(The difference between winning and losing in 2010 isn’t the mushy middle. The difference is the base. And this is a good start. – promoted by Brian Leubitz)

California’s Senate Appropriations Cmte passed Mark Leno’s SB 810 out of committee, and the Senate will vote on it next week.  (UPDATE: make that this week.  Started this diary on weekend.)  Leno says that the timing is coincidental and not a response to the Brown debacle, but it works for me.  SB 810 would create a single-payer, universal health care system in California.

You’ll be shocked to learn that Republicans are framing this as Democrats Out of Touch, and it’s possible that SB810’s supporters will get wobbly.  Two things need to happen:

Call the California Senators Calderon, Correa, and Wright and let them know that saving the state billions in waste and fraud is still politically viable – contact info on the flip.

Push back on the corporate narrative – talking points and media links on the flip.

Attack attack attack.  If you’re not a constituent, call them anyway.  Let them know that California can show the rest of the country that Democrats understand we want universal healthcare.

Action Alert on SB 810 (Leno) Single Payer Universal Health Care Bill

from California School Employees Association (full disclosure, this is my employer)

<[The] … single payer universal health care system in California, SB 810, is up for a crucial vote in the Senate this week and we need your help.

SB 810 is real health care reform that we desperately need in California. It would provide affordable, comprehensive health care to all Californians and would allow them to choose their own doctors.  Under this bill, nobody could be denied coverage because they had a pre-existing condition, and they would not lose their coverage if they changed jobs or went away to college.

SB 810 will be voted on by the full state Senate in the coming days.  We need your help in contacting three Senators whose vote may be important to the passage of SB 810.

Please make sure you use the following points when you contact the following two Senators:



• Thank you for your prior support of single payer universal health care.

• SB 810 is the new single payer bill and will come before you for a vote on the Senate Floor in the coming days.

• SB 810 is true health care reform that will cover every Californian and provides us comprehensive, affordable and quality health care.

• I am asking you to continue to support single payer health care and vote “YES” on SB 810.

Senator Ron Calderon (Montebello)

Phone: 916-651-4030

Email: [email protected]    

Senator Lou Correa (Santa Ana)

Phone: 916-651-4034

Email: [email protected]

For Senator Wright the message is:

• I am asking you to vote for SB 810 that would create a single payer universal health care system in California.

• This bill will come before you for a vote on the Senate Floor in the coming days.

• SB 810 is true health care reform that will cover every Californian and provides us comprehensive, affordable and quality health care.

• We need this bill and we need it now.  Please vote “YES” on SB 810.

Senator Rod Wright (Los Angeles)

Phone: 916-651-4025

Email: [email protected]

This final push in the Senate is very important to the passage of SB 810 and keeping real health care reform efforts alive in California.  Thank you!

OK, you’ve taken care of the legislators.  On to the media:

Articles on SB810 here, here, and here.

Ammo for your blog or Letter to the Editor:

I am writing to respond to your recent article on the passage of single payer universal health care in the California Legislature.

It’s about time that someone stood up to the insurance companies and banks and I am thankful that there are some legislators in Sacramento standing up for the people by standing up to insurance companies.  

The real reason average people are so upset about health reform is that we want our elected representatives to listen to us instead of insurance company lobbyists who have run our health care system into the ground.

I have watched as health insurance companies raise our premiums, impose huge co-payments and deductibles and then lower our coverage at the same time.  Health care is now an unaffordable luxury for middle class America, and we are losing jobs to Canada because our health care costs are so much higher.

I am tired of paying twice as much as every other nation for health care while we live at the mercy of heartless insurance companies who take 30% off the top and then deny us care whenever they can.  It’s time to get rid of the insurance company middleman.

California legislators need to listen to the voices of millions of Californians who have no health coverage.  California legislators need to listen to the voices of millions more who have insurance but can’t access it because of growing deductibles, co-payments or other insurance company games.  

I urge California legislators to support the California Universal Health Care Act.  The people are desperate for true courageous leadership on health reform.

