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KPBS Commentaries

Will California Legislators Find a Political Fix for our Health Care System?

On January 8, 2001, I moderated the first of four hour-long radio programs on KPBS called Health Care Roundtable. These programs were broadcast statewide and brought together distinguished medical professionals, advocates, policy makers, and elected officials. We talked about the struggles of Californians to gain access to health care, the quality of that care, the growing population of people without health insurance, and whether the government should take over from the much criticized private health care market. Four hours of straight talk just werent enough. The programs won some prestigious journalism awards, but the health care landscape has not improved in the last six years.

In fact, the health care delivery system has devolved into a true crisis with a burgeoning uninsured population, emergency rooms drowning in marginally sick patients and unable to care for true emergencies, and the out-of-pocket costs to those with health coverage escalating daily with increasing premiums, deductibles, co-pays, and prescription drugs. Health care costs have risen steadily, and now account for 15.5 percent of the U.S. gross domestic product . Health care spending is double what is spent on education. And in 2020, 31.5% of the gross national product will be spent on health care, according to one noted economist ( PDF ).

So, why hasnt government stepped in to offer some controls on a situation that is spinning quickly out of control. The federal government is paralyzed into inaction on this front. Perhaps the Iraq War has sapped the energy and creativity in Washington. So now, the states are leading the way . Massachusetts and Vermont passed laws in 2006 to achieve universal coverage.


Whats ahead for California? Four bills are kicking around in the Legislature, with the governor vowing to veto the Democrats push for a universal health care system administered by a state health commissioner who would oversee a state health care agency, Senator Sheila Kuehls SB 840. But the governor and other Republicans recoil from a government administered health care system and raise images of the Canadian (read Socialist) system.

Instead, Governor Schwarzenegger is on board for some form of universal health care legislation which will maintain a private marketplace including private insurance companies, and a mingling of public and private interests. And hes using his legendary political skills to forge coalitions to convert his persuasive rhetoric about universal coverage into reality.

It is generally agreed by health policy experts that what California does to reform health care has the potential to set a nationwide model. But the California Legislature is set to adjourn on September 14th and wont be back in session until 2008. What chance is there that something substantial will be passed before then by our elected officials eager to begin their three-and-a-half-month vacation?

September 14, 2007 at 05:12 PM
Great! Just what we need! More government socialized failures. Example: The post office that pays over 80% of its budget in Salary and benefits and charges us double what a private company would charge for the same service. UPS offered to deliver it faster at event lower then half the cost but the unions and government refused to give it up. Let us not forget Walter Reed Army Medical Center and its problems, a perfect example of a classy socialized program. How about the motor vehicle department and its bed side manner. As for me I will take the free enterprise profit driven company that has checks and balances any day. Private companies have to perform or else we do not use them any longer. The end result is they go out of business or improve their operations. When government programs dont work they stay in business anyway, ask for more money, add inefficiency and continue on their marry way without any oversight. Competition is the best equalizer; it allows us to make the decision not some committee or Czar. If government is so good why dont we nationalize food stores? Everyone needs food. Then we could all buy what we want, not care about prices and fill forms out at the check out. Problem is innovation and profit motivation will cease and there will be limited food available. Then will come rationing to certain people over others. Socialism spawned by governments is the beginning of equal distribution Misery. All this has been tried before and failed; remember the USSR! Government is the problem of the health care rising costs now! But, like most government failures it is never their fault. More money is always the answer. Government schools system is a perfect example where it is top heavy with bureaucrats and unions all with their hands out. Unfortunately the kids who the schools are for get very little and are only mentioned at budget time. All we here every year from the bureaucrates, as results plummet in the schools, is they need more money for it to work. Its the tax payers fault. The increase cost and problems with health care today can be traced back to good old government intervention over the last decade without oversight. 1. Tax treatment laws of health insurance, where premium are deducted from employees pre tax income, explains why so many of us rely on our employers to select and pay for health insurance. Since their is a third party payer, we have little incentive to shop around and wisely use the health care services. The same as if food were nationalized no more price shopping by the customer therefore no more checks and balances on prices. Who cares someone else is paying for it! 2. The "guarantee laws" that require insurance companies to sell Health insurance to anyone seeking it. This is like allowing someone to buy insurance after their house burns down or there is a theft. 3. Then last but not least there are the price controls such as reimbursement schemes to medicade. As a result many doctors refuse to treat medicate patients. Next the government will force doctors to treat anyone whether paid or not they already do that at hospitals which have put many out of business. State or Federal government nationalized Health Care would be a disaster for us all! If anything we should be screaming for legislation outlawing government price fixing and controls against competition. The measures by government are responsible for the problems now and we never seem to discuss it. Why people want a system like those in Canada, France, Sweden, and other Countries whose motto is we have the best Health Care system if you do not get sick. Here is why as reported Canadas Fraser institute. 1. Shortest waiting time for Oncology 4.9 Weeks 2. Orthapeetic surgery 40.3 weeks 3. Neurosurgery 31.7 weeks Frances failed Health Care system reported 13000 deaths from dehydration during a heat wave. The reason was the Health Care system shut down and took no more calls and told the people to fend for themselves is the 2003 heat wave. As reported in the June 28 National Center for Policy Analysis, Daily Policy digest Britains Department of Health acknowledged that one in eight patients waits more than a year for surgery. Where do you think all the innovation and medicine comes from to support these failed systems? Yes the good old U.S.A! Why would you want to go to these types of systems and give up our innovation that is the best medical supplier of the world? THE ANSWER IS LESS GOVERNMENT NOT MORE.PLEASE! -----


