Well, now that AB 8, the legislative health care plan, has been vetoed by the Governor, I suppose we're back at the beginning. But this time, for the love of all that is good in the world, can we please forget the Massachusetts health care "plan"? It hasn't worked there, and it certainly is not exportable. As I remarked about Gavin Newsom last week, willing away a problem alone doesn't actually do anything. Press releases, while all well and good, cannot solve real problems, like health care (or Halloween in the castro). This is what the Massachusetts plan does. It attempts to will the problem away without really addressing the issue of affordability for a huge swath of the middle class. But this is not something we didn't know already, at least here at Calitics (Robert in Monterrey, David Dayen, Sen. Kuehl, and Brian Leubitz).
Already we have seen that the costs are so out of control that Massachusetts exempted part of the state's citizens from the requirement of buying insurance because it would take up too much of their income. But that's only the beginning:
Earlier this year, officials exempted about 60,000 people (estimates of the uninsured there range from roughly 400,000 to 650,000) from the health care mandate after concluding itwould eat up too much of their income. Concerns about affordability are expected to escalate in the coming months, when residents will face fines of hundreds of dollars - and, later, thousands - if they fail to buy insurance. (SJ Merc 10/13/07)
It didn't work there, it certainly won't work here given the far higher rate of uninsurance in California. (about 9% in Mass, about %19 in CA) And it certainly won't work nationally, as much as Hillary Clinton and John Edwards want it to. Flip it...
By margins of 22-17 in the Senate and 45-31 in the Assembly, AB 8, the health care reform package co-authored by Speaker Nunez and Senator Perata, has passed out of the Legislature. The governor's recent statements seem to indicate that he will veto the bill, but that is yet to be seen.
First off, I do not love this bill. I will not be satisfied until we have single payer healthcare. The bill gives more power to insurance companies that favor bottom lines over Californian's lives. That's the market, and no system will remedy that other than single payer. That being said, this is an important step that has been made today. It brings healthcare reform one step closer to fruition.
So, what does AB 8 do? It builds on the (crumbling) employer based healthcare system, and that is certainly a major problem. However, it requires all employers to either provide health care equal to 7.5% of payroll or to pay that amount into a state fund.
But whatever else can be said about AB 8, that it is not a valiant effort should not be said. The bill "expands access to Medi-Cal/Healthy Families, broadening eligibility to include both parents and children with incomes between 133% and 300% of the federal poverty level." That is a really big deal for the people of California. There's something in this bill for everybody to like, and, unfortunately, for everybody to hate.
Look, the underlying issues cannot be resolved in the Legislature as current constituted. That's nothing against the current legislators, it's just that single payer would need 2/3, and that seems unlikely to happen. So, we either A) get 2/3 majorities and a great progressive as Governor or b) take single payer to the ballot at some point. I don't take lightly the efforts of the Speaker and Senator Perata. They were important, but we must be totally cognizant of the fact that this is going to be a long, bloody battle on the road to single payer.
Yet that's what you might have expected given the rhetoric coming from some quarters. The rhetoric has gotten well beyond ridiculous, and it's time to stop engaging in bizarre fantasies and the shrill invective and start talking seriously about the healthcare reform debate in California.
When it comes to debating the merits of AB 8 and SB 840, it's easy to bash insurance companies and it's easy to believe that politicos are about to sell us out on something so vitally important. But none of that deals with the fact that large elements of the progressive movement are supportive of AB 8 for very legitimate reasons.
Reasonable people can disagree. Nobody is compelled to support AB 8. But to ignore these stakeholder groups and their legitimate interests in seeing healthcare reform this year (much less to demonize them as some have done) is not only bad politics, it's wrong.
(AB 8 is on the floor of the Assembly right now. - promoted by Brian Leubitz)
There are other things going on besides the Petraeus/Crocker testimony today, though I'm not covering much of it. But this is kind of important for the future of our nation on its most valued domestic policy. Over the past few days in California rumblings of a health care deal was moving into focus. Dan Weintraub that this would result in a deal between the Governor and the Legislature on a workable reform featuring shared responsibility from hospitals, individuals, employers and doctors, with the funding for said deal to be delivered in a ballot measure later on. Here's the way it would go:
AB 8 seems set for legislative passage, but after that an Arnold veto is expected, writes Bayne. So what next for health care? As the legislature and the governor plan a special session, the details of any final compromise will be absolutely important - and will determine whether the bill will actually be useful, or will be a cure worse than the disease. More...
