In health care reform, California needn't settle for second best
By Kay McVay, RN
San Jose Mercury News
03/29/2007
Anyone worried about the cost and availability of health care should be very wary of some of what’s being said about health care reform in California.
SB840, state Sen. Sheila Kuehl’s bill providing guaranteed health care as an expanded and improved version of Medicare for all Californians, is the gold standard reform. It’s the most comprehensive - and the only plan that controls costs by eliminating administrative waste rather than limiting care and shifting costs to families.
But, Sacramento insiders insist, SB840 is not palatable for a governor who has vetoed the bill once before.
Instead, the voices of political expediency are browbeating us to lower our standards and accept an inferior approach such as Gov. Arnold Schwarzenegger’s proposal to force Californians to buy unaffordable, substandard health plans.
Under this plan, a typical Santa Clara County family could end up spending more than $12,000, nearly one-fifth of their annual income, on insurance premiums and deductibles before their insurance company spends a dime on their medical care.
If a medical emergency occurs, out-of-pocket costs could rise to 25 percent of household income, and this minimal insurance would probably exclude such basics as dental, vision, mental health and long-term care. They would all cost extra.
There is a better path: SB840.
Since Schwarzenegger vetoed a similar proposal last year, momentum for a real solution has grown in California and across the nation.
A recent New York Times-CBS poll shows 64 percent of Americans believe the government should guarantee health insurance for all; 55 percent identified it as the top domestic priority for Congress and the president. In California, 60 percent favor a publicly funded universal health care system, like SB840 and Medicare, over the current system. The public is ahead of the politicians and policy wonks.
Schwarzenegger now says he’s for a “universal” system, although it’s cloaked in mandated, high-deductible insurance policies.
With majorities in both the Senate and Assembly, the Democrats call the shots on health care reform. It’s their decision, not the governor’s, what health care reform will pass the Legislature.
If they unite behind SB840 - which Senate President Pro Tem Don Perata in January called the “benchmark” and “ultimate solution” for our health care crisis - they have the power to make that the only plan that Schwarzenegger can sign or veto, just as they did last year.
Why should the Legislature take that step?
Premiums have jumped 87 percent in six years. SB840 is the only reform that contains costs while increasing benefits, primarily by curbing administrative waste and insurance industry profits. In California, that’s $20 billion per year.
The insurers are the principal opposition to any systemic reform. To successfully counter their elephantine influence - through the millions of dollars the insurers spend on campaign contributions - legislators need the public support generated by a guaranteed health program of quality care for all.
Would Schwarzenegger ever sign a bill detested by his insurance industry donors, who don’t want anyone interfering with their profits? A recent Datamar poll found that voters who support what the governor says he wants to accomplish also favor SB840; they want a solution that works, not a windfall for insurers.
Registered nurses are used to fighting the insurance companies for the care our patients need.
In 2004, the governor issued an emergency regulation to roll back key portions of the state’s landmark law requiring minimum safe nurse staffing levels in hospitals. The same experts who argue Schwarzenegger will never sign SB840 counseled nurses not to fight for patient safety because the governor was too popular and could not be challenged.
Instead, California’s nurses launched a spirited campaign and, with public support, ultimately persuaded Schwarzenegger to end his efforts to erode patient care standards.
There are dozens of other examples - from Social Security to women’s suffrage to ending legal segregation - that were achieved despite the perceived wisdom of the time.
Today, the public interest can prevail again. Schwarzenegger, who wants a grand accomplishment on health care for his legacy and on his re`sume` if he runs for another office, can be encouraged to sign a bill that will make all Californians proud, end our health care nightmare and set another model for the nation.
KAY MCVAY is president emeritus of the California Nurses Association. She wrote this article for the Mercury News