September 24, 2007 at 03:46 PM
It would be hard to express my feelings about government involvement in health care any better then the following aricle of Ann Coulter's. The only "crisis" in health care in this country is that doctors are paid too little. (Also they've come up with nothing to help that poor Dennis Kucinich.) But the Democratic Party treats doctors like they're Klan members. They wail about how much doctors are paid and celebrate the trial lawyers who do absolutely nothing to make society better, but swoop in and steal from the most valuable members of society. Maybe doctors could get the Democrats to like them if they started suing their patients. It's only a matter of time before the best and brightest students forget about medical school and go to law school instead. How long can a society based on suing the productive last? You can make 30 times as much money as doctors by becoming a trial lawyer suing doctors. You need no skills, no superior board scores, no decade of training and no sleepless residency. But you must have the morals of a drug dealer. (And the bank wire transfer number to the Democratic National Committee.) The editors of The New York Times have been engaging in a spirited debate with their readers over whether doctors are wildly overpaid or just hugely overpaid. The results of this debate are available on TimeSelect, for just $49.95. "Many health care economists," the Times editorialized, say the partisan wrangling over health care masks a bigger problem: "the relatively high salaries paid to American doctors." Citing the Rand Corp., the Times noted that doctors in the U.S. "earn two to three times as much as they do in other industrialized countries." American doctors earn about $200,000 to $300,000 a year, while European doctors make $60,000 to $120,000. Why, that's barely enough for Muslim doctors in Britain to buy plastic explosives to blow up airplanes! How much does Pinch Sulzberger make for driving The New York Times stock to an all-time low? Probably a lot more than your podiatrist. In college, my roommate was in the chemistry lab Friday and Saturday nights while I was dancing on tables at the Chapter House. A few years later, she was working 20-hour days as a resident at Mount Sinai doing liver transplants while I was frequenting popular Upper East Side drinking establishments. She was going to Johns Hopkins for yet more medical training while I was skiing and following the Grateful Dead. Now she vacations in places like Rwanda and Darfur with Doctors Without Borders while I'm going to Paris. Has anyone else noticed the nonexistence of a charitable organization known as "Lawyers Without Borders"? She makes $380 for an emergency appendectomy, or one-ten-thousandth of what John Edwards made suing doctors like her, and one-fourth of what John Edwards' hairdresser makes for a single shag cut. Edwards made $30 million bringing nonsense lawsuits based on junk science against doctors. To defend themselves from parasites like Edwards, doctors now pay hundreds of thousands of dollars in medical malpractice insurance every year. But as the Times would note, doctors in Burkina Faso only get $25 and one goat per year. As long as we're studying the health care systems of various socialist countries, are we allowed to notice that doctors in these other countries aren't constantly being sued by bottom-feeding trial lawyers stealing one-third of the income of people performing useful work like saving lives? But the Democrats (and Fred Thompson) refuse to enact tort reform legislation to rein in these charlatans. After teachers and welfare recipients, the Democrats' most prized constituency is trial lawyers. The ultimate Democrat constituent would be a public schoolteacher on welfare who needed an abortion and was suing her doctor. Doctors graduate at the top of their classes at college and then spend nearly a decade in grueling work at medical schools. Most doctors don't make a dime until they're in their early 30s, just in time to start paying off their six-figure student loans by saving people's lives. They have 10 times the IQ of trial lawyers and 1,000 times the character. Yeah, let's go after those guys. On to nuns next! But Times' readers responded to the editorial about doctors being overpaid with a slew of indignant letters -- not at the Times for making such an idiotic argument, but at doctors who earn an average of $200,000 per year. Letter writers praised the free medical care in places like Spain. ("Nightmare" in the Ann Coulter dictionary is defined as "having a medical emergency in Spain.") One letter-writer proposed helping doctors by having the government take over another aspect of the economy -- the cost of medical education: "If we are to restructure the system by which we pay doctors to match Europe, which seems prudent as well as inevitable, we must also finance education as Europeans do, by using state dollars to finance the full or majority cost of higher education, including professional school." And then to reduce the cost of medical school, the government could finance "the full or majority cost" of construction costs of medical schools, and "the full or majority cost" of the trucks that bring the cement to the construction site and the "the full or majority cost" of coffee that the truck drivers drink while hauling the cement and ... it makes my head hurt. I may have to see a doctor about this. I should probably get on the waiting list now in case Hillary gets elected. That's how liberals think: To fix an industry bedeviled by government controls, we'll spread the coercion to yet more industries! The only sane letter on the matter, I'm happy to report, came from the charming town of New Canaan, Conn., which means that I am not the only normal person who still reads the Times. Ray Groves wrote: "Last week, I had the annual checkup for my 2000 Taurus. I paid $95 per hour for much needed body work. Next month, when I have my own annual physical, I expect and hope to pay a much higher rate to my primary care internist, who has spent a significant portion of his life training to achieve his position of responsibility." There is nothing more to say.