To the Governor’s Health

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Nine months ago, Governor Arnold Schwarzenegger proposed a much-publicized healthcare plan for California. It was not a perfect plan. In fact, it was really barely an outline, but it announced to the state legislature, to the insurance lobby, and to all Californians that the desperately awaited campaign to reform healthcare had, at last, begun.

Everyone knows just how desperate the situation is: Employers and employees alike find the cost of health insurance for a family of four — $12,000 a year — unaffordable. Each year, 18,000 Americans die unnecessarily because they have no insurance. Our infant mortality rate is among the worst in developed nations. One in five Californians is uninsured. In Santa Barbara County, 16,000 children are uninsured. True, the U.S. has probably one of the best medical systems in the world, but it is a system available only to the wealthy or the lucky.

These sad facts, and many more, have been known for years, but despite gallant attempts by citizens and their elected officials from Washington, D.C., to state capitals, little has been done. Even a charismatic, popular politician such as Governor Schwarzenegger hit a wall. Ironically, the governor’s plan never left his desk because no Republican in either the Assembly or the state Senate would sponsor it.

Happily, however, encouraged by Governor Schwarzenegger’s bold initiative, the Democratic-dominated legislature has been able to pass three broad reform plans of its own. Perhaps the best bill — sponsored by Senator Sheila Kuehl — proposed a system known as single-payer, which would cut out insurance companies and rely on state administration; but that is the most controversial of the bills, would never get the governor’s signature, and would not have enough votes in the legislature to override his veto. The best chance for immediate reform is a combination of plans: Assembly Bill 8 — proposed by Assembly Speaker Fabian Núñez and Senate President pro tem Don Perata — and the original proposal by Governor Schwarzenegger. Compromise between the legislative and executive branches now seems actually within reach.

Both plans — AB 8 and the governor’s — share much commonality. Both make it harder for health insurers to deny coverage to individuals; both plans extend coverage to all children in families making 300 percent of poverty or less — regardless of immigration status. Both plans make employers offer some health benefits or require them to pay into a purchasing pool. The biggest challenge to compromise is probably Schwarzenegger’s insistence that all Californians have some health plan even if it is a bare-bones, high-deductible policy. But working groups on healthcare are meeting this week in a special session of the legislature. Let’s hope they can rise to the occasion. Unhappily, even if a compromise is reached, a ballot measure will probably have to be put to a statewide vote in November, because Republican legislators are blocking all funding mechanisms. But a compromise measure would have such a diverse coalition of supporters — from labor unions to chambers of commerce — that many savvy politicians and healthcare activists alike believe it would pass. If so, Californians will have taken a step toward sane, reasonable healthcare in one of the wealthiest states in one of the greatest nations in history.

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