The Modesto Bee
December 22, 2002
Bridging insured-uninsured gap becomes fiery health care battle
By Jim Sanders
(California State Senators Sheila Kuehl and Jackie Speier) each are preparing legislation for universal health care, but their approaches differ significantly in style, financing and scope.
Kuehl is pushing for a complete overhaul – a “single payer” system – in which the state would replace insurance companies in collecting monies, contracting for medical services, and paying doctors and hospitals for services rendered.
Kuehl contends that the program would not cost more than is now spent statewide for health care. Conceptually, the program would rely on various taxes, not insurance premiums. Expansion could be supported partly from savings in administrative costs and through bulk purchasing, she said.
Doctors would have wide latitude to determine appropriate care under Kuehl’s proposal. The managed-care system would be replaced by one that relies on medical experts, under the auspices of an elected state health commissioner.
By contrast, Speier wants to build on the existing system, leaving private insurance in place but filling the gaps.
Speier proposes a “play-or-pay” system, Senate Bill 2, that would require employers to provide medical benefits or pay taxes toward creation of a publicly subsidized plan, Healthy California, to provide basic benefits to those lacking insurance.
The California Labor Federation also is developing a “play-or-pay” proposal that would reduce the ranks of the medically uninsured while retaining health care as a central element of collective bargaining.
Sen. Sheila Kuehl:
“Where we used to talk about whether we should attempt universal health care, the argument seems to have shifted to how we can accomplish it.”
http://www.modbee.com/local/story/5679831p-6653530c.html
Comment: Fortunately, the California Health Care Options Project was not just one more study of reform to be filed away, having no more impact than a footnote in future treatises on failed efforts at reform. The findings of the study are now being translated into legislation that actually offers real hope of reform.
Most of the major hurdles are still ahead, but at least we’ve broken from the starting gate. Let’s begin with the assumption that we will have universal health care, and let’s direct our efforts to identifying and adopting policies that are in the best interests of patients. That way, we’ll all be winners.
California Health Care Options Project:
http://www.healthcareoptions.ca.gov/