Other suggestions:

California’s budget crisis is directly linked to rising health care costs.  Health care for teachers, police officers, firefighters, transit workers face annual increases that are much higher than wages.  Do the math!

SB 810 is a public private partnership where everyone pays into a universal health care plan and then everyone chooses their own private doctors and hospitals.  It’s been proven to save California families and employers billions of dollars in the first year.  It works by taking the money we already spend on health care and then getting rid of the wasteful insurance company bureaucracy that stands between us and our doctor.  

Thank you!

Crossposted at dKos

(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. 

More on the flip…

To fill the void raised by the Governor’s magical “we must do something this year” drumbeat, the Democratic leaders began crafting their own reform plan.  To date, however, the Governor and the Legislative leadership have remained oceans apart on the broad policy strokes of health care while public support for the current insurance-company controlled system has plummeted and support for the reforms contained in SB 840, the Medicare-like fix for California, has grown.

Now, with less than two weeks remaining in the first half of the two-year legislative session, there is still no “something” on the table and the Governor, like a Barnum and Bailey’s ring leader, continues to announce that he will, assuredly, pull a rabbit out of a black hat.  Actually, there is no way of knowing if the result would really be a rabbit; it could just as easily be an albatross. 

The Governor has further limited discussion by announcing that he would veto both of the legislative proposals that have actually been introduced as real bills. SB 840, by far the most carefully crafted, transparent and fully vetted bill, will remain in the Legislature until next year, since sending it down to him for a veto would end any consideration of single payer until 2009.  The individual mandate provisions in the Governor’s pronouncement are being emphatically rejected by virtually all stakeholders representing the people who would be forced to pay uncapped premiums.  The percentages to be paid by employers and individuals, hospitals and doctors, people in a “pool” and those outside, those above differing percentages of the poverty scale and those below, are so far apart in the Governor’s pronouncements and the Speaker’s bill, you could drive trucks through the gaps.  The Governor’s lynchpin financial mechanism of a provider tax remains submerged under the very murky water of a 2/3 vote.  What convoluted compromise might be devised in a last-minute attempt is anyone’s guess.

Nonetheless, we are told that, unless we agree to pass a yet-to-be hastily drafted bill that incidentally may be the biggest reform proposal ever attempted in health care, and pass it in two weeks, thus completely bypassing the entire political process and any semblance of open public input, we’ve completely failed and health reform is doomed forever.  Please.

The prospect of legislative staff, sitting behind closed doors, hastily crafting a 100-page health reform “compromise”, to be pushed through the legislature with little or no public input over the course of the next 14 days, is deeply irresponsible.  Frankly, given the example of the energy deregulation bill, we ought to know better.

Moreover, we lose nothing by taking advantage of the fact that the sessions of the California legislature are two year sessions.  Many of our major accomplishments, most recently, AB 32, the bill related to greenhouse gas, took more than one year to achieve.  Next year’s Presidential campaigns will ensure that health reform stays as the top of the agenda.  More importantly, the issue of health reform will continue to dominate because the people need it and want it.  What they want, and deserve, however, is responsible health reform, not a new debacle that benefits the health insurance companies the way the electricity bill benefited Enron.

Finally, we must not forget the reason that we are in this crisis to begin with.  Health care premiums changed by insurance companies continue to grow 3-4 times faster than wages.  A solution is needed that pays attention to adequate funding, affordability, cost controls and quality.

Even if the Legislature should pass a last minute convoluted experiment in health reform, there will still be a need to continue the work to enact a fully vetted, Medicare-like single payer system that replaces the insurance companies with a plan for all Californians, allows each person to choose their own providers, and protects affordability, comprehensive coverage and quality.  Such a solution is the only sensible and tested way to achieve universal health care responsibly.  Whatever happens in the next two weeks, the movement for single payer universal health care is continuing to grow, and SB 840 will continue as its focal point, the only legislation that establishes the kind of truly universal, modern and affordable health care system the people of California need and deserve.

