Let voters reform health care
By David Lazarus
San Francisco Chronicle
Friday, June 8, 2007
Passage of SB840 — a bill that would guarantee health coverage for all Californians — by the state Senate this week is a significant victory for all those who believe health care is a right, not a privilege. But that may still be wishful thinking.
It’s unclear how SB840, authored by state Sen. Sheila Kuehl, D-Santa Monica, will fare in the Assembly. And even if it’s passed by the full Legislature, as was the case last year, it almost certainly would face a veto by Gov. Arnold Schwarzenegger, as was the case last year.
So I say this: Let the people decide. If our lawmakers can’t or won’t recognize the urgent need for universal coverage, then it’s time to repackage SB840 as a ballot initiative and put it to a vote by those most directly impacted by our obscenely dysfunctional health care system — us.
For her part, Kuehl told me that she still wants to try her luck in the Legislature before taking SB840 straight to voters.
“Ballot initiatives should be brought only when the tipping point is reached,” she said. “I think a lot more education has to be done so that people understand why this bill is the gold standard for health care.”
Well, school’s about to start. On June 29, Michael Moore’s new documentary, “Sicko,” hits theaters. It’s said to offer a devastating depiction of the roughly 47 million Americans who lack health insurance and to make a powerful case for universal coverage.
Moore will screen “Sicko” in Sacramento on Tuesday and participate in a legislative briefing at the Capitol. He’s also scheduled to join Kuehl at an afternoon rally that organizers hope will draw more than 1,000 supporters of universal coverage.
“This movie is going to have a big impact on the movement,” Kuehl said. “It will be a major indictment of the insurance industry and what they’re doing to us.”
After SB840 passed 23-15 in the state Senate on Wednesday afternoon, Moore issued the following statement:
“The health care industry has a death grip on our society because the insurance companies put profits before patients, which is why we as a country spend considerably more on health care than other developed countries and get back far less.
“In recognizing that for-profit insurance is incompatible with a caring, a moral and a high-quality health care system that provides coverage for all, Sen. Kuehl is leading the fight to break the industry’s death grip.”
The timing has never been more auspicious for health care reform in both California and the nation. The issue is consistently polling at or near the top of voters’ concerns, and politicians have been busy cobbling together a variety of plans for how things could be different.
But most of those plans envision expanding our current system to cover most (but not necessarily all) of the uninsured. They don’t address the nagging problem of ever-increasing health care costs, nor do they remedy the extraordinary fact that an estimated one-third of all health care spending is squandered on bureaucratic overhead.
SB840 would tackle these issues only on a statewide basis. But this would be a start, and it would demonstrate for the rest of the country that universal coverage is both politically and economically feasible.
“It’s the only sensible approach,” said Rose Ann DeMoro, executive director of the 75,000-member California Nurses Association. “It takes away the power of the insurance companies and essentially creates an expanded Medicare system.”
SB840 would establish what’s called a single-payer insurance system for all Californians. In other words, tax dollars would create a pool of publicly administered funds that would be applied to covering medical treatment for state residents.
This would replace the existing employer-based system and private insurers’ premiums, deductibles and co-pays.
A 2005 study by the Lewin Group, a health care consulting firm, found that a government-run system as envisioned by Kuehl’s legislation would cover the almost 7 million Californians now without insurance while saving about $8 billion.
Rival plans put forward by Schwarzenegger and Democratic leaders in Sacramento would seek to extend coverage to the uninsured by having employers contribute varying amounts to a state pool.
The insurance industry, meanwhile, is also championing reform — but only to the extent that reform means enlarging its customer base, not introducing a single-payer system. Insurers and their allies are already blitzing the airwaves with ads touting favored proposals.
So would a ballot initiative work? It wouldn’t be easy.
“Insurers would spend hundreds of millions of dollars to defeat it,” observed Jerry Flanagan, health care policy director at the Foundation for Taxpayer and Consumer Rights, a Southern California consumer advocacy group.
“They’d attempt to focus people on tax increases and drown out that this would be far less than what people now pay in premiums and deductibles,” he said.
A Field Poll found in January that 81 percent of voters believe that government should be responsible for ensuring “that all Californians have access to affordable health care insurance.”
At the same time, though, more voters (42 percent) would choose to receive coverage from an employer than from the government (22 percent), the poll found.
Flanagan interprets these numbers to indicate that California voters don’t yet understand the nuts and bolts of a single-payer system, or the savings that would be achieved under a government-run insurance program.
The onus would be on reform advocates to educate voters about the facts amid what would undoubtedly be an all-out campaign by insurers to maintain the status quo.
I think people are smart enough to tell right from wrong, and to know what’s in their best interest.
If state lawmakers are unclear on the concept, let us have a say about California’s health care future. It’s our money, after all. And our lives.
David Lazarus’ column appears Wednesdays, Fridays and Sundays. He also can be heard Saturdays, 4 to 7 p.m., on KGO Radio. Send tips or feedback to dlazarus@sfchronicle.com.