The massive health care reform plan brokered by Governor Schwarzenegger and Speaker Nuñez has been fraying at the edges a bit in recent weeks.  State hospitals appeared to waver on supporting the fees that would be charged to them under the plan, and hearings in the Senate Health Committee were delayed a week pending an analysis from the Legislative Analyst.  That hearing is currently scheduled for Thursday tomorrow, but State Senator Leland Yee just put a major wrench into that plan.

On the eve of a hearing for landmark health legislation, a spokesman for Sen. Leland Yee said the San Francisco Democrat will oppose the health care measure. The move throws into limbo whether the legislation has the necessary votes to move forward.

“The costs are a big concern for him,” said Adam Keigwin, a spokesman for Yee, regarding the $14 billion health care price tag that coincides with a projected $14.5 billion budget hole […]

Keigwin said Yee conferred with labor leaders in his district over the weekend who were “almost unanimous” in urging Yee “to vote no.”

With Health Committee chair Sheila Kuehl already opposed to the bill, this means that it would be unable to get out of committee without a Republican crossover vote.  And even with moderate (for the GOP) Abel Maldonado on the committee, that is unlikely.

I don’t think this is the end of the bill by a longshot.  Yee or Maldonado could have their arm twisted, or Kuehl could let the bill pass without a recommendation.

What happens next is unclear, though options certainly remain for passage.

For instance, Senate President Pro Tem Don Perata could ask Kuehl to grant the measure a courtesy vote, allowing it to proceed to the Senate floor despite her personal opposition.

In an interview Tuesday morning, Kuehl reiterated her position, saying, “I’ve been very clear with all the advocates and everybody that I do not favor the bill.”

She said she had not been contacted by Perata or his staff to support the bill. Asked if she would consider granting a courtesy vote if she was, she replied that she “can’t answer that.”

“In the Senate, we generally are equal as members,” Kuehl added.

Don Perata could also kick Yee off the committee and replace him, although he hasn’t exactly been wildly supportive of the bill thus far.

What will happen is anyone’s guess.  But for the moment, this is a major blow to efforts to overhaul health care in California.

UPDATE: Frank Russo has more:

There are rumors that the report of the nonpartisan Legislative Analyst’s Office, to be released soon-tonight or tomorrow morning-will not be all that favorable. That report had been sought by Senator Perata in December to further vet and test the assumptions made so that voters would not be faced with a ballot measure with shaky financial underpinnings in a year of a massive budget deficit, cuts in other programs including health, and uncertainties.

Making it even less likely that Perata will act.  But the pressure on him must be intense.

The UAW’s strike against GM is not just about their members’ healthcare…but also about the healthcare of millions of people not represented by a powerful union.  We’ll look at the potential impact of this historic strike and what it means for workers and the nation that is healthcare increasingly becoming the central issue for labor, both in bargaining and activism…

…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.

You probably know that the UAW has called a national strike against GM.  This is the first auto strike since 1976, the first strike against GM since 1970…and the first strike since the AFL endorse a “Medicare for All” style guaranteed healthcare plan.

And what are they fighting for?

G.M., in return, had pushed for the creation of a trust that would assume responsibility for its $55 billion liability for health care benefits for workers, retirees and their families….Union officials criticized G.M. for continuing to pay bonus compensation to its executives, while pressing U.A.W. members to make concessions.

No one keeps the stats, but about 90 percent of strikes are caused by the issue of healthcare.  The labor movement remains at the heart of the movement to protect and expand access to healthcare for all people, while employers are looking to get out of the healthcare field.  It is cruel and short-sighted of employers to just want to drop benefits rather than look for solutions that are in everbody’s interests.  Don’t take my word for it.  Ask GM Canada:

Just two years ago, GM Canada’s CEO Michael Grimaldi sent a letter co-signed by Canadian Autoworkers Union president Buzz Hargrave to a Crown Commission considering reforms of Canada’s 35-year-old national health program that said, “The public healthcare system significantly reduces total labour costs for automobile manufacturing firms, compared to their cost of equivalent private insurance services purchased by U.S.-based automakers.” That letter also said it was “vitally important that the publicly funded healthcare system be preserved and renewed, on the existing principles of universality, accessibility, portability, comprehensiveness and public administration,” and went on to call not just for preservation but for an “updated range of services.” CEOs of the Canadian units of Ford and DaimlerChrysler wrote similar encomiums endorsing the national health system.