(Thanks Sen. Kuehl! Keep on fighting! – promoted by Brian Leubitz)

The Budget Process Through July 21st

This is my third essay for 2007 and the first one I have done on the 2007-2008 budget, which has now passed, after a series of cuts and more cuts.  In this first of several essays on the budget, I will set out some of the provisions of the budget originally agreed to by the budget conference committee, the changes that were made to that budget in the Assembly in order to get 6 Republican votes and the reasons for the two-month stalemate in the Senate. Visit my website at www.sen.ca.gov/kuehl to read my previous essays. If you wish to subscribe to receive these essays on a continuing basis, (no charge), please send an e-mail to [email protected], titled “subscribe”.

Edits by Brian For form and space only. See the flip…

Budget Process, January to June

The Governor sends his proposed budget to the two houses of the Legislature in January, shortly after his “State of the State” speech.  It is immediately divided into four or five sections and given to the budget sub-committees in each house to analyze, critique, change and adopt, piece by piece.  Each administrative Agency and unit appears before a budget sub-committee to defend their budget.  In May, the Governor submits a revised budget, called the “May Revise”, based on adjusted (tax) income and expense figures for the current year and expected savings or increases. 

Hundreds, perhaps thousands, of individual line items are adopted in exactly the same language by the budget sub-committees in both houses of the legislature.  These provisions become a part of the budget without going to the budget Conference Committee for resolution, as none is needed.  Those items that are different in the Senate and Assembly versions of their budget sections are sent to the budget Conference Committee where the differences are ironed out and one budget is presented for adoption by both houses.

The Big Four or The Big Five

At the close of the Conference Committee, the closed door dealing among the leaders of both houses and the Governor begins.  This is often referred to as a meeting of the Big Five. Unlike previous governors, however, during the Schwarzenegger administration, the Governor is often absent from these deliberations and the four house leaders are left to try to iron out the differences and horse trade on their own.  This was the case with discussions on the bond package from last year and the prison “reform” package this year.  And it was the case with negotiations related to the Conference budget and cuts taken, as shown below, to get Republican votes on the budget in the Assembly on July 19th.

Why Do We Need Republican Votes on the Budget?

In California, Rhode Island and Arkansas, a 2/3 vote by each house of the state Legislature is required to adopt a budget.  In the other 47 states, only a majority is required, which means that the majority party is held to account for their budget and their priorities, and the voters judge them on those priorities.  In California, the budget is generally held hostage by the minority party (I was in the minority in my first two years in the Assembly), because the budget vote is the only issue the minority can truly affect.

The Conference Budget Before Changes by the Big Four

The Budget put forward by the Conference Committee was already a lean and mean budget in many ways.  It was leaner than the Governor’s May Revision proposal, but managed to reject the Governor’s proposed cuts to CalWorks kids only grants, retained a cost of living increase for the poorest CalWorks working recipients, (however, putting that increase off for six months), and retained funding for the homeless mentally ill the Governor had wanted to cut.  In addition, the Conference budget moved $500,000,000 worth of transit money to the general fund, in order to fill some of the “structural deficit”: the difference between revenues and expenditures.  The reserve was a healthy one: about two billion, approximately what the Governor had in his budget.  The revenue assumption included a $4.8 billion fund balance brought over from last year’s budget, $102.3 billion in revenues and $103 billion in expenditures. The final General Fund reserve in the Conference Budget was projected at $3.4 billion. 

Additional cuts and tax credits added by Assembly

The Budget, as originally passed by the Assembly, reflected even deeper cuts, including deleting all funding for CalWORKs cost-of-living adjustments; providing no General Fund help to cover student fee increases at UC and CSU; delaying, from January to June, the state portion of the SSI/SSP cost-of-living adjustment; reducing funding for Proposition 36; and increasing the monies shifted from public transit to the General Fund to a total of $1.2 billion. 

