 to 2007, the likelihood of being uninsured has risen for all but those 20 and under and the near elderly. The largest increase is seen in the 45 to 54 age group.

Likelihood of being uninsured by age group
2000		2007
Total	20.0%	20.2%
Under 18	14.8%	10.7%
18 to 20	29.6%	27.6%
21 to 24	34.9%	35.1%
25 to 34	26.6%	29.2%
35 to 44	18.5%	21.9%
45 to 54	15.9%	20.4%
55 – 64	19.7%	17.2%

Source: California Healthcare Foundation

Total Population			Uninsured Rate
In millions	Noncitizen		Citizen	Noncitizen
California	32.2	16.7%	15.2%	44.7%

Source: Employee Benefit Research Institute estimates of the Current Population Survey, March 2008 Supplement.

Uninsured Americans will spend $30 billion out of pocket for health care in 2008, new research shows.

People uninsured for any part of 2008 receive about half as much care as those who are fully insured.

"The uninsured receive a lot less care than the insured, and they pay a greater percentage of it out of pocket. Contrary to popular myth, they are not all free riders," study author Hadley, a senior health services researcher at George Mason, said in a news release from the journal.

Source: Health Day News, August 28, 2008

March 16, 2009 - (Bloomberg) -- Breast enlargements eclipsed fat suction as women’s favorite plastic surgery last year, even as the recession shrank demand for all cosmetic work, doctors said.

The value of cosmetic procedures for men and women fell 10 percent in 2008 to $11.8 billion, according to a member survey released today by the American Society of Aesthetic Plastic Surgery. The number of breast augmentation procedures for women fell 11 percent, to about 356,000, compared with a 22 percent drop for fat removal, or liposuction, to 341,000.

Hair Transplants Grow

The biggest increase in 2008 among cosmetic surgical procedures was for hair transplants, which grew 10 percent overall, with a 13 percent increase among women and a 10 percent jump for men. Lower-body lifts, which tighten skin loosened by massive weight loss, fell by 37 percent, the largest decline.

Buttock lifts grew in popularity for men by 35 percent, while falling 37 percent for women.

A 46 percent drop in liposuction for men didn’t budge the procedure from first place, even as nose reshaping moved to second place and eyelid surgery fell to third.

The fourth and fifth most popular surgical procedures for men were breast reduction and hair transplants. For women, the top five procedures were breast implants, liposuction, eyelid surgery, tummy tucks and breast reduction. Botox injections, used to smooth wrinkles, were the most popular nonsurgical procedures for both men and women.

Botox Price

Doctors charge an average of $443 for Botox, made by Allergan, and that needs to be repeated every four to six months, according to the group. A facelift averages $6,700, according to the group’s figures. Botox generated $1.31 billion in sales last year, or 30 percent of the company’s total revenue, Allergan reported last month.

March 25/PRNewswire-USNewswire/ — Showing sensitivity to weaknesses in the U.S. economy, plastic surgery was not spared from the recession's grasp. According to the newest national procedural statistics report from the American Society of Plastic Surgeons (ASPS), in 2008, doctors performed over 12 million cosmetic plastic surgery procedures - encompassing both surgical and minimally-invasive procedures. Surgical numbers dropped nine percent and minimally-invasive numbers rose five percent. Nearly 5 million reconstructive plastic surgery procedures were performed, slightly more than the previous year. "Like most sectors, plastic surgery is feeling the effects of the economic downturn," said John Canady, MD, ASPS president. "However, repeat patients and those putting off surgery, likely sustained demand for some minimally-invasive procedures. Growth in demand will likely return as the recession eases and baby boomer's offspring begin to explore surgical options." The following are the top-line 2008 National Plastic Surgery Statistics:

— 12 million total cosmetic plastic surgery procedures; up three percent versus 2007 — 1.7 million surgical cosmetic procedures; down nine percent versus 2007 — Top 5: Breast augmentation (307,000; 12 percent decline), Nose reshaping (279,000; two percent decline), Liposuction (245,000; 19 percent decline), Eyelid surgery (221,000; eight percent decline), Tummy tuck (122,000; 18 percent decline) — 10.4 million minimally-invasive cosmetic procedures; up five percent versus 2007 — Top 5: Botox (5 million; eight percent increase), hyaluronic acid fillers (1.1 million; six percent increase), chemical peel (1 million; two percent increase), laser hair removal (892,000; two percent decline), microdermabrasion (842,000; six percent decline) — 4.9 million reconstructive procedures; up three percent versus 2007 — Top 5: Tumor removal (3.8 million; five percent increase), laceration repair (307,000; seven percent increase), scar revision (163,000; eight percent increase), hand surgery (100,000; 13 percent increase), breast reduction (89,000; 16 percent decrease) "Although many obstacles remain in patients acquiring insurance coverage for reconstructive procedures, it is promising to see, for the first time in several years, a gain in reconstructive plastic surgery procedures," said Dr. Canady.

Source: American Society of Plastic Surgeons

Dental

The percentage of Californian’s without dental insurance is estimated to range between 50% to 65%.

Average costs for a crown paid for by Delta Dental, the largest dental insurer, is $800 as per contract with dentists in their network who accept the amount as the total. The co-pay is 50% - thus a crown costs the insured $400. Other dental insurance companies have larger co-pay.  Those not insured face payments of $1,200 to 1,400.A crown in Baja is $400 or under. Fillings average $400 while in Baja the average is $125.

Cost of Braces from a Dentist or Orthodontist can vary as dentists tend to charge less, however the range for children’s braces range from $3,500 to $6,000 largely dependent on area. Adult braces costs a few hundred dollars more. In Tijuana braces prices using an orthodontist costs between $800 to $1,500 possibly more depending on the severity.

A recent case (September 2008) a person on a dental blog wrote he had been quoted $40,000 for implants some crowns, fillings, whitening for his family was quoted close to $40,000 in San Diego. The total costs for the family in Tijuana for all the work was under $8,000.

The demand for affordable dental services is a cornerstone for the potential of medical tourism to Baja California.

Numerous other specialty medical services are offered constituting tremendous differential in costs between those charged in Baja California and those in California. Potential savings are also found in generic over the counter and prescription medicines.

Summary of costs of medical care in California:

Distribution of Health Care Expenditures by Service by State of Residence (in millions), 2004 – total annual expenditures over $1.5 trillion
	CA %	CA $	US %	US $
Hospital Care	35%	$57,805	38%	$566,886
Physician and Other Professional Services	33%	$55,595	28%	$446,349
Drugs and Other Medical Nondurables	13%	$20,799	14%	$222,412
Nursing Home Care	5%	$8,424	7%	$115,015
Dental Services	7%	$11,625	5%	$81,476
Home Health Care	3%	$5,537	2%	$42,710
Medical Durables	2%	$2,552	1%	$23,128
Other Personal Health Care	2%	$3,899	4%	$53,278
Total	100%	$166,236	100%	$1,551,255