And guess what?  It’s only going to get worse.  Just like GM will try to dump their U.S. employees out of the healthcare system, and end their own interest in solving the healthcare crisis, many of the healthcare reform proposals being floated by politicians will encourage the same thing to happen. 

Let’s look at the emerging deal between Schwarzenegger and the legislature in California:

Employers spend between 12% and 15% of payroll on average for health care, and CNA fears either the 4% or 7.5% plan would encourage them to move to high-deductible insurance policies with limited services, Communications Director Chuck Idelson said.

“If you think we have a lot of labor strife now over health-care benefits, wait until this plan goes into effect,” Idelson said of the Democratic bill.

Unlike employers, labor unions, however, won’t give up the fight for guaranteed healthcare.  Why?  Because more and more employers think of Medicaid and charity care as their health benefit.  And now even healthcare workers are in danger of losing their healthcare. 

Strikes like the UAW’s will help us build momentum for guaranteed, single-payer healthcare-and force corporations to really grapple with the crisis.  The rapid unionization of America’s RNs will also provide the movement with a committed, organized, knowledgable group of activists who are personally committed to improving patient care. 

As UAW is standing up to GM, California’s nurses will take the lead in standing up to the fake healthcare reform bill that is being pushed by a “coalition of the willing” Sacramento insiders.  Healthcare hero Sen. Sheila Kuehl, author of the groundbreaking single-payer bill SB 840, gives an update on the strategy:

  “I continue to believe that the movement that’s been building for single payer, a movement that has seen support for a single payer universal health care system more than double over the last six months alone, will continue to build in ’08 in’09 in 2010,” Kuehl said. “Then, with a new governor, perhaps there might finally be a chance to get a signature on the bill that is actually the best solution for businesses, for employees, and for all the people in California. Because if you take the insurance companies out of the system, and they are the only entity that adds no value at all to the provision of health care, the overall costs for health care in California drop $19 billion in the first year alone, simply because we’re finally not paying their inflated overhead and profit.” 

And finally, Zenei Cortez, RN, a member of the Council of Presidents of the California Nurses Association/National Nurses Organizing Committee issued the following statement on the UAW strike:

America’s registered nurses recognize that the UAW is standing up not just for their own healthcare-but for the healthcare of all our patients.  The California Nurses Association and National Nurses Organizing Committee strongly supports their efforts, and will continue to work to see guaranteed healthcare won for autoworkers and everyone else in this nation.

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.

For all his “post-partisan” bluster, Arnold is a right-wing Republican at heart. Sure, he sometimes calls the GOP a “obese person in denial”, but away from the glare of media lights he busies himself gutting public transportation, or removing folks from state commissions who don’t toe a firm right-wing line.

It comes as no surprise then that Arnold is now engaging in one of the core right-wing practices – trying to roll back civil rights legislation by gutting state enforcement power.

Sheila Kuehl, proving that she’s more than just a force for single-payer, has been trying to draw attention to a proposal by Secretary of Consumer Affairs Rosario Marin that would eliminate the Fair Employment and Housing Commission’s administrative law judges (ALJs) and instead make FEHC staff responsible for handling discrimination complaints. This would have a crippling effect on state civil rights laws.

As Sheila Kuehl explains, these ALJs are essential to the effectiveness of state civil rights protections:

In 1992, under Governor Pete Wilson, the Legislature specifically authorized the Commission to hire its own ALJs. This was done because the OAH, which had been hearing cases and which Secretary Marin and the Schwarzenegger administration want to put back in charge, had proven to be both uneconomical and ineffective. The legal staff of the Fair Employment and Housing Commission had been required to use its time and financial resources to revise and rewrite over 90% of all OAH decisions in this area as incorrect on both the law and Commission policy One decision would have overruled the Commission’s own regulations. Another allowed an employer to ban all women from his workplace.