The budget, as passed by the Assembly and sent over to the Senate on July 19, provided full funding for growth and a cost of living adjustment for K-12 education but did not create new programs, rejected the Governor’s bid to cut $314 million in CalWORKs that would have penalized children and families seeking to become self-sufficient, invested in a 5 percent rate increase for foster family homes, restored $26 million in academic preparation programs at UC and CSU, and included $1.6 billion to fully fund Proposition 42 (transportation). (This is different from the projects that would have been funded by the gas tax revenues shifted into the general fund and referred to, above.)

The Assembly Vote on the Budget

This year, the Assembly voted on the Budget before the Senate, in one marathon session on Thursday night, July 19th.  The Republicans in the Assembly held out for a number of changes until 4:30 in the morning, when they negotiated a $500,000,000 tax credit package in a separate bill, sent the budget to the Senate and left town.

The Senate’s Deliberations on the Budget

Perhaps “deliberations is not quite the right word.  The budget and all the trailer bills (except the amazing tax credit package, which had come out of nowhere) were put up for a vote the next day, Friday, July 20th.  Each budget vote garnered 25 Democrats for, 14 Republicans against and one abstaining.  27 votes are required to adopt the budget and the trailer bills.  The bills were put “on Call” while President pro Temps Perata attempted to get two Republicans to vote.  Throughout the next 23 hours, as all Senators remained on the Floor of the Senate (trying to sleep, if at all, in their chairs or taking turns on the couches), the Republican caucus made their demands clear: they would not vote for a budget unless another $700,000,000 was cut from the budget in order that revenues and expenses would zero out.  Even though there is a very healthy reserve, that was not sufficient.  At 10am Saturday morning, July 21, we were adjourned, with no budget and no budging by the Republicans.

Next…..

Senator Perata told minority leader Senator Ackerman that morning that if his Republican caucus were simply continuing to say “no”, they needed to come up with their own budget, one that clearly showed the cuts they wanted to make.  On Wednesday, July 25th, with the Senate again in session, the Republicans failed to present a budget, but had given the press a list of cuts they would like to make to “balance” the budget, including eliminating the subsistence CalWorks payment made to children whose parents have been unable to find work and have “timed out” of CalWorks, or for children of undocumented parents. The demands also included transferring the 200 million left in the gas tax transportation account that had not already been swept into the budget, into the General Fund, leaving several current transportation projects without funding; exempting certain construction projects from the California Environmental Quality Act relating to greenhouse gas emissions; and attempting to add parental consent for reproductive services for minors in the budget, which the electorate of California has turned down twice.

The next day, Senator Ackerman indicated he did not want the Republican budget to be heard on the floor because even his caucus was divided on it.  The Governor was unable to secure the two Republican votes needed to pass the budget in the Senate.  Republican Senators refused to meet with the Governor and, as the days passed, instead of working on a compromise, the Republican caucus simply increased their demands, cheerfully indicating that they were dedicated to holding out until the Assembly returns into session so they could reopen the entire budget.

No Budget…No Money

For state services, for hospitals, for K-12 education, for community colleges.

See the next essay for the resolution, such as it is, to the budget stalemate.

(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).

Check for updates below the fold.

Speaker Nunez has just arrived and will start the discussion on AB 8. Senate Pro Tem seated right beside him.

In front of Senator Kuehl is a white sign with black text: “DO NO HARM.”

Speaker Nunez says that he and Perata are pleased to be here to make a major step in ailing a system that is broken.

Nunez: [Kuehl] You are a champion of healthcare for all Californians.

Nunez: AB 8 built on the idea of shared responsibility between employers, government and individuals. These measures will not fix the entire healthcare market, but improve it. This is a rare opportunity to fundamentally improve our healthcare system. We need to act now; take advantage of this opportunity.

Nunez: All of the uninsured children in California will be covered by this legislation. It will move 3.4 million (of the 6.5 million) under coverage.

Nunez: This is not a perfect plan, but will help pave the way for “real healthcare reform.”

