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Schwarzenegger Asks Doctors, Businesses to Buy Into Universal Health Care Plan

Governor Schwarzenegger has been touring throughout the state to drum up support for his healthcare reform package. The governor says his ultimate goal is to make sure everyone in California has insur

Schwarzenegger Asks Doctors, Businesses to Buy Into Universal Health Care Plan

Governor Schwarzenegger has been touring throughout the state to drum up support for his healthcare reform package. The governor says his ultimate goal is to make sure everyone in California has insurance. To help pay for it, he's asking doctors, hospitals, and some business owners to cough up a percentage of their income. As KPBS Health Reporter Kenny Goldberg explains, that idea isn't going over too well.

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It's lunchtime at Players Bar and Grill in Clairemont Mesa. The place is packed with locals grabbing a quick bite, or shooting pool. Owner Mike Pasulka says business is good. But he says it's a constant grind.

<b> Mike Pasulka: </b> It's not easy. Everybody thinks that you own a business and you're rich, and by no means are you. Most of my employees if you look at an hourly basis make more money than I do.

A few years ago, Pasulka offered his 30 employees a group health insurance plan. He says most of them didn't want to pay into it.  Under Governor Schwarzenegger's proposal, businesses with ten or more employees would have to provide health coverage. Or, companies would pay four percent of their payroll to help the state cover the uninsured.

Pasulka says that idea stinks.

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<b> Pasulka: </b> It's basically saying, Mike, I want you to take $2,500 a month out of your pocket, and give it to me, so I can decide who it gets distributed to.

Restaurants statewide would be hard hit by the governor's plan. That's why the California Restaurant Association says it will fight to get an employer mandate taken out of the proposal.                     

Another group hoping for changes is the California Medical Association, more than 34,000 doctors strong.

Dr. Ted Mazer and patient: You're having the headaches in the morning. The headaches are not coming from obstructive sleep disorder, that we know for sure, we've gone through that . .

CMA board member Ted Mazer is an ear, nose, and throat specialist in San Diego.

Governor Schwarzenegger wants doctors like Mazer to help treat more of California's uninsured. The governor is offering to boost Medi-Cal payments as an incentive. In exchange, he wants to doctors to pay what he calls a two percent dividend on their gross income. Mazer says physicians want to do what they can to help. But he says a two percent tax is beyond the pale.

<b> Mazer: </b> How would you feel if I came to you and said you've been so good to me for the last year helping me do things, I'd like to buy you a great big present. Give me your credit card so I can charge it to you.

Mazer says the governor's plan would be even worse for hospitals. It would give them higher Medi-Cal rates, but would charge back four percent of their gross revenue.

<b> Mazer: </b> If you're going to tax gross revenues, you're going to wipe out any margin for reinvestment, or maybe force hospitals in the red. This at a time when hospitals are already behind in being able to capitalize, and are being asked to spend billions on seismic retrofit. That's a non-starter.            

Officials with the Schwarzenegger administration take these criticisms in stride. Sandra Shewry directs the California Department of Health Services. She says the governor's reform plan is based on the idea of everyone giving up something for the greater good.

<b> Shewry: </b> We feel that that is a fair balance. We know that every sector in society's gonna benefit from a comprehensive reform, and the governor's calling on every sector to change a bit in terms of how they practice what they do today.

Shewry says that includes the insurance industry.

Under the proposal, insurance companies could no longer deny people coverage because of their medical history.

Chris Ohman is president of the California Association of Health Plans.

He likes the idea of requiring everyone in the state to be insured. But Ohman says to avoid problems, people must maintain that coverage year-round. Otherwise, people could buy insurance when they need an expensive procedure, and then cancel it.

<b> Ohman: </b> And really when what you're doing when that happens, is you leave the rest of the folks who have coverage with your bill. And that's not fair.

Ohman is also concerned about another provision in Schwarzenegger's plan. It would require companies to spend 85 cents of every premium dollar on patient care. Ultimately though, Ohman says insurers would like to work things out.

<b> Ohman: </b> The health plan industry is generally supportive. There are parts of the proposal which are challenging for us. But we are working hard to get to yes.

The key is whether the California legislature will get to yes. So far, Democrats seem to be supportive. Republicans on the other hand, don't like the employer mandate.

Hearings on Schwarzenegger's plan will begin later this month.

Kenny Goldberg, KPBS News.