In other words, staffers untrained in the nuances of the law and with other duties were being forced to handle these complaints, making them both ineffective workers and ineffective enforcers of the law. By eliminating the ALJs and returning enforcement to the staffers, Marin and the governor’s administration are in effect trying to prevent the proper enforcement of state anti-discrimination law.

A commentor on one of the California Progress Report’s articles on the issue notes that Marin has been pushing this change for a while:

Marin has been pushing this for a while, even though she keeps inventing new reasons for it. First they claimed they wanted to move the current judges to Sacramento, because Chief Justice Ron George asked to take over the FEHC’s San Francisco office space for court admin. When that lie was exposed, they claimed it was all about the cost saving. Then they worked out a back-room deal with the head of OAH — the ALJ’s at OAH would hear the cases, but the cases would only go to ALJ’s with no knowledge about civil rights.

Ken Scudder, a SF attorney, left this comment in the same thread:

I’ve always admired the ALJs who work with state boards and commissions; they have somehow managed to survive and to persevere in their efforts to provide fair hearings and adjudication to employees, injured workers, the disabled and sick. They’ve all been the targets of right-wing Republican attempts, over the past 25 years and more, to gut and silence any essential state action for administrative remedy of the injuries, discrimination, and injustice that is so frquently [sic] the lot of those without power or wealth.

Enforcement is THE KEY to civil rights law. Activists learned this the hard way – although a raft of anti-discrimination laws and constitutional amendments were passed in the 1860s and 1870s, when the federal and state governments refused to enforce them, segregation, discrimination, and widespread inequality was the result.

By the 1950s and 1960s activists had finally gotten government to recognize the need to pass stronger laws, but they still had to fight to get them properly enforced. The result on the federal level were laws like the Civil Rights Act of 1964, or the 1965 Voting Rights Act, which contained extremely strong enforcement provisions, like the EEOC and the Department of Justice oversight of elections in specific areas targeted by the Voting Rights Act.

California saw similar struggles. The fight for a state-level anti-discrimination law and adequate enforcement power consumed activists in the 1940s and 1950s. By the 1960s California had strong laws, even though the best of them – the Rumford Fair Housing Act – was repealed by voters in 1964. In the early 1990s, with the FEHC staff overworked and the law not receiving adequate enforcement, Willie Brown helped strengthen its work by creating the ALJ system that has since proved effective in protecting all Californians from unfair and illegal discriminatory practices.

The need for a strong FEHC and effective enforcement is still clear to many Californians. At a time when anti-Latino bigotry is on the rise, when GLBT Californians still face hostility and the governor’s refusal to accept their basic human equality, the last thing we need is a weakening of the ability of Californians to get justice and fair treatment.

As Kuehl notes, a strongly worded letter opposing the elimination of the ALJs was sent to Secretary Marin, and its signatories included:

Senate Pro Temps Perata, Speaker Nunez, Senator Kuehl, and the chairs of Senate Judiciary Committee, Senate Labor Committee, Senate Budget Committee, Assembly Labor Committee, Assembly Judiciary Committee, Assembly Budget Committee, Latino Legislative Caucus, Legislative Black Caucus, API Legislative Caucus and the Legislative LGBT Caucus.

Kuehl reports that “the proposal to dismantle the panel of Administrative Law Judges has been removed from the Commission’s agenda with no word on how the matter will, ultimately, be resolved.” But given the longstanding desire of the right-wing to have the FEHC defanged, we cannot be certain yet that we’ve beaten back this attack on Californians’ basic rights.

A little activism goes a long way, and more is needed to ensure that this proposal is and remains dead.

Contact:

Governor Arnold Schwarzenegger
State Capitol Building
Sacramento, CA 95814
Phone: 916-445-2841
e-mail

Rosario Marin, secretary of the State and Consumer Services Agency, (916) 653-4090.

George Woolverton, chairman of the Fair Employment and Housing Commission, (323) 935-6669.

And thanks to all the California Democratic legislators, from Perata and Núñez to Kuehl, Mervyn Dymally, John Laird, and many others who have fought to prevent Arnold from setting back the cause of freedom and equality in California.