Senator Perata now at the podium.

Perata: “[Bills merged because] we got tired talking to each other. We wanted to talk to the Governor.” Says we should have a national healthcare program. “Scandalous” that the U.S. is “woeful” on healthcare. California must provide the leadership [for the country].

Kuehl: In MA, they just added “affordable” to the name.

Witness: (Speaking of SB 840 support) “It seems like Kuehl’s gang were all over the place.” Kuehl replied jokingly, “Kuehl’s angels, we call them,” and the room chuckled.

Angie Wei, California Labor Fed acknowledged the huge number of IOH supporters that have traveled from across the state today. Provisions supported: Creation of statewide purchasing pool; establishment minimum of healthcare spending requirement; subsidies and discounts for families below 300% poverty level.

Concerns: issue of cost containment (union members have been able to hold on to their healthcare but pay a dear price for that; early retirees face risk of losing their healthcare; current system is unsustainable); affordability (we need to protect families from maximum exposure out of pocket).

Beth Capell, Health Access California: [Legislators] have been receiving healthcare Stories of the Day. Retells her own personal healthcare story involving her husband. “Never once did we worry we whether we could pay for his care. It should be that way for everyone.”

Number of studies released today on employer-based coverage. AB 8 would have a modest, yet positive, impact on California’s economy and not cost jobs.

Capell: We can do something this year that will improve the economy and help with people’s care.

Witness: AB 8 would improve healthcare for low-income Californians.

Mary Hernandez, SEIU: We support AB 8 if amended to control healthcare costs.

Gary Passmore, Congress of California Seniors: Add amendments on two issues for support; truly a work in progress; “we like what we see”

Consumers Union: support if amended; transparency a must;

AFSCME: We want to make sure this bill includes cost controls.

California Medical Association: support if amended; refinement of cost control efforts; inclusion of fiscal transparency

CNA voiced opposition to AB 8, instead favoring SB 840.

Senator Sam Aanestad (R-Grass Valley) suggested to the Speaker that he work with the chair, put a hold on the bill and work on it through the fall.

Kuehl: “I don’t like your bill as much as I like my bill.” (The assembled crowd laughed.)

Kuehl: If we had the right Governor, we’d have it (SB 840). But my responsibility, is to now. Responsibility to push as hard as I can to hammer on the issues at hand. I am going to support this bill today (AB 8). It must keep moving to have a vehicle better than the Governor’s plan.

Nunez: Your bill (SB 840) is not only a bill that I not only support, but enthusiastically support. AB 8 is not perfect but will help a lot of people — 3.4 million.

Kuehl voted in favor of AB 8, vote is currently still open.

(Horray for the nurses… And horray for a health care proposal that actually helps real working people! : ) – promoted by atdleft)

State Senator Sheila Kuehl yesterday re-introduced SB 840, her historic bill to move California to a “Medicare for All” health plan.  These kinds of SinglePayer health systems exist in every other developed nation in the world and are the only solution to the problems of access and cost of healthcare-problems caused by the wasteful private insurance bureaucracy.  Schwarzenegger vetoed the bill last year; this year he has promised to bring about healthcare reform and, when SB 840 lands on his desk again, he will have to consider if he is serious about his promise.

The California Nurses Association is the lead sponsor of SB 840, and a strong advocate of H.R.676, the national bill sponsored by Rep. John Conyers.  Nurses are motivated to fight for SinglePayer healthcare because so much of their time is spent fighting insurance corporations on behalf of their patients.  A nurse explains below….

Brought to you by the National Nurses Organizing Committee/California Nurses Association as we organize to make 2007 the Year of SinglePayer Healthcare.

Deborah Burger, RN, President of the California Nurses Association explains why nurses support SinglePayer in her testimony from the SB840 hearing yesterday, and why nurses will continue to fight for it every way they know how, including in a new advertising campaign.  We are at a historic moment in this movement, and California’s progress should provide hope to people across the country that we can cure this healthcare tragedy that is touching so many of us.

