Tag Archives: AB 8

Back to Square 1, but this time, forget Massachusetts

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 it would 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…

And just why doesn't it work? Oh, yeah, right, you can't force people to choose health insurance over food and shelter. And insurance companies are unwilling to cut their rates of profit.

The “cheapest” insurance plans offered through the state program lack prescription drug coverage and include an annual deductible of $2,000 for individuals and $4,000 for families (check-ups and other preventive care are typically excluded from the deductible).

That means people with significant medical needs could be forced to spend upward of 10 percent of their income on health care. Democrats in the California Legislature, by contrast, are pushing for an out-of-pocket cap of 5 percent.

So, can we think about this a little more productively, and without all of the magical thinking?

The No-Brainer Healthcare Reform, Or, The Importance of a “Real” Job

Back when AB 8 passed, I said it didn’t accomplish everything I would like it to do.  And I think that’s abundantly clear to everybody, from every which way you look at it.  The obvious failure in the healthcare system is the employer-based system itself. It is now falling apart, and the individual healthcare system is not yet robust enough to be a replacement.  So, you end up with people, even perfectly healthy people like myself, denied coverage.

But the no-brainer in there? A state health insurance pool. The state needs to organize a pool that will allow people to buy insurance, at a reasonable price, backed up by the power of the state. There are thousands, probably millions, of people who would be happy to pay for health insurance, if they could just get it.

So, without getting too personal about my situation, I’m going to tell you my story. Not that being too personal has really stopped me in the past, but oh well.  All future Oppo researchers, flip the page.

As many people who read Calitics regularly know, I’m a recent graduate of the Goldman School of Public Policy at the state’s premier institution of higher learning, the University of California Berkeley. (Yeah, take that, UCLA!) My student health insurance terminated in the middle of August, and so I tried to apply for Kaiser.  But, you see, the questions are not so easy to answer no to.  In essence, to get coverage you either lie or get denied.  I told the truth, and I got denied.  For example, check out Blue Shield’s application questions. I don’t want to pick on Blue Shield, or even Kaiser, because there are worse companies, but well, the whole system stinks, so I’ll pick on everybody.

So, tell me you can answer the favored choice on some of those applications.  For example, how about the “skeletal system” question:

Musculo-skeletal system — such as: pain, injury, sprain, or other problems of the neck, spine, or back; sciatica; herniated or bulging disc(s); curvature of the spine; scoliosis; pain, injury, or other problems of the joints, bones, or muscles; arthritis; rheumatoid arthritis; temporo-mandibular joint syndrome (TMJ); Lyme disease; broken bones or retained hardware; dislocation of joints; bunions; hammertoe; carpal tunnel syndrome; physically handicapped; polio; amputations?

So, they group back injuries with sprained ankles? Of which, I have had one within recent memory. So, I answer yes. But there is no room to explain that you injured your ankle in a basketball game, and it’s not been a problem since.  Same thing with several other sections of the application. They give you these massive groups of disorders, major and minor, and then expect you to answer with no explanation. It’s pretty much a joke. If you tell the truth they deny you now. If you lie, they rescind coverage, and you end up even worse than square 1. 

And then if you do lie on the healthcare application, you have to make sure you keep lying to your doctors. So, say I had another ankle sprain, had I lied, I guess I would have had to say to my doctor, “Uh, yeah, never had anything wrong with my ankle, doc.” That kind of dishonest doctor/patient relationship helps nobody. It increases costs, by requiring additional tests and what not, and delays necessary treatment.  But for many in California, it’s either “Lie or Die.” That’s no way to run a healthcare system.

The funny thing here? I’m extremely healthy. I run several times a week and haven’t been to the doctor for several years. Even if you were going to cherry pick, you would want to cherry pick me. I mean, I hate the doctor, and certainly don’t go there for kicks and giggles.  Yet as somebody who is trying to build a career slightly out of the traditional mold, I am discouraged at every corner.  In other words, this health care system is a way to discourage small business growth in a way that is far more pernicious than any tax.  You are left with a crap shoot, or worse, left living your life based on how you can get health insurance. It’s wrong, it’s bad for our economy, and it’s bad for Californians.

But a state health insurance pool wouldn’t even be that hard to organize, and should be a no-brainer. Sure, Blue Cross will fight it, but they fight everything.  So, all you Legislators out there, how about this as the first course of business? Get a state health insurance pool passed as the first order of business in the special session, separate of any other grand insurance reform. And then get on to the grand notions of reform (and hopefully to single payer) during the rest of the session.

Or, hey, anybody want to hire me and get me on your health insurance group? Maybe we can provide insurance one blogger at a time.