Whatever you do don’t be ladylike:

Barbara Ehrenreich was channelling Mother Jones when she gave this advice to 1,000 nurse activists gathered in California this week, but she really didn’t have to worry. Like her the nurses were channeling the famous labor leader, as the emotional gathering marked the true birth of a national nurses movement, whose women (and men) have made “elegant militancy” their calling card. 

We’ll take a look at some of the glowing press coverage and consider the implications for the important healthcare battles in California and the nation after the flip.
…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.

Here’s the deal: NNOC/CNA is the fastest-growing union in America, and we are dedicated to improving patient care with the kind of guaranteed, single-payer healthcare succeeding in nearly every other industrialized democracy.  In order to make that happen we aim to continue our rapid expansion, and nurses around the country are responding to our themes of patient care and nurse activism, and joining the union. 

In the words of Barbara Ehrenreich:

“Registered nurses have got to be at the forefront of the struggle for a just and egalitarian healthcare system in this country for the simple reason that you are the last generalists in the healthcare field…as well as the strongest, boldest, loudest voice for genuine healthcare reform in this country today.”

Unfortunately, RNs have never had a say at the national level, or any kind of real representation.  That’s why NNOC/CNA’s rapid growth is so important.  Over the last ten years, we’ve grown 350%.  Since 1992, we’ve gone from 17,000 members in California alone to 75,000 members in all 50 states, with nurses now active in numerous healthcare struggles, as well as sponsoring the key single-payer bills.

That’s why Media News Group says,

When the California Nurses Association/National Nurses Organizing Committee opens its convention today in Sacramento, it’ll do so as a darling of the national labor movement.

At a time when labor unions seem to be on the ropes …the CNA/NNOC’s explosive growth seems almost miraculous.
How’d this happen?
“We stopped looking at our role as patient advocates solely at the bedside,” CNA president Deborah Burger RN said Friday. “We’re patient advocates for the entire society, for the community as a whole. 

The LA Times suggests the impressive organizing success fuels the guaranteed healthcare movement:

From intensive care wards to the halls of Congress, they’re exerting growing influence over hospital practices and patient treatment. With the clout they’ve gained through unionization, they’ve raised their incomes and their profession’s profile.

Now they’re lobbying for a radical change to the country’s healthcare system, starting in California.

On Monday, hundreds of members of the California Nurses Assn. marched on the Capitol in Sacramento and pledged to continue to campaign for universal healthcare coverage.

The nurses actually marched *into* the Capitol Monday to protest an insurance-industry-friendly fake healthcare reform proposal, with 1000 nurses participating in the kind of dramatic protest not seen there in recent years.  Pics here.  One reporter called them “militants in tennis shoes.”

Why are we fighting so hard?  Because the insurance industry is about to see a bill passed in California that purports to reform healthcare but will in fact only entrench the failed, for-profit insurance companies right in the heart of our healthcare service. 

It is a concept that has to end here.  Governor Arnold and Assembly Speaker Nunez have between them taken almost $1 million from the insurance industry.  As a result, they’ve set the terms of the debate thus: should employers be forced to purchase expensive, wasterful, corporate health insurance for their employees or should individuals be forced to purchase it on their own?  The problem is neither choice is successful, and each will only delay the arrival of genuine healthcare reform.  We know how to fix this mess; we just need the political will.

The good news?  We’ve likely going to the ballot.  The public trusts nurses, likes unions, and looks to nurse unions for leadership on healthcare questions.  Our polling shows that the legislature’s “healthcare reform plan,” AB 8, starts at 49% support, but drops to just 25% when the public finds out nurses are opposed to it.  We led the defeat of Arnold’s anti-worker ballot measures in 2005 and we’ll do the same thing in 2008.

We’ll still have a healthcare crisis once the fake-reform ballot measure is defeated.  But we will have put the insurance industry in their place, taught politicians they need to grow spines, and further built the national movements of nurses and patients…setting the stage for day we can end the unnecessary pain and suffering inflicted on millions of patients by this cruel, broken system.

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.