(Absolutely. Pushing a rushed reform compromise in two weeks would be a travesty, and it speaks to how deeply broken the legislative process is, because it creates all of these bottlenecks that, deliberately IMO, stifle debate. Sen. Kuehl makes a ton of sense here. However, I would be open to a special session to get something done if the process were made more open. - promoted by David Dayen)
Health Reform and the Year of Magical Thinking
The Year of Magical Thinking is the title of a memoir by Joan Didion detailing her state of denial, inexplicable behaviors and, finally, coming to grips with, the death of her husband. It's also an apt description of the Governor's 2007 approach to reforming our broken healthcare system, with the glaring difference that he still hasn't come to grips with the truth. (After all, if a complicated movie plot could be resolved in less than two hours, who not fix healthcare in California in nine months?)
Beginning in January, the Governor ordered his health advisors to sketch the outlines of a plan that would magically "cover" all Californians by simply requiring them to buy health insurance. To this moment, he has refused to negotiate any of his major points with the Legislature. The language for his plan was finally drafted five months later, and shown, under wraps, to a few, select people. Not one legislator agreed with it, and no one would carry the bill as legislation.
Senate leader Don Perata finally has some good news on the healthcare front: the Enron-style grand bargain between Schwarzenegger and Nunez looks like it's dying faster than you can say, "energy deregulation I mean healthcare deform." And none too soon, because California's healthcare reform could set the tone nationally and spark states across the country to mimic our plan.
At least two health care options, AB 8 (Nuñez) and SB 840 (Kuehl) will be part of the discussion when the governor's Pension Commission meets in San Jose on Thursday.
The commission has been holding monthly meetings around the state and taking in testimony from stakeholders in the pension debate. They are due to present recommendation to the Governor by January 1, 2008.
California Speaks: We Want Single Payer
by Senator Sheila Kuehl
On August 11th, 2007, at the culminating and boisterous OneCareNow rally in Los Angeles, as well as eight coordinated "listening" events around the state, sponsored by Blue Shield and the California Endowment, among others, a random selection of thousands of Californians spoke out overwhelmingly in favor of major health care reform.
At the largest rally of the year, more than two thousand advocates, patients, nurses, doctors and universal health care fans gathered on the steps and lawns of the Los Angeles City Hall to excoriate a health care system that does nothing but devastate working families with systematic cancellations, denials and delays in care. This doesn't promote health, it isn't care, and it certainly isn't a "system"-- it's traumatizing and often deadly for people who thought they would be given care, but, instead, got nothing but a tangle of insurance red tape.
Convinced that single-payer universal health care is the only hope for fixing our broken health care system, they gathered to support SB 840 (Kuehl), the only truly universal health care plan proposed in legislation that is shown to contain costs, improve health care quality and allow Californians total choice of their doctors and hospitals.
The big news out of Sacramento this week, aside from the worsening budget situation, is movement on health care reform. As was liveblogged here yesterday, Sheila Kuehl's Senate subcommittee held a public hearing and vote on AB 8, the less ambitious effort to reform health care by bringing more people into private insurance. As that hearing revealed, one of the most common statements from groups offering conditional support was that cost containment was a necessity - without it the bill was worthless, and many of the groups present would come out in opposition to it.
Cost containment is the key to AB 8. It's the devil that lurks in the details. It's worth a further look, if we are to believe that AB 8 is something that we who support real health care reform should help with our time and effort.
(I love me some liveblogging. Just so everyone is clear: SB 840 is Keuhl's single payer bill and AB 8 is the Nunez/Perata bill that stays within the private insurance model. - promoted by juls)
Things are about to get underway as It's OUR Healthcare! will be liveblogging from the John L. Burton Hearing Room where the Senate Health Committee chaired by SB 840 author, State Senator Sheila Kuehl (D-Santa Monica), will meet at 1:30pm.
Senator Kuehl is setting the ground rules for the hearing. (No cheering, clapping or booing.)
Scheduled to speak are the Speaker of the Assembly Fabian Nunez (D-Los Angeles) and Senate President Pro Tem Don Perata (D-Oakland).
