State lawmakers say California’s troubled healthcare system is due for a major overhaul. Democrats in the legislature are introducing their ideas. And Governor Schwarzenegger is scheduled to unveil his plan next week. KPBS Health Reporter Kenny Goldberg has the story.
You could say California’s healthcare system is ripe for reform. After all, it would seem nearly everyone is unhappy about it. Employers are struggling with rising health insurance premiums. Many workers are having to pick up a larger share of the tab. And the system has left some 6.5 million state residents uninsured.
Democrat Don Perata got a jump on the debate a few weeks before Christmas. The Senate President Pro Tem laid out an ambitious plan in a press conference at the state capitol building.
Perata: Insuring all working families and adults, and children who are most at risk. That seems to be a goal that everybody could agree to.
Perata says his idea is modeled on the workers’ comp and unemployment insurance programs.
Perata: There would be an employer contribution and an employee contribution. There’s no free ride; everybody pays in something. Secondly there would be the creation of something, for want of a better phrase, of a purchasing pool broker.
A new state agency would serve as the broker. It would use the purchasing power of millions of Californians to get discounts on three different insurance policies: a bare bones arrangement, an HMO-based program, and a plan that lets people choose their own doctors.
The concept would also depend on getting additional federal funds to expand the Healthy Families program. All told, Perata says his plan would cover some 4.5 million people who are currently uninsured. Perata believes when the program is fully fleshed out, there will be something for everyone to oppose.
Perata: But that wouldn’t make it any different this year than it has been in years past. What I am doing is challenging the Democrats and Republicans in this building, business and labor, public and private healthcare providers, to muster the political will that’s necessary to compromise and conclude this issue.
Governor Schwarzenegger appears eager to accept that challenge. He’s expected to unveil his ideas in next week’s state of the state speech.
Kim Belshe is the governor’s Secretary of Health and Human Services. She says the governor’s health advisers include Democrats, Republicans, and other stakeholders. Belshe says the key to real reform is shared responsibility.
Belshe: So any solution to our healthcare problems that rely exclusively on government, or exclusively on employers, or exclusively on individuals, that really isn’t going to be a solution. We need to come together and advance a set of reforms that bring everyone to the table, and has everyone being a part of the answer.
Belshe won’t reveal any specifics of the governor’s plan. But she says the governor is open to any ideas that could make healthcare more affordable. These could include rollbacks of state mandates for things like contraceptive care or mental health treatment.
Belshe: But the most important message here is that everything is on the table, no final decisions have been made. So whether or not the governor’s January proposal includes a modification of benefits, that’s a decision that has yet to be made, and we’ll leave it to the governor to announce.
In the meantime, consumer groups hope elected officials will take their concerns into account. Anthony Wright directs the non-profit group Health Access. He says so far, a key element seems to be missing from the discussion.
Wright: Any reform of the healthcare system needs to take a hard look at the insurance companies, their role and their profits, and putting some oversight over their practices.
But that appears unlikely, at least if Republicans have anything to say about it. Senate Republican Caucus Chair George Runner doesn’t want to clamp down on the insurance industry.
Runner: I think we need to go the opposite way, I think we need to be freeing up insurance products. I think if a person, for instance, needs a product that doesn’t include maternity, they ought to have access to that. Instead the legislature goes just the opposite. They want every product to look exactly the same to give maximum coverage. That just drives costs up.
Runner says Republicans won’t agree to a plan that requires all employers to provide health insurance. And he says offering coverage to illegal immigrants is dead on arrival.
But Republicans legislators may have very little influence in this debate. Unless there’s a tax increase on the table, Democrats can pass anything without a single Republican vote.
Observers believe what goes on between Democratic leaders and the governor will be key. And after Schwarzenegger reveals his plan next week, the battle will really begin.
Kenny Goldberg, KPBS News.