(I’ve been wanting to write something about this for a long time, but here’s an informed opinion from a former legislator. In my view, this bottleneck is designed to vest power in the leadership – if they wanted more time for the process, maybe the Assembly wouldn’t have taken a month off just a month ago! – and ought to be a part of any reform agenda to make California even moderately governable. – promoted by David Dayen)

This article written by: Former Assemblymember, Hannah- Beth Jackson of Speak Out California

There is little doubt that watching legislation work its way through the process is much like watching sausage being made. The bottom line is: You don’t want to watch. Although theoretically it is interesting, informative and exciting to see the democratic process of law-making take form, in reality there is so much push-and-pull, give-and-take and last minute backroom dealing that it’s impossible to follow. It’s often impossible to understand.

So when the Speaker of the Assembly asks his members to “read the bill” when debating the frenetically altered and re-altered health care reform measure, AB8, it’s asking for a logical response to an impossible situation. How can one read a bill that comes to your desk literally “hot off the press”, so hot that you can warm your hands on the paper? How can you understand what’s there when it deals with a convoluted system in a convoluted way—with no opportunity to vet the latest in a series of compromises, re-writes and reformulated policy?

Granted, the efforts are the result of hard-fought and truly late-night negotiations, but there has been little time to analyze the possible impacts and “unintended consequences” of legislating at the 11th hour, with dozens of special interest groups hovering over the negotiations and dozens of people trying to craft language that fits the proverbial square peg into a round hole. That’s exactly what the end of session looks like on a good day. But here we’ve got what is billed as a major overhaul of the healthcare system in California, a measure that will lead the nation in healthcare reform. Really? Has anyone read the entire bill in its final form? Highly unlikely.

Having been there at the end of each of six legislative years, my bet’s on the fact that even the authors of AB 8 haven’t read it in its final form. How many pages is it? How many hours have people been up without sufficient sleep so they can even think straight? How do the final amendments affect earlier amendments? Does this create a seamless system or one with glitches, omissions, administrative nightmares, unexpected costs? Is it like some of the old American cities that were built piecemeal, like my hometown of Boston where the old joke goes,”You want to go three blocks down the street?….Well, you can’t get there from here.”

Much credit must be given to those dozens of staffers, stakeholders and legislators who have worked hard to put together this compromise mishmash of who pays for what, who’s covered by whom and when and how. This is a compromise bill for a system that needs an overhaul that takes the real villain out of the process entirely–the health insurance industry. But the Governor won’t hear of it–after all, the insurance industry is among his biggest supporters-and they give lots of money to both sides as well. And we have a governor who has vetoed the best chance at real reform and real coverage of all Californians when he vetoed Senator Sheila Kuehl’s SB840 last year. Her bill is the true reform, providing universal health coverage-similar to the Medicare system that has worked so well in this country for decades. But no matter, AB8 deals with the reality that we have a Republican governor who will hear nothing of removing profit from our health care delivery system. So AB8 is the compromise effort.

But with the clock ticking down, nerves fraying and concentration fading with exhaustion, the legislature is whirling through hundreds of bills, many of which have been totally “gutted” and rewritten with entirely new issues and language. This is an ugly time of year to watch the legislative process in action. And we’ve been very lucky over the years that so few mistakes have been made as a result. Of course, when they have, the mistakes can be enormous–remember the energy deregulation plan that was approved at midnight on the last night of session many years ago? I suspect no one read the bill then. As a result of the rush-to-judgment mentality that year, billions of dollars were extorted from Californians by companies like Enron among many others, a governor was recalled and rate-payers today continue to pay for that debacle.

It is hard to watch the goings-on in these last, crazy days, let alone be part of it. The most important part of legislating, I was told when I first arrived in Sacramento as a new Assemblymember, was to “do no harm.” I hope that this message was passed along to all the membership and that at the end of this year, they will not have done any as well. In the meantime, we can only hold our collective breath and hope.

1000 Registered Nurses storming the Capitol and clogging its halls in one of the most dramatic and militant protests in recent history was not enough to stop Sacramento politicians from selling out patients and rewarding their insurance industry donors with a major financial boon, in the latest step of a complex healthcare dance orchestrated by and for Governor Schwarzenegger

We’ll take a look at what it means for the drive for guaranteed healthcare nationally over the flip, but first take a look at these pictures from inside the Capitol this morning. 

…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.