Registered Nurses use what’s called the “nursing process” to assess and treat patients.  We are educated to collect objective and subjective data, synthesize that data, and apply our judgment skills to help patients survive both their health problems and the treatment for those problems.  When we ask a patient how they are doing, what their favorite flower is or if they have children, we are not just being pleasant.  We are noting their skin tone, their speech, their pain level, their emotional response and many other indicators of their overall condition.  We are doing a comprehensive assessment of their health, although it may not be apparent to them.

Applying the nursing process to the ailing patient called California, we note symptoms of less access, increasing costs and a less healthy population leading to a diagnosis of healthcare crisis.

The good news is that there is a cure.  It is called SB 840 authored by Senator Sheila Kuehl.

It is probably no accident that the same legislator who fought to protect patients in hospitals and authored California’s historic nurse-to-patient ratios is also the author of SB 840, a SinglePayer, or “Medicare for All” system, where everyone is in, benefits are better, and costs are controlled.  We are very proud, as the principal sponsor of SB 840, to work again with Senator Kuehl.

The California Nurses Association and nurses around the country have  fought insurance companies, HMO’s, patient-care gatekeepers, hospital corporate chains, and everyone else who wants to put us in the position of letting our patients suffer from inadequate care. 

We know one very important fact: a SinglePayer system is the only cure for the current market-based system that has turned our health into a commodity subjected to “insurance products” that cost more and deliver less every year.

Treating these symptoms with more insurance would be like treating a patient with lung cancer or asthma with cigarette smoke.

A SinglePayer plan is the only way to assure genuinely universal care – not universal insurance with a windfall to health plans.

It is the only way to avoid a multi-tiered system, assure better, more comprehensive benefits, and guarantee patient choice of physician and hospital. 

It is the only effective way to adequately control premium and out-of-pocket costs and to end an insurance bureaucracy that wastes 30% of every healthcare dollar because it quite simply takes the insurance middle man out of the middle.

Therefore, CNA RNs are proud to stand with Senator Kuehl, other advocates and other legislators who will fight for the right cure for California’s health crisis.

If you want to join the fight for SinglePayer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

(Shiela Kuehl is back, this ought to be interesting. – promoted by dday)

While Schwarzenegger’s healthcare plan languishes, California State Senator Sheila Kuehl will re-introduce her historic SinglePayer bill tomorrow.  It landed on Arnold’s desk last year and it will land there again–except this year he has promised to finally deal with the healthcare crisis.  Elsewhere, Republican and Democratic Governors are fighting Washington for their healthcare dollars, indicative of the national consensus for reform, but the Cook County Board of Supervisors drops the ball by fighting for their patronage jobs instead.  Meanwhile bloggers and editorialists check in on the state of healthcare reform in this country.

Brought to you by the National Nurses Organizing Committee as we organize to make 2007 the Year of SinglePayer Healthcare.

The battle for genuine healthcare reform is shifting now to California, where tomorrow Sen. Sheila Kuehl, hero of the SinglePayer movement, will re-introduce SB840, the nation’s signature SinglePayer bill.  It was vetoed by Arnold Schwarzenegger last year even though, as Senator Kuehl remarks, 

“SB 840 represents the gold standard for healthcare reform-the plan that will move California into healthcare solvency and security, not only for ourselves, but for the generations that will follow.”

The time for this bill is now:

Universal health care is possible.  Polls are showing that 60% of Californians now support a publicly funded universal health care system over the current system.  The conversation is steering away from whether we need to enact such a system in favor of how.  SB 840, the California Universal Healthcare Act, is a very important step forward in this because it answers the how.

Here’s how it works:

SB 840 is the only proposal that establishes universal, affordable, comprehensive health insurance for all Californians and that guarantees the right of each patient to choose his or her own doctor.  SB 840 replaces insurance companies with a state-wide trust fund that collects premiums paid by employers and individuals, sharing the responsibility for funding.  This reduces the administrative portion of California’s healthcare costs from nearly 30% to under 10%.  With everyone in one risk pool, no one is denied coverage for a so-called pre-existing condition. Consumers are free to change jobs; start a business; go to school or start a family without losing the doctors they trust.