September 11, 2007 Blog Roundup

Today’s Blog Roundup is on the flip. Let me know what I missed.

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Things to Read Today

Health Care (AB 8)

Environment &

Reform Efforts and
“Reform” Efforts




Electoral Politics

All the Rest

AB 8, healthcare reform, heads to the Governor

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.

Press release over the flip.

SACRAMENTO – Historic health care reform legislation extending coverage to millions of California’s uninsured, including all children, was approved by the state Senate and Assembly today by votes of 22-17 and 45-31, respectively.

Assembly Bill 8, co-authored by Assembly Speaker Fabian Núñez (D-Los Angeles) and Senate President pro Tem Don Perata (D-Oakland), now heads to Governor Arnold Schwarzenegger’s desk for consideration.

“I believe today is an historic opportunity for California to put itself on the map once again, to send a loud and clear message to Washington, D.C. that the inaction of Congress and our President to deliver on health care reform is falling on California and the state legislature,” Speaker Núñez said on the Assembly floor. “This year we will lead the nation in real comprehensive health care reform.”

“This bill is not perfect, but it’s the best we could come up with this year and better than anything produced by any other state in the nation so far,” Perata said. “We’ve taken a giant, important step here by coming up with a practical, workable plan to make sure every working Californian has access to affordable health care.”

“The Governor should sign this,” Perata added. “However, if the Governor rejects this, we will pick up ourselves and go at it again. I am committed to fixing California’s broken health care system, and if we need to do it in a special session, so be it.”

“AB 8 is based on the principal that health care shouldn’t just be available for those that can afford it, but that it should be a right for each and every Californian,” Speaker Nunez added. “This bill represents more than a year and a half of work on the part of Democrats in both the Assembly and Senate to come around to a comprehensive health care reform package for California.”

AB 8 would extend health insurance to more than two-thirds of the 5 million Californians now uninsured. AB 8 would also insure all children, take steps to rein in spiraling medical costs and guarantee coverage for people who have pre-existing medical conditions.

The legislation does this through a system of shared responsibility in which employers, employees and government each pays a portion of the costs.

AB 8 is backed by a diverse array of labor groups, children’s health advocates, and others, including the American Federation of State, County and Municipal Employees (AFSCME), California Labor Federation, AARP, Health Access, 100% Campaign, Association of Community Organizations for Reform Now (ACORN), California Teachers Association (CTA), and Service Employees International Union (SEIU).

AB 8 is the product of close to two years of negotiation and engagement with health care providers, businesses, labor, hospitals, doctors, children’s health advocates, and others interested in promoting comprehensive health care in California. AB 8:

ü  Builds on the employer-based system in which most Californians already get their health care;

ü  Promotes shared responsibility from employers, employees, and where necessary the state;

ü  Mandates that most employers must meet a minimum spending threshold of 7.5% of payroll on insurance, contributing that fee into a statewide fund or spending it directly on their employees;

ü  Allows all employees whose employers pay a fee to get coverage through a statewide purchasing pool that will negotiate for discounted prices with health insurers;

ü  Encourages employees to use pretax income to pay for health insurance premiums;

ü  Provides prorated subsidies for families below 300% of the federal poverty level so working people can afford to pay their insurance premiums;

ü  Mandates that insurance companies must use 85 cents out of every premium dollar to go to health care, not administration;

ü  Ends cherry picking by insurers, ensuring that most people will have to be offered coverage by insurance companies at a competitive rate;

ü  Establishes the new California Health Care Cost and Quality Transparency Commission and requires the commission to develop, implement and update a health care quality and cost containment plan to help improve health outcomes for Californians and keep health care costs affordable;

ü  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;

ü  Promotes prevention and management of chronic disease such as asthma and diabetes;

ü  Assists with personal health and wellness management; and

ü  Simplifies benefit choices in the insurance market so that everyone can make real world, apples to apples comparisons when they are choosing a health plan.

AB 8 Supported By Legion of Doom…

Update: AB 8 Passed the Senate and the Assembly

(Note: I work for the It’s Our Healthcare Coalition which includes member organizations in support of both SB 840 and AB 8).

This morning, Assembly Speaker Fabian Nunez and Senate Pro Tem Don Perata held a press conference about AB 8. 

They were joined by supporters of AB 8 such as Count Dracula, the CEOs of all of the major health insurance companies in California, the honorary co-chair of the Schwarzenegger for Senate 2010 committee, and a bunch of people who like to drown kittens. Oh wait, that’s not what happened at all. 

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.

