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Newspapers examine health care reform efforts in California

Aug 30, 2007--With "its potential to set a nationwide model," health policy experts, states and federal lawmakers are closely watching California's health reform efforts, USA Today reports. According to USA Today, proposals in California "could launch an even bolder experiment" than in Massachusetts because California's "problems are so much larger." For example, there are 4.9 million uninsured California residents, compared with 500,000 uninsured Massachusetts residents before the state implemented its health insurance law, according to USA Today.

Larry Levitt, a vice president of the Kaiser Family Foundation, said, "Any progress in California would make a substantial dent in the problem of the uninsured nationally," adding, "Action in California would create real momentum, both in the presidential debate and in other states" (Appleby [1], USA Today, 8/30).

However, the "prognosis for universal health care in California is grim this year," as unions, physicians and "other powerful interests are arrayed against Gov. Arnold Schwarzenegger's (R) $12 billion-a-year plan to make" health insurance mandatory, AP/Long Island Newsday reports.

Meanwhile, Schwarzenegger has said he would veto state Democrats' health reform legislation and instead place his measure on the statewide ballot.

The state Assembly on Thursday is expected to vote on Schwarzenegger's plan, and Democrats, who control the state Legislature and have pushed their own proposal through both chambers, are using the vote to "show how little support" the governor's plan has, AP/Newsday reports (Kurtzman, AP/Long Island Newsday, 8/29).

Comments
According to USA Today, "Few expect California to find the same consensus" on health reform as lawmakers did in Massachusetts. Lawmakers have only until Sept. 14 to reach an agreement on legislation before this year's legislative session ends. However, Schwarzenegger at a recent health care debate said, "At the end, we will sit down and negotiate. If everyone has the will ... within two weeks ... we can hammer it out." He added, "We want to make it so the rest of the country can look and say it's a great model."

Levitt said, "Compared with almost every other state in the country, they (the governor and the Democratic majority) are remarkably close in their proposals" (Appleby [1], USA Today, 8/30). Robert Ross, president of the California Endowment, said the failure of universal health care legislation in California would "have the effect of a wet blanket on health care reform nationally," adding that "the presidential candidates will all look with a very watchful eye at what happens in California" (AP/Long Island Newsday, 8/29).

Schwarzenegger Q&A
USA Today on Thursday published a Q&A with Schwarzenegger on his efforts to overhaul the state health care system. Schwarzenegger said, "I believe we can go all the way and do real reform where everyone is insured and everyone has access ... no matter their medical history." He said that among the "serious players" and "experts" involved in the issue, "[e]veryone agreed ... the only way to get it done is if we all recognize we can't get everything we want." However, Schwarzenegger noted that he is "shooting for" the "whole package" and would be opposed to altering his proposal. He also cited a recent poll showing that 82% of state residents said "they don't mind paying extra money as long as they have insurance" (Appleby [2], USA Today, 8/30).

Opinion Pieces
The San Francisco Chronicle on Thursday published two opinion pieces on Schwarzenegger's universal health care proposal. Summaries of the pieces appear below.
 

• Spyros Andreopoulos: Initially, "Schwarzenegger's mandatory insurance proposal seems to offer a starting point for fashioning a feasible plan for the short term to fix California's health care crisis," but it "now appears doubtful that states can effect health care reform," Andreopoulos, director emeritus of the Office of Communication and Public Affairs at Stanford University Medical Center, writes in a Chronicle opinion piece. "Economists believe that states are incapable of sustaining health insurance programs when economic recessions rob them of the revenue to cover their costs," according to Andreopoulos. He continues, "States cannot respond because, unlike the federal government, they are constitutionally barred from running deficits. Experience from developed countries has shown that nationally financed health care works," he writes, concluding, "Our system will make sure that the uninsured remain a permanent feature deep into the 21st century, unless we stop thinking in terms of what is politically feasible and tailor a solution to what is really needed" (Andreopoulos, San Francisco Chronicle, 8/30).
  
   
• Len Nichols/Leif Haase: Universal health care can be achieved in California if "our leaders are willing to work as teammates and share the credit as well as the responsibility," Nichols, director of the health policy program at the New America Foundation, and Haase, director of the foundation's California program, write in a Chronicle opinion piece. The governor's plan, which "was good, but not perfect," has been "effectively blocked" by those "for whom the perfect is the enemy of the good," they write. The plan proposed by Assembly Speaker Fabian Núñez (D) and Senate President Pro Tempore Don Perata (D) "invites a grand compromise, which could bring this saga to a happy ending," according to Nichols and Haase. They conclude, "Now the governor has to find the legislative leaders with a high hard pass that only he can throw and only they can catch and turn into glory" (Nichols/Haase, San Francisco Chronicle, 8/30).