So what about Arnold?  He has promised to bring universal, affordable coverage to California.  His mask briefly slipped off this weekend, when he made a slightly different promise in reference to the insurance companies:  “You must let everyone make their profits.”

Nonetheless, he hopes to make his legacy with healthcare reform.  His problem is that his plan won’t work.  Legally, he won’t be able to mandate employers provide their workers with health care.  Practically, he won’t be able to mandate individuals to purchase insurance they can’t afford.  And financially, the numbers don’t add up. 

It’s interesting to note that Mitt Romney’s plan in Massachusetts is also facing severe problem; he over-promised and under-delivered.  Unfortunately for Schwarzenegger, RomneyCare was his inspiration.  Here’s one of many articles detailing the Massachusetts mess, in which a conservative activist notes “RomneyCare is in the intensive care unit, soon to be wheeled into hospice.” 

This kind of uncertainly is leading to legislative trouble for Schwrazenegger.  He has yet to find a sponsor for his bill, much of the state is still sitting on the sidelines watch the drama unfold, and it is entirely unclear that his plan will even get out of committee.  Moreover, the California Nurses Association today unveils a wide-ranging media campaign to shape public opinion about the Governor’s plan, and spread the word that it is an insurance industry giveaway barely pretending to address the problems of cost and access of healthcare.  The San Francisco Chronicle writes:

The ads are strong and striking in a political arena that so far has treated the governor’s health care plan with kid gloves.
Although a lot of interest groups have expressed doubts about parts of the governor’s plan, there’s been little public criticism. Many groups, like the Service Employees International Union and the California Chamber of Commerce, have said that they are withholding judgment until the legislative process takes it course and at least, so far, are willing to work with the administration. The nurses do not appear interested in being part of that effort.
“We will never be a part of any plan that benefits only the big insurance companies,” said Chuck Idelson, association spokesman.

Schwarzenegger will have to choose between affordable, universal coverage under the SinglePayer system proposed by Senator Kuehl or breaking his promise of healthcare reform.  The movement for SinglePayer healthcare runs through the California legislature for the next few months.

Around the country, despite the strong public mood for an increase in healthcare, much of our public health system is in deep peril.  A bi-partisan coalition of Governors is raising a red flag about underfunding of the State Children’s Health Insurance Program, a stop-gap program which helps millions of families.

The program in question, the State Children’s Health Insurance Program, covers more than six million children in families that have too much income to qualify for Medicaid but not enough to buy private insurance.

Karen A. Smigielski, a spokeswoman for the Minnesota Department of Human Services, said her state had a federal allocation of $48.6 million this year, would run out of money in July and would need $15 million to continue the program as it is.

In a separate letter to Congress, the National Governors Association criticized a Bush administration proposal to cut federal Medicaid payments to public hospitals and nursing homes. The White House says the changes are needed to ensure the “fiscal integrity” of Medicaid and to curb “excessive payments.”

It is extraordinary that Republican governors are forcing a confrontation with a Republican President over a healthcare issue.  Are we seeing healthcare emerge as the new third rail of American politics-the issue that no candidate dares to fail on?

If so, Cook County Board President Todd Stroger in Chicago hasn’t gotten the message.  Many of Cook County’s 5.2 million residents rely on their public health system, which is among the best in the nation.  Not for long, if Stroger has his way-his new budget would cut nearly 10% of the system’s nurses and close half the clinics, while maintaing 400 high-paid patronage jobs doled out by the politicians.

The County’s RNs, represented by the National Nurses Organizing Committee, promises a furious fight-back.  Watch this one.