[More on the jump]

First, let’s look at some of the groups who have come out in support of AB 8:

They’re not exactly the Legion of Doom

Were AB 8 to pass, it would represent the single largest expansion in health coverage in decades.  It would extend coverage to literally millions of Californians. AB 8 would cover approximately 70% of the uninsured, a tremendous increase over SB 2 (passed in 2003), which would have covered approximately 20% of the uninsured had it not been repealed via referendum (Prop 72) in 2004. 

There is no denying that AB 8 is not universal healthcare.  But there is nobody who is seriously arguing that true universal healthcare, much less single-payer healthcare, will be signed into law in California this legislative session. 

And so those who argue that we ought to withhold support for AB 8 in favor of waiting for something better (e.g. SB 840) are actually saying that it is better to continue to allow people to suffer now and take the risk that nothing substantial will happen for years instead of helping those we can in the interim.

For the 4.9 more than three million Californians who would get coverage under AB 8, the issues are real and urgent, and asking them to wait even another year is asking them to endure the risk of incalculable harm: bankruptcy, preventable sickness and death, harm to themselves and their loved ones.  It is fine to argue that AB 8 does not represent a complete solution to the healthcare problems we face, and I would agree with that.  But absent a strong argument (one that shoulders the burden of proof) it’s simply callous to ask that others be martyred and denied protection based on some abstract political calculation. 

And make no mistake about it, a political calculation is what undergirds all of the arguments against AB 8 from those who will not tolerate anything less than a jump from the status quo to a single-payer system in one fell swoop. 

There is no reason that I have seen offered by supporters of SB 840 to oppose AB 8 in its current form except that a) AB 8 putatively helps the insurance companies by expanding health insurance coverage to more people and b) passage of something now might stymie a change to a universal or a single-payer system. 


First, let’s deal with the issue of momentum.  Opponents of AB 8 like the California Nurse’s Association have (amazingly) pointed to the enactment of Medicare as an example of gradualism gone awry, thereby killing momentum for fundamental reform.  RoseAnn DeMaro, the Executive Director of the California Nurses Association, in an article with the inflammatory title of Whose
Life Doesn’t Count?

With public frustration over the collapse of our healthcare system mounting, we have the greatest opportunity in years to achieve fundamental reform. Yet the gradualist approaches would undercut the momentum and squander that opening.

Our most successful national health program, Medicare, also provides one of the best arguments against incremental steps. When Medicare was enacted 40 years ago many contended that the dream of a full national health system was right around the corner.

Four decades later, Medicare has not been expanded. Most of the changes have been contractions – higher out of pocket costs for beneficiaries and repeated attempts at privatization by the healthcare industry and its champions in the White House and Congress.


You follow that logic?  Medicare is “our most successful national health program,” which demonstrates that we ought not to take incremental steps like…the enactment of Medicare.

We know we can help millions of people now. We don’t know whether it is even possible, much less likely, that we will be able to enact more meaningful reform in the next couple of years.  I don’t think that this means we pack up and settle for something short of a solution.  But taking one affirmative step towards a solution does not mean that you can’t take another step later on.  Does anyone really think that enacting Medicare seriously made us worse off? Would any progressive, if they could go back in time, argue against its enactment because of our current situation? Bueller? Bueller? 


Anyone who’s concerned about the role of insurance companies in our healthcare system would be perverse to oppose AB 8. Here’s why: AB 8 substantially reforms the role of insurers in our healthcare. It sets a floor for the percentage of premium dollars that must be spent on healthcare (85%). It creates a public insurer to change the playing field and guarantee that there’s real competition with low overhead and driving the market in the right direction. Finally, it bans denial of insurance for pre-existing conditions and actually requires health insurance plans to help fund a real, adequately-funded, high-risk pool.

Many of the things we hate about insurance companies are now completely and utterly legal.  It boggles my mind that anyone who supports single-payer healthcare wouldn’t, while we still have the current system, want insurance companies to be better regulated.

Schwarzenegger Calls For Special Legislative Session On Health Care: A Fait Accompli?

(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:

The legislation would outline a program requiring nearly everyone in California to buy insurance, with subsidies for people making less than four times the federal poverty rate, or about $80,000 a year for a family of four. Insurers would have to cover everyone who applied, regardless of pre-existing conditions, and could not charge customers more because they had been sick in the past.

The subsidies, along with an expansion of free care for the poorest of the poor, would be financed by a new payroll tax, an increase in the sales tax, a special fee on hospitals and an infusion of federal money. The new state charges would be put before the voters because they would require a two-thirds vote for approval in the Legislature, where Republicans have vowed en masse to oppose any increase in taxes or fees.

