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?