Finally, the Agonist notes why market-based health insurance simply CANNOT work,  USA Today notes that we are approaching a choice: change the employer-based system of healthcare or junk it, and an insurance corporation executive argues that it’s not his bloated industry driving costs in our healthcare system-it’s those darn, sick patients!

If you want to join the fight for single-payer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

(Shum is the type you want to have in a foxhole with you and CNA rocks! – promoted by blogswarm)

The California Nurses Assocation/National Nurses Organizing Committee will spend 2007 organizing for John Conyers’ “Medicare for All” bill, and Sheily Kuehl’s California Health Insurance Reliability Act.  Thesd kinds of single-payer healthcare plans are the only affordable, just way to provide a single standard of high quality care to all people.

We’re developing our internal blog; below is today’s news on the fight.

LOS ANGELES TIMES-Superstar columnist Patt Morrison notes the problem at the heart of today’s broken health-care system: insurance corporations.  America wastes hundreds of billions of dollars a year to subsidize a private insurance industry that does little but create a middleman between patients and care providers, while frittering away care dollars on marketing, profits, and bureaucrats AND denying coverage to customers it doesn’t like.  Take it away, Patt: 

Business, which has a firm grip on the legislative joystick, hits the panic button at talk of single-payer healthcare or universal healthcare, and it hauls out its own boogeyman phrases, such as “job-killer” and “drag on the economy.”

I’ll tell you what’s a drag on the economy. Healthcare insurance that’s impossibly expensive, or impossible to get. If the United States wants a vital economy of personal enterprise and risk-taking, then it needs to guarantee health coverage, period. Americans are willing to take chances in business and careers, but not with their families’ health, or their own.

She notes that Arnold Schwarzenegger-a 59 year-old cigar smoker-would find it impossible to buy health insurance for himself.

ABC NEWS- Finds great news on the battle for single-payer healthcare.  Rep. Barney Frank, incoming chair of the House Financial Services Committee, will offer the business community a “grand bargain” that includes single-payer healthcare and extension of unionization rights in exchange for pro-business policies on trade, immigration and direct foreign investment.

LOS ANGELES TIMES and SACRAMENTO BEE-Governor Arnold Schwarzenegger today begins a PR blitz for the Monday announcement of his healthcare reform plans.  He had promised “universal” health care, but is dialing that back to just include more coverage of the state’s children.  What about adults and seniors?

The LA Times reports that his plan for securing health insurance of the state’s 763,000 children would cost approximately $400 million, and the Sacramento Bee reports it will apparently be run through a state program known as Healthy Families.  While details of the plan for adults and seniors of his plan remain sketchy, it appears to fall into the “much more of the same” category-extending business-based coverage through private insurers, perhaps with an individual mandate that criminalizes those who don’t purchase insurance.  This is a recipe for continuing the trend of declining quality and exploding healthcare costs, while leaving significant portions of the population without coverage or access to the quality care they need.

NEW YORK TIMES- Governor Eliot Spitzer is proposing legislation that would expand Medicaid and state children’s insurance to cover more New York residents.  Like Schwarzenegger, Spitzer is choosing a “nibbling around the edges” approach that does not resolve the fundamental and tragic problems in our healthcare system that are leading so many of us to pain, heartbreak, financial ruin, and early death.

SAN FRANCISCO CHRONICLE-Reports that 8 out of 10 state residents want the government to assure health coverage.  Do the politicians know this?

THE HEALTHCARE BLOG-Carries an interesting proposal for a partial single-payer system, combining Medicaid, the public health systems and other institutions into a National Health Service for the Uninsured, which could serve as a model for a national health program.

NEW ENGLAND JOURNAL OF MEDICINE- Overviews the Democratic agenda on healthcare.  They’ll start with the feel-good stuff-prescription-drug pricing and embryonic-stem-cell research.  It’s not clear where they go after that. 

  BLACK COMMENTATOR- I just found this excellent article from a couple of months ago in which Marilyn Clement lays out “A Strategy for seeking a national-single payer healthcare system that will cover everyone in the United States.”