By Alicia Lanier, REALTOR
After vetoing two separate health care reform bills passed by the California Legislature – this year’s Assembly Bill 8 and last year’s Senate Bill 840 (Single Payer) – Governor Arnold Schwarzenegger has finally put pen to paper for his own reform proposal. Now he’s called a special Legislative session and his health care proposal will be heard Wednesday – on Halloween - by the California Assembly Health Committee, chaired by Mervyn Dymally. Sofar, no lawmakers have stepped up to author a bill using his concept.
This will be the first legislative consideration of the 220-page bill language of the Governor’s health care reform proposal. There will be no vote; it is called an informational hearing only.
In past weeks, there have been many behind-the-scenes negotiations among lawmakers about the future of health care reform in California. Still on the table is the 2007 Senate Bill 840, the Single Payer health care reform proposal. Its author, Senator Sheila Kuehl, turned SB 840 into a two-year bill because of another threatened veto by the Governor who says his concept of a “shared responsibility” health care proposal retaining the current private insurance system is a better approach.
However, a Field Poll released this past August showed that Californians are now leaning toward a state-managed “single-payer” system. The poll said support for the single-payer system has risen from 24 to 36 percent in the last few months and support for the Governor’s concept has dropped from 52 to 33 percent.
The Governor’s proposal, as now written, was previewed in its first public forum in Santa Clara County last week (October 26) when Senator Elaine Alquist held a Health Care Reform Forum in Santa Clara. Senator Alquist is listed as an author for both SB 840 and AB 8.
Speaking on behalf of the three health care proposals were Agnes Lee, Director, Senate Office of Research, speaking for AB 8 as proposed by Speaker Fabian Nunez and Senate Pro Tempore, Don Perata; Sara Rogers, Consultant, Office of Senator Sheila Kuehl, speaking for single-payer health care as proposed by Senator Sheila Kuehl in SB 840; and Cindy Ehnes, Director, California Department of Managed Health Care, speaking on the administrative approach to health care reform as proposed by Governor Arnold Schwarzenegger.
On two other panels were representatives from Working Partnerships, People Acting in Community Together (PACT), The Permanente Medical Group, San Jose Silicon Valley Chamber of Commerce, Valley Medical Center, Santa Clara Family Health Plan, California Primary Care Association, and Santa Clara County Medical Society.
The hearing room at Santa Clara University was almost full for the event – and attendees were rewarded by an indepth discussion of the proposals, of how each would impact consumers and providers in our county, and how they would impact local governments and the health care delivery systems they support.
Proponents of the single-payer concept of affordable health insurance for all Californians, as embodied in SB 840, say this program would cover everyone with eligibility based on residency, not employment or income. SB 840 would require no new spending. The system would be paid for by federal, state, and county monies already being spent on healthcare and by affordable insurance premiums that replace all premiums, deductibles, out-of-pocket payments and co-pays now paid by employers and consumers.
Not everyone on the panels agreed that SB 840 would be the best choice. However, most of the panelists agreed that, during the election year of 2008, there is a small window of opportunity for passing health care reform in California. Afterwards, said some, it might be 15 years or so before that window opens again. Others said it’s better to “pass something” and “take a small step” toward reform than do nothing. And, one remarked that the “worst” thing that could happen for health care reform in California would be for legislative negotiations to stalemate and for California voters having to make a choice in the November 2008 election between competing health care reform ballot initiatives.
Senator Alquist said: “If you look at the numbers, you know we must do something. We have some 140,000 uninsured adults and tens of thousands of uninsured children in Santa Clara County. We can no longer sit back and ignore the cold hard economic and social reality of what this means. In Silicon Valley with our high housing costs, it means that working families must choose between health care and other basic necessities. I can’t in good conscience ask hardworking families to choose between a roof over their heads and their health.”
It will be interesting to hear whether the Assembly Health Care Committee in its Halloween Day meeting deems the Governor’s proposal is a “trick” or a “treat” for Californians when it comes to health care reform.
