Calls for Healthcare Fixes Grow
By HOWARD FINE
Proposals to overhaul healthcare in California suddenly are all the rage. But it’s doubtful any can emerge from the current legislative session in Sacramento.
Three major healthcare reform plans have been introduced in the Legislature this year, and more are certain to follow.
Given the state’s massive budget deficit, the proposals with the most realistic chances of passage are those requiring employers to provide health coverage. Both Democrats and Republicans are proposing employer-based initiatives.
But healthcare advocates and industry lobbyists generally agree that a sweeping reform package of any sort is unlikely to emerge until at least 2004.
So why all the recent activity?
“This year is looking to be a staging year, where the proposals are laid out on the table,” said Clark Miller, spokesman for the San Francisco-based Pacific Business Group on Health, which represents employers. “Next year, with a presidential election that’s sure to focus on healthcare, there may be more impetus for reform.”
The pressure for healthcare reform is coming from several fronts: employers fed up with double-digit increases in healthcare costs; middle-class voters concerned about losing coverage; local governments straining under the burden of providing care for the uninsured; and physicians, hospitals and other healthcare providers getting squeezed by pressures to hold costs down.
“The problem we have today is a confluence of crises in both the public and private healthcare systems,” said Dr. Jack Lewin, chief executive of the California Medical Association in San Francisco, the advocacy group for physicians. “That’s why you’re seeing this pressure for reform.”
Sacramento’s Democratic leadership is offering a bill that would require all employers to provide health insurance to workers or else put funds into a health insurance pool. The legislation would come as a result of the merging of pending employer mandate bills from Senate President John Burton, D-San Francisco, and Sen. Jackie Speier, D-San Mateo.
Another approach, favored by Republicans and business, is to provide tax credits or other incentives to coax businesses into providing health insurance for workers.
The only Republican bill comes from Assemblyman Keith Richman, R-Northridge, which would expand the state’s Healthy Families program to working childless adults.
A third initiative, proposed last month by state Sen. Sheila Kuehl, D-Santa Monica, calls for a single-payer healthcare plan along the lines of the system now in use in Canada.
A similar proposal was defeated at the polls in 1996. With the state facing a budget deficit of up to $35 billion this year, healthcare observers agree the chances of legislators passing a program requiring a huge infusion of state funds is basically nil.
“The single-payer proposal is dead on arrival this year,” Lewin said.
The California Medical Association generally opposes a single payer plan. But Lewin said about a third of the association’s member physicians support it.
Gov. Gray Davis has not taken a stance on healthcare reform,not surprising, say Sacramento lobbyists, given that the budget deficit is consuming almost all the administration’s time.
Even Insurance Commissioner John Garamendi, who has said he wants to put forward a plan for universal health coverage, has been sidetracked by other issues.
Last week, Garamendi spokeswoman Nanci Kramer said the commissioner is focused on the workers’ compensation and homeowners’ insurance crises.
“These are huge, pressing, near-term issues,” Kramer said.
Garamendi has formed a working group on healthcare reform, which Kramer said should come out with proposals later this year.
Even if the Democrat-dominated Legis-lature managed to put forward an employer mandate bill,which many believe is likely,it is not clear it would pass muster with Davis.
With the state’s economy so shaky, resistance from the business community to an employer mandate could prompt a Davis veto.
The last time such a confluence occurred was 10 years ago and led to the formulation of the Clinton health reform plan, which led to a powerful backlash from health insurers and Republicans.
Fine is a staff writer with the Los Angeles Business Journal.
