^{Posted on February 14, 2007}

Slow start for health coalition

By David Lazarus
San Francisco Chronicle
Friday, February 9, 2007

It caused quite a stir when some of the biggest names in the business world came together this week to declare that they want nothing less than” a new American health care system by 2012.”

Among those seeking this revolutionary change are Wal-Mart, the country’s biggest private employer, and the Service Employees International Union, the country’s biggest labor union.

“What unites us here today is our shared belief that it will be a far greater America when we get affordable health care for all Americans,” Andy Stern, president of the union, said at a news conference Wednesday.

And no one would dispute that. But what precisely are these powerful economic forces seeking?

At this point, not even they seem to know.

“It’s symbolic — all these people coming together,” Dave Tovar, a Wal-Mart spokesman, told me Thursday. “Now we need to get some ideas on paper and figure out how we’re going to do this.”

Yeah, that’d be a good start.

Health care experts are reluctant to dismiss this private-sector initiative as a headline-grabbing publicity stunt. Any discussion of health care reform is better than none, they say.

But they point out that everyone knows the health care system is broken. What’s lacking now is a serious plan to fix things.

“Unless they’re actually willing to give us a plan, they’re being dishonest,” said Steffie Woolhandler, an associate professor at Harvard Medical School and longtime advocate of overhauling the U.S. health care system.

“They’re saying that they want to give us an omelet but they don’t want to break any eggs,” she said.

Wal-Mart and SEIU are being joined in the “Better Health Care Together” campaign by AT&T, Intel, Kelly Services, the Howard H. Baker Jr. Center for Public Policy, the Center for American Progress, the Committee for Economic Development and Communications Workers of America.

(Many Chronicle employees, including me, are represented by the Newspaper
Guild, a CWA labor group.)

Here, in their words, are the “four common sense principles” that the coalition partners announced this week as the cornerstone of their efforts:

We believe every person in America must have quality, affordable health insurance coverage.

We believe individuals have a responsibility to maintain and protect their health.

We believe that America must dramatically improve the value it receives for every health care dollar.

We believe that businesses, governments and individuals all should contribute to managing and financing a new American health care system.

The first principle is a commitment to universal coverage, but it doesn’t say how this can be achieved. The second points to a need for greater personal accountability in limiting health care costs, but once again avoids saying how this can be accomplished.

The third principle reflects statistics from the Organization for Economic Development and Cooperation showing that the United States spent an average $6,102 per person on health care in 2004 (the latest year for which figures are available). By contrast, Canada spent $3,165 per person, France $3,159, Australia $3,120 and Britain a mere $2,508.

At the same time, life expectancy in the United States was lower than in each of these other countries as of 2004, and infant mortality was higher.

And the fourth principle, well, it doesn’t say anything at all, except that nobody should be off the hook when it comes to paying for any of the changes that the group hasn’t actually called for.

“We want better health care for all Americans,” said Wal-Mart’s Tovar. “If that were simple, it would have been accomplished already.”

True, but there are no shortage of proposals already on the table, ranging from expansion of our current employer-based insurance system to switching to a government-run system similar to programs that exist in all other industrialized democracies.

The problem isn’t a shortage of ideas. The problem is finding the political will to make changes that would reinvent how medical coverage is delivered in this country and, in so doing, potentially devastate the powerful insurance and pharmaceutical industries.

Colin Evans, director of policy and standards for Santa Clara’s Intel, said members of the coalition deliberately avoided making any specific proposals in their news conference this week.

“We want to have a discussion about health care, and we want to have the right discussion about health care,” he said.

By that, Evans said he means that people shouldn’t just focus on the financial aspects of health care reform.

“That’s the wrong question,” he said. “The real question is why does health care in America cost twice as much per capita as it does in any other country with running water?”

Not much of a mystery. According to researchers at Harvard, about a third of the $2 trillion spent each year on health care in the United States is squandered on bureaucratic overhead — the result of having a wide variety of insurance plans and a wide variety of clerical procedures.

Yet despite the vast amount of money devoted to medical coverage annually, 47 million Americans remain uninsured.

“The burden of paying for health care can’t just be placed on individuals, and it can’t just be placed on business, and it can’t just be placed on the government,” said Sara Howard, a spokeswoman for SEIU. “We need to figure out a way to get all these sectors together.”

Again, not much of a mystery. A government-run insurance system funded by individual and business taxes could serve as the basis of a universal-coverage program, with private insurance plans providing additional coverage for anyone who desires it.

In 2005, the Lewin Group, a health care consulting firm, was commissioned to study the economic impact of a government-run insurance system proposed for California.

It determined that if such a system had been in place in 2006, the state would have saved about $8 billion in health care spending. From 2006 to 2015, the group concluded, total savings would run as high as $343 billion.

Nationwide, of course, the savings would be even greater, thus allowing for coverage of all uninsured Americans without an additional cost to taxpayers.

As it happens, a government-run system is one of four proposals already put forward by the National Coalition on Health Care, a separate grouping of business, financial and labor entities that for years has been calling for change in the U.S. system.

However, the National Coalition on Health Care (which includes the California Public Employees’ Retirement System but not Wal-Mart, SEIU and most other members of the new coalition) has yet to place its collective weight behind a single proposal.

Therefore, like the new coalition, it isn’t advocating anything specific — just change.

But Henry Simmons, president of the National Coalition on Health Care, said his group is already out front in seeking reform. The implication is that another business coalition will only muddy the health care waters on Capitol Hill.

“I’m not sure what their principles are,” Simmons said of the new group. “It’s not enough to just say that we ought to work on this problem.”

No, it’s not.

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.