The inside-the-Capitol rally was amazing.  While the Democratic leaders of the Assembly and the Senate voted to keep the health insurance companies in the business of profiting from care, a beautiful sea of hands-on caregivers chanted in the hallways, their pleas bouncing off the walls and permeating the entire building.  “Don’t sell out our patients! Single-payer now!”

But for today it wasn’t enough.  Here’s the deal: because they had to do “something” the California Senate just voted to send Governor Arnold a pro-insurance faux healthcare reform bill that nurses and healthcare activists have been trying hard to kill. 

Arnold will veto it–despite the fact that it is based on and basically similar to his own proposal.  Each bill will send more patients to the insurance industry, giving them more revenue and influence over medical decisions…meaning each bill will expose more patients to runaway costs, and force them to beg for healthcare from corporations that make money by denying it.

Here’s the good news: After vetoing the Senate’s bad bill, Arnold will call a special session to push his own bad bill, the next step in the process he’s choreographing.  This will give nurses and patients one more chance to convince politicians to do the right thing…and fix the healthcare crisis by getting rid of the insurance companies

Healthcare hero Sheila Kuehl explained her opposition to both versions of the insurance-centered bill:

Senator Kuehl’s statement in opposing AB 8 was generous in her praise for those who had worked on the bill and their improvements to it. But in the end, she told the Senate that she had learned of the problems caused by any approach that retains insurance. She said that, “For those of you who vote for the bill, I understand you are voting your hopes, knowing it will be vetoed by the Governor.”
Using the analogy of the Titanic for the current health care system, she said she had criticized some measures as rearranging the deck chairs, but that there has been a real attempt in AB 8 to “turn the direction of the ship.” But she said the Titanic was sunk because the ship had tried to turn rather than “facing the iceberg head on” which would have at least kept it afloat longer and saved more lives. I have no idea of the facts about the Titanic, but she made her point.

A former legislator-turned-progressive activist, Hannah-Beth Jackson, summarized the problems with both the Schwarzenegger and legislature’s approaches:

Schwarzenegger is insisting that everyone have health insurance. This is NOT universal healthcare, it is universal insurance- whether people can afford it or not. This deference to the insurance industry is maddening for those who realize the private companies are a major part of the problem and need to come out of the equation completely.

What does it mean nationally?  If the insurance industry can write the rules for healthcare reform in California, they can in many other states around the country as well.  We have to block it here.

Just for fun, here’s an article from this morning calling the California Nurses Association, the “darlings of the national labor movement.”

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.

Speaker Fabian Nunez went to the LA Times editorial board last week to tell them about the big plans he and Arnold Schwarzenegger are dreaming up: to take their hasty, half-cooked, gift-to-the-insurance-industry-masquerading-as-a-healthcare-reform-plan straight to the voters as a ballot initiative next year.

Not so fast.  A new poll release today by the California Nurses Association/National Nurses Organizing Committee finds considerable unease among the California public over the Schwarzenegger-Nunez plan.  Voters don’t want a bad bill just for the sake of having a bill; they don’t want a bill born from a dirty political deal; and they don’t want a bill that simply won’t work.  All of which adds up to trouble for the healthcare deal currently known as AB 8.  It would likely start out under 50% in the polls, and face an uphill struggle that would only get harder as voters learn about the opposition from the state’s nurses and healthcare activists.

The tragedy here is that these politicians are playing games while we have a historic opportunity to rid our healthcare system of the insurance industry that is poisoning it.  Sen. Sheila Kuehl’s SB 840 is based on the very systems that are succeeding in every other industrialized democracy in the world. 

This is a high-stakes issue not just for patients in California, but also for the future direction of the movement for healthcare reform around the country.  Fortunately, voters have smelled the rat.…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.

Greenberg Quinlan Rosner surveyed 700 voters on behalf of the California Nurses Association about the Schwarzenegger-Nunez healthcare plan.  The toplines:

More than two-thirds of California voters – a margin of 68 percent to 25 percent – said they prefer “making sure we pass healthcare reform that gets it right and improves the system, and not take the risk of passing bad legislation.”

