By Jim Steinberg and Mediha Fejzagic DiMartino, Staff Writers
Contra Costa Times, May 22, 2011
State Democrats have revived a bill that would create a single-payer health care system and provide access to doctors for everyone in the state, including illegal residents.
Senate Bill 810, the California Universal Health Care Act introduced earlier this month by Sen. Mark Leno, D-San Francisco, would replace President Barack Obama’s health care reform legislation with a more comprehensive system — one its advocates say would cost everyone no more than what they already pay.
But local Republican legislators emphatically deny that assertion.
“S.B. 810 is a job-killing measure that will end many insurance plans, lead to huge tax increases and health care rationing,” said Assemblyman Curt Hagman, R-Chino Hills. “S.B. 810’s socialized medicine makes the ruinous Obamacare look like small government.”
Supporters of the measure say it would create a public-private partnership to provide every state resident with medical, dental, vision, hospitalization and prescription drug benefits, while still allowing patients to choose their own doctors and hospitals.
This plan would set up a single-payer “Medicare for All” type of program by pooling the money that government, employers and individuals already pay and using that money more efficiently by cutting out the middle man — insurance companies.
State Sen. Bob Dutton said he understands that there needs to be some fixes within the health-care delivery system, but making it government-run is not the answer, said Larry Venus, Dutton’s spokesman.
“Sen. Dutton wants to make sure the cost is accounted for,” Venus said. “That you would be able to cover every single person without increasing cost, it’s not a reality. That cost has to be borne by somebody, generally the taxpayer.”
Assemblyman Tim Donnelly, R-Hesperia, said creating a single-payer health care system in California would impose a massive overgrowth of government that will be costly to both the state and the people at a time when the state is working to close a huge budget gap.
“It is unrealistic and disingenuous to promise what the author has promised in this bill,” Donnelly said. “It is impossible to offer coverage to every resident at a reasonable cost without engaging in rationing. S.B. 810 promises to destroy any semblance of consumer choice in health care left.
“Furthermore, the bill does nothing to address shortages in doctors and nurses and will only exacerbate the problem. Promises to provide greater access to health care are void without ensuring there is someone to provide that care.”
So how will the health care solution created by S.B. 810 not cost more than we are paying now?
Advocates say a big reason will be in the reduction of administrative expenses of health care by reducing the involvement of insurance companies — and trimming administrative expenses of doctors’ offices — and other medical providers — as they seek payment from insurers.
“There are some 6,000 health plans in California, and health care providers spend about one-third of their resources just getting paid,” Leno said.
And there will be other saving opportunities as well — in unprecedented bulk purchasing power for everything from pharmaceuticals to hearing aids, eyeglasses and the investment in primary and preventive care, Leno said.
The bill will not conflict with the federal health care reform legislation — it allows states to set up their own health care systems if their program does not obligate Uncle Sam to shell out more money.
“We applaud the president’s affordable-care program, but we know it leaves 3 million Californians without insurance,” Leno said.
In some areas the state version of health care reform seems more comprehensive.
S.B. 810 would provide dental care – something largely not addressed in the federal program.
The California proposal would also cover both legal and illegal residents.
“Infection and disease does not recognize immigration status,” Leno said.
S.B. 810 is estimated to save California about $20 billion its first year through reduced administrative costs, based on a study conducted in 2006, for an earlier go-around with this proposal.
The bill has passed through Senate Health Committee and is now in the Rules Committee.
Leno said the bill will not advance this year and that the 2006 study will be redone to bring up-to-date figures to a campaign for its approval next year.
Single-payer systems were passed twice by the Legislature in recent years, only to be vetoed each time by then-Gov. Arnold Schwarzenegger.
The proposal was tabled in 2009.
Leno reintroduced it in January, making this the fourth effort.
“We (were not) surprised,” Venus said. “There is never new bill ideas, just different people introducing it. Now they have a Democratic governor.”
Leno said he has not discussed the plan in detail with Gov. Jerry Brown, but noted that when Brown ran against former President Bill Clinton in the 1992 presidential primary, he said he favored a nationwide universal health care plan.
Leno said he hopes to have that in-depth conversation with Brown soon.
Patrick Johnston, the president and CEO of the California Association of Health Plans, said S.B. 810 “has no chance of becoming a law.”
The association represents 39 public and private organizations that provide health care coverage to more than 21 million Californians.
He said an analysis of the bill in a previous form determined there would be a shortfall of $45 billion three years after its implementation.
“There is not enough money in the system to provide services to everyone who shows up,” Johnston said, adding that private money to purchase new medical technology would dry up. “The president and Congress reviewed all the options and decided on the course of the affordable health care plan.
“Implementing that federal law is a huge task that state and federal health care officials are working on. The debate over this law is a diversion” from the work that needs to be done, he said.
One academic observer of health care policy said, “If you think the fight over affordable care was nasty, you haven’t seen anything yet.”
“This plan is going to gore a lot of oxen,” said Gerald F. Kominski, associate director for UCLA Center Health Policy Research. “No. 1 is the insurance industry. They are not about to see their business go up in smoke.”
Kominski said that the federal Patient Protection and Affordable Care Act “is a very moderate, middle-of-the-road approach to health care reform. It fills the gaps in the current system.”
On the other hand, he said the state proposal “is a fundamental reform.”
Asked if he thought S.B. 810 has a chance to become reality, Kominski said, “I’ve seen enough things happen to never say `never.’ I don’t know how the ongoing financial crises might change public opinion on health care to vote for a more fundamental change of health care delivery.”
http://www.contracostatimes.com/california/ci_18118630?nclick_check=1