But before such a deal can be reached, Democrats might send Schwarzenegger legislation that would place the entire burden for expanding access to insurance on employers — an approach the governor has already said he would reject. Labor union supporters of the Democrats may want to force Schwarzenegger’s hand on that issue before any discussions about a compromise can occur.

Once Schwarzenegger vetoes that bill, if it comes to him, he would call the Legislature back into a special session to focus on health care and a handful of other issues. If that happens, the governor’s aides believe they could reach agreement with lawmakers relatively quickly.

If so, such a deal would set the stage for a ballot measure campaign in 2008 that would promise Californians two things: an expansion of health insurance to millions of people who lack coverage today and protections against losing coverage for people who already have it.

Well, let’s take a look at what happened today.  An amended AB8, with positive movement on affordability and cost containment, received the support of health care experts and top labor groups.  The Senate and Assembly schedules a vote for today which has only an employer-based pay mechanism.  And the governor pledged to both veto it and call a special session.

Gov. Arnold Schwarzenegger said today he will call a special session of the state Legislature to deal with health care, as lawmakers prepared to debate a Democratic plan he has pledged to veto […]

“What everyone wants, and what we all want, is access to health care so it is affordable and so that everyone can have health care, and no one ever has to worry about it again, that they maybe have to file for personal bankruptcy because they have to stay in a hospital for a few days,” Schwarzenegger said at the University of California, Los Angeles. “So we are working on this right now. We’re going to have an extended session, a special session that we are calling today.”

Schwarzenegger says the Democrats’ bill asks too much of employers, while they reject his demand that health insurance be mandatory.

Sounds like Weintraub got some good information.  The question is whether the resolution will wind up as Weintraub suggests it.  If so, this entire move by the Democratic leadership and their allies in labor has been an enormous kabuki dance.  They get a chance to say they tried it their way but they just had to compromise with the governor, when it seems this may have been part of the deal all along.

Maybe we’ll get meaningful health care reform out of a special session.  But I’m not terribly optimistic.

UPDATE: In addition, it’s not clear to me that having 50 separate health care deals in 50 states is a desirable outcome.

Health Care Updates: AB 8 to Pass, But What Will Final Compromise Look Like?

Over the last few days there has been significant legislative movement on AB 8, the Núñez/Perata health care reform bill. Anthony Wright of Health Access California describes some of the crucial amendments that passed on Friday, amendments which Randy Bayne notes garnered the Cal Labor Fed’s support of AB 8 as the bill now includes some cost containment protections (though not as much as hoped, since caps on hospital billing weren’t included).

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…

In today’s Sac Bee, Daniel  Weintraub suggests that a health care deal “is coming into focus” and describes the details:

The agreement would likely come in two pieces — legislation that lawmakers would approve this week or soon after in a special session, and a separate measure that would appear on the November 2008 general election ballot to finance the plan.

The legislation would outline a program requiring nearly everyone in California to buy insurance, with subsidies for people making less than four times the federal poverty rate, or about $80,000 a year for a family of four. Insurers would have to cover everyone who applied, regardless of pre-existing conditions, and could not charge customers more because they had been sick in the past.

The subsidies, along with an expansion of free care for the poorest of the poor, would be financed by a new payroll tax, an increase in the sales tax, a special fee on hospitals and an infusion of federal money. [A tax that would have to be put to voters – Robert]

It’s not clear where Weintraub is getting this from – but it is a major cause for concern, because such a compromise includes the thoroughly odious individual mandate. The centerpiece of Mitt Romney’s reform, individual mandates have proved a disaster in Massachusetts, with sky-high premiums and insufficient guarantees of care. Even if subsidies materialize – and as the current plan depends on federal funding of programs like S-CHIP for this that is being opposed by the Bush Administration, it seems those subsidies are far from certain – it will not be enough to prevent the premium costs from ruining many who are underemployed, work part-time, or face other sources of financial stress.

An individual mandate is poison, and must NOT be a part of any final health care plan. All it would accomplish is a massive transfer of wealth from struggling individuals and households to insurers, who would still be able to deny care, slash benefits, and raise premiums. At worst it would be junk insurance that folks would be forced to buy.

I have expressed my skepticism of AB 8 in the past. I think it suffers from a common misconception in America, that the problem is a lack of health insurance, when in fact insurance is by no means a guarantee that people will receive the care they need, or that they will get that care at an affordable price. As it stands now, AB 8 does appear to be a worthwhile plan. Even though the California Nurses Association is right that it won’t do much to solve the core problems, and that we should be trying to get rid of the health insurers, AB 8 seems like it would be able to extend to more Californians some kind of coverage with sufficient, though incomplete, cost containment provisions. As a stopgap until we get single-payer, AB 8 may work, although I am also skeptical about whether it’s worth a ballot fight – those resources should be reserved for a single-payer ballot effort.