Kudos to Senator Alquist for holding a hearing in the Silicon Valley on this important issue. Other hearings she has slated on topical issues include the following this fall:
“Getting Trans Fats Out of Our Schools and Our Communities” – November 7, 2007, 9:30 to 11:30 a.m., Ocala Middle School, 2800 Ocala Ave, San Jose
“Emerging Green Technology and Economic Growth: Can California Remain Competitive?” – November 13, 2007, 9:30 to 11:30 a.m., NASA Ames Exploration Center, Eagle Room, Bldg. 943, Moffett Field, Mountain View
For more information and RSVPs, contact Senator Alquist’s San Jose office at 408-286-8318
Alicia Lanier is a REALTOR and member of the Coldwell Banker Diamond Society – Top 8% of Agents Internationally www.AliciaLanier.com 408-491-1634
Dear Speaker Nunez,
I think you and the other Democrats know what the Gold Standard of Health Care is: SB 840. So I just don’t understand why you and Senate President Perata are allowing the Governor to drag you around by the nose just like the Democrats in the US Congress is allowing the Republicans to do in Washington.
Take this as a friendly warning: The American people are slowly seeing the Democratic Party as a gutless organization. I hope you don’t wait until it’s too late to realize that.
There are millions of people in California who just cannot afford to pay the insurance companies their ransom. But more worrisome for me is that you know it too. Please try to remember that you are where you are to protect those who cannot protect themselves, not to protect the insurance companies, they don’t need your help, the people do.
Sincerely,
Rufus Wesley
San Jose, CA
(A life long Democrat and hope to remain that way, but it’s up to you.)
The following was received yesterday from Gerry Hunt:
I have managed my insulin dependent diabetes for 35 years with minimal side effects, but I have observed how healthcare is delivered from the inside and I have been passionately opposed to every aspect of private health insurer business practices. I passed my C.P.A. license two years before I became diabetic so business practices are a fundamental and ethical aspect of my professional life.
The health insurance industry capitalizes deceit. The marketing of health insurance products as choice is deceitful because the vast majority of medical failures are unforeseen. The health insurance policies that they write are built on deception because coverages are offset by exceptions buried in the policies. The health insurance questionnaires required for policy consideration are detailed to the point of entrapment (or deceit), like the case of a woman with breast cancer whose treatment was voided because she didn’t disclose a past incicident of vaginal fungus. The manner in which claims are filed, reviewed, and authorized for reimbursement are subjective (or deceitful). And medical providers receive their reimbursements on a delayed basis after running a gamut of deceitful queries that are useful only to aid denials. Providers spend 9-13% of their reimbursement revenue on staff who file claims and attempt to expedite reimbursement. And this does not even touch on the
actuarial ratings from which premiums are set. There are no national actuarial standards for health conditions as there is for life insurance, so premiums are based on estimates that have no correlation between the insured population and the general population.
A health insurer receives premium dollars and pays reimbursements much like a fiduciary agent, adds no value to the process, but keeps close to 35% of the premium dollars as a reward for their wonderful, unaccountable service. The primary cost of service is the campaign contributions which influence what legislation is passed.
As far as government run I would refer you to another fiduciary agency, the securities industry, which was reconstituted by the Securities Act of 1933 and the Securities Exchange Act of 1934. Due to those regulatory statutes, the securities industry is essentially government regulated and is both respected and very profitable. Medicare has been in existance since 1967 and pays out 97.5% of its tax based funding on medical reimbursements. Why do private insurers only pay out 65% of their premium funded dollars on medical reimbursement? (65% is an average which makes some people question the validity of this factor but there is enough circumstantial evidence to support this claim.) The financial performance of the private health insurance industry has been treated as a trade secret for most of the past century.
All of these conditions discussed above would be resolved by SB 840. I have been active with Health Care for All-California for 13 years.