More worrisome for the prospects of a ballot initiative:

In the Greenberg Quinlan poll, when provided a favorable description of AB 8, a plurality, but not a majority, of voters said they supported the bill, by a 49-40 percent.
But once voters were told of serious flaws in the bill, opposition rose to 50 percent while support fell to just 35 percent. And, when told it was opposed by nurses, opposition climbed further to 57 percent while support fell to just 25 percent.

Any ballot initiative that starts under 55% support is likely to lose.  But if voters had the option of voting for real reform, things might be different:

By contrast, by a huge margin of 70 percent to 21 percent, voters said they would be willing to pay more for a health plan that covered everyone, had no co-pays or deductibles, wasn’t attached to one’s job, and guaranteed choice of doctor or hospital. That’s the approach reflected in Sen. Sheila Kuehl’s SB 840 single-payer bill.
Further, that approach won support among voters across political lines, by Democrats, 77-13 percent; independents, 72-20 percent; and Republicans 60-32 percent.

And, of course, ethical concerns are key here:

Two-thirds of the voters, 67 percent, said they would have a less favorable opinion of their legislator if they learned he or she was supporting AB 8 “for political reasons” to seek Gov. Schwarzenegger’s backing for the term limits initiative, to 15 percent who said they would have a more favorable opinion.

In case you missed the LA Times story Saturday about the grand Nunez-Scwharzenegger deal here it is:

“I think we’re on the verge of doing something huge,” Nuñez told The Times’ editorial board Friday.

The plan would require all Californians to have insurance and would give subsidies to those unable to afford coverage. It would also address the problems of the private insurance market

In other words, Californians would be driven into the arms of the for-profit insurance industry exposed in Sicko.  And despite the line above, there is no way to make this equation affordable-as the Massachusetts mandate mess made clear.

And don’t miss healthcare hero Sen. Sheila Kuehl’s explanation for why magical thinking won’t fix our healthcare mess.

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.

Without a health care plan of his own that any legislator would back, Arnold Schwarzenegger is left to mold the Democratic leadership plan in his image.  He came out strong yesterday in the opening salvo in the negotiating process:

Gov. Arnold Schwarzenegger took a firm stand Wednesday against the Democratic healthcare proposal moving through the Legislature, saying for the first time that he would not support an expansion of medical insurance if it were financed solely by new requirements on employers.

The Democratic proposal would require employers to spend at least the equivalent of 7.5% of their payroll on their workers’ health. The governor insisted that the plan also must require all Californians to have insurance, an idea at the core of his January proposal.

Democrats omitted that concept, believing that many people would be unable to afford the premiums.

Schwarzenegger’s program would have given employers the option of providing insurance or paying into a state fund that would offer it to uninsured workers and those who couldn’t afford individual policies. It also would have spread the responsibility of paying for expanded healthcare to doctors and hospitals, an idea that was rejected by Democrats as politically infeasible.

Schwarzenegger essentially wants MassCare, with its individual mandate, along with a buy-in from doctors and hospitals along with individuals and employers.  This is what he calls a fee but is probably a tax, which means Republicans would have to get involved because it would require a 2/3 vote.  But that doesn’t matter; he’d rather have no health reform at all than one without an individual mandate:

Schwarzenegger has said repeatedly that all parts of society — including healthcare providers, individuals and businesses — must make sacrifices if all Californians are to be insured. Nearly 5 million residents lack coverage at any given time. The Democratic proposal would cover 69% of them. Schwarzenegger’s comments were even more pointed earlier in the day, when he told the Sacramento Bee editorial board that he would veto a bill that failed to spread the costs around.

“If anyone over there thinks that I will sign a bill that . . . has only employer mandate, they shouldn’t,” he said, according to an account posted on the newspaper’s website.

“I won’t sign it. It won’t happen,” he said.

My favorite part of the article is the part where Schwarzenegger just ignores reality.

The idea of scrapping private insurance altogether and enacting a state-run program — an idea championed by Sen. Sheila Kuehl (D-Santa Monica) in the Legislature and Michael Moore in his film “SiCKO” — has gained support: The poll found that 36% of Californians now prefer this approach, up from 24% nine months ago.

Schwarzenegger, however, reiterated his opposition Wednesday.

“It’s very clear people don’t like government running their healthcare system,” he said.