That conditional support of AB 8 would vanish entirely if an individual mandate were to be included as part of a final compromise. And as that idea keeps getting floated, it becomes all the more important that we let our Democratic legislators know that an individual mandate is completely unacceptable.

As someone who is currently uninsured, I would be willing to fight against an individual mandate plan, and would certainly vote against a ballot measure to fund a plan that included an individual mandate. Californians want health care reform – but that doesn’t mean any reform is good reform.

Health Reform and the Year of Magical Thinking

(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.

Sunny and Cheery Don Perata

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.

We’ll take a look at this and more, cross-posted at the National Nurses Organizing Committee/California Nurses Association’s Breakroom Blog, as we organize to make 2007 the Year of GUARANTEED healthcare on the single-payer model.

California voters are moving to support a system of guaranteed healthcare on the single-payer model-like that working in every other industrialized democracy in the world.  This is, obviously, because voters are victims of the insurance industry, whereas most politicians are beneficiaries of huge donations from insurers.  As such, both Schwarzenegger and Nunez are supporting plans to increase the customers, revenue, and medical interference of health insurance corporations…or would be, if they could just get their act together.

Via the Sac Bee we get some news suggesting that they can’t:

Gov. Arnold Schwarzenegger and legislative leaders plan to meet today to discuss health care reform, but state Senate President Pro Tem Don Perata is “not optimistic anything substantial” will be accomplished this year.
In an interview with reporters after Monday’s Senate floor session, the Oakland Democrat said a “lot of momentum” was lost during the 52-day budget stalemate that ended last week.

I’m not sure if Dan Walters was arguing for the proven simplicity of a single-payer system when he wrote these words about a possible healthcare “deal”, but he should have been:

The health insurance gap has plagued California for decades, although it appears to be worsening due to changes in the economy that have left fewer workers with employer-provided coverage. As adjournment approaches, the danger is not so much that the issue won’t be addressed but that having promised to do something about it this year, politicians will enact some complicated scheme that has not been fully vetted and will collapse of its own ponderous weight.

In case you don’t think this is a big deal, the Washington Post pointed out that it could set the tone for the nation.  And they’re right…if insurance-bought politicians can pass fake healthcare reform here, and hurt patients in the guise of helping them, it could happen anywhere.  That’s why we have to stop it here and now. The insurers want to lock in their profits and kill guaranteed healthcare forever.  That’s why we have to stop them now.

And finally…(reg. req’d.) Paul Krugman makes fun of the right-wing paranoia about healthcare.

To join the fight for guaranteed healthcare (with a “Medicare for All” or SinglePayer financing), visit GuaranteedHealthcare.org, a project of the National Nurses Organizing Committee/California Nurses Association.

Health care options on the table at next Pension Commission meeting

by Randy Bayne
X-posted at The Bayne of Blog

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.

Besides discussions on the process by which its report will be developed, the Commission will also have health care on the San Jose agenda.

Sumi Sousa, health-care policy adviser for Speaker Fabian Nuñez, D-Los Angeles, is also expected to give testimony Thursday. Núñez’s AB 8 is the primary legislative vehicle for health-care reform this year. The measure is co-sponsored by Sen. Don Perata, D-Oakland.

I would argue that AB 8 is only considered “primary” because Speaker Nuñez says so, and it is the only bill that has been allowed to see sunlight.

Also on the agenda is the only real solution to the health care crisis, SB 840, Senator Sheila Kuehl’s single payer plan. Sara Rogers, chief of staff to Sen. Sheila Kuehl, will be making the presentation.

Commission spokeswoman Ashley Snee said the commission will be looking at how the various proposals in the Capitol may specifically impact post-retirement health-care benefits. Snee said health care is “inextricably linked” to the discussion of governmental obligations to former employees.

I can tell you how single payer will impact post-retirement benefits. A universal single payer health care system would take health care for retirees out of the retirement system and wipe out the underfunded/unfunded liabilities that currently exist. The solution to the retiree health care issue is before us. All that is needed is the will to take on the insurance industry and do what every other industrialized nation in the world has done successfully — stop tinkering with half solutions like AB 8 and pass a universal, single payer health care system like the one proposed in SB 840.

Single payer would eliminate the need for post-retirement benefits to be provided through retirement systems. Single payer eliminates the underfunded/unfunded liabilities that post-retirement benefits have caused.