Yes, so clear that it’s the most popular proposal before the people.

This is bluster from an action hero, and I’m not sure it should be taken seriously by Don Perata and Fabian Nuñez.  Schwarzenegger wants a ready-made market for the insurance industry, and his plan had no floor on coverage and no ceiling on costs.  That individual mandate starts to look like a gun barrel under those circumstances.  And I’d rather see nothing enacted than something that holds up California’s indigent and forces them to pay through the nose. 

The guaranteed issue part of his proposal, whereby nobody could be denied insurance, should be retained.  As we move toward an eventual not-for-profit system, setting up some public framework, as the new AB8 is rumored to strengthen, is crucial.  And clearly, the Governor shouldn’t be saying a word about healthcare until he fights the callous Bush Administration proposal to deny coverage to children by tightening S-CHIP eligibility.

UPDATE: The California Budget Project released a report detailing what California families could actually afford for health care, and according to their assessment, a family making twice the poverty line would be unable to contribute ANYTHING toward their own health care given the cost of living in the state.  Even those making 300% above poverty would require some help.  If you like feeding your inner wonk, it’s a good report.

A new Field poll today in California shows voters choosing a single-payer healthcare plan over the insurance-driven proposals supported by Governor Arnold and his Democratic allies.

The finding is in line with past research finding voters way ahead of politicians on the issue of guaranteed healthcare.  The timing on this poll, however, could not have been better for healthcare advocates, as the California budget just got passed and Governor Arnold, his Democratic helpers, and their insurance buddies are about to try to shove a regressive healthcare measure through the legislature.  Their plan just got harder.

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.

Tom Chorneau in the San Francisco Chronicle:

As voter dissatisfaction with the state’s health care system grows, increasing interest is emerging in moving to a state-run, single-payer program, according to a Field Poll released today.

For years, a single-payer system had been the favorite of a small but loyal minority, but the new poll shows that 36 percent of California voters now favor replacing the current employer-based system with one operated by the state – a jump of 12 percent since December.

Meanwhile, the number of voters who want to make reforms within the framework of the current system has dropped from 52 percent in December to 33 percent in August.

Mike Zapler in the Mercury News notes:

Ironically, the drumbeat of attention on health care this year, fueled by Gov. Arnold Schwarzenegger and other would-be reformers, seems to have dampened support for the one approach to change that had majority backing last year: shoring up the current insurer-based system. That solution, which is favored by the governor and calls for shared responsibility among government, employers and individuals, is now favored by just one-third of voters, down from 52 percent in December.

Call it the Michael Moore effect.  Sicko drew unprecedented attention to the problem of for-profit insurers…and now legislators want to expend the reach, customers, revenue, and medical influence of these same movie villains?  Thumbs down!

A Bureau of National Affairs article today (sub. req’d.) updates the latest backroom maneuvering on AB 8, which is the legislative offer to Governor Arnold:

SACRAMENTO, Calif.–“Play or pay” health care legislation authored by California’s Democratic legislative leadership was amended Aug. 20 to move up by one year, to Jan. 1, 2009, the proposed date that employers would be required to offer health coverage or pay 7.5 percent of payroll into a state-run purchasing pool .

The health care bill, A.B. 8, amended the same day lawmakers reconvened after a month-long summer recess, is pending in the Senate Appropriations Committee. It must clear both houses of the Legislature by Sept. 14, the last day of the regular legislative session. 

One problem with making this the centerpiece of a healthcare reform initiative?  It is blatangly, obviously, blindingly illegal-and will be tossed out of by the courts faster than you can say Erisa. 

So why put it in there?  To give the appearance of standing up on behalf of patients-while distracting attention from the other provisions in the law.  The other elements of this plan?  Expanding some public health programs while pushing some half-baked insurance “reforms” that will just lead to more paperwork…and more insurance overhead.

That’s it!

Here is a recent  background column from Sen. Sheila Kuehl’s office about the various proposals being thrown out as road-blocks to her single-payer plan, which has the big advantages of being the only plan that will actually work, as well as being the only one with a solid constituency (of healthcare reformers and a growing number of labor unions) pushing for it.

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.