by Joel Moskowitz
IndyBay
Thursday Dec 18th, 2008
In 2007, CaliforniaSpeaks, a statewide initiative led by government and major health foundations, invited 3,500 Californians to discuss their views on health care reform. To the surprise of the organizers, an overwhelming majority expressed its support for single payer (which was explicitly written out of the “discussion guidelines”). Yet somehow, the final report managed to ignore the will of the people. Today, as Americans throughout the country head to house parties to discuss health care reform, invited by Tom Daschle, future Secretary of Health and Human Services, and armed by similarly constraining “discussion guidelines”, the experience of Californians is worth remembering.
On Saturday, August 11, nearly 3,500 people gathered in eight locations to discuss health care reform in California. We were randomly selected to represent the views of 26 million California adults by AmericaSpeaks, a national nonprofit organization that conducts “21st century town meetings” to tackle issues ranging from the design of the World Trade Center site to the rebuilding of New Orleans.
Fifty-eight round tables filled the floor of the Oakland community college gym. Ten of us sat at each table along with a facilitator and a note taker with a laptop computer. We were each provided a wireless keypad to send our votes to a computer that would instantly tally them.
The meeting began with a pep talk from the Governor. Broadcasting from the Los Angeles meeting site via satellite hookup, he seemed larger than life on the two screens in front of us. He attacked his Republican legislative counterparts for holding up the state budget to avoid the health care discussion. He ordered us to help the politicians resolve the health care issue.
Next, the State Senate leader stepped onto the podium directly in front of us to address all eight sites via satellite. In the midst of his remarks, a woman across from me shouted out, “Single Payer! We want Single Payer!” A long burst of applause pervaded the room. Later, I learned that she was an attorney who had worked for the insurance industry until she could not stomach denying people access to needed health care to maximize profit.
We were informed that our task was to review two initiatives: the Governor’s proposal and a bill supported by the Democratic legislators (AB 8). We were told not to discuss “Single Payer,” i.e., government-funded universal health care coverage (like Medicare for all), because the Governor vowed to veto this bill (SB 840) as he vetoed its predecessor (SB 921). He claimed this was too expensive despite a study which showed that it would actually save Californians $8 billion in its first year because it would reduce the insurance industry role and administrative overhead and profits.
Was this “town meeting” convened to let the people of California speak about the health care reforms we wanted as had been promised? Or was this $4.2 million “town meeting” funded by three health foundations so we would rubber stamp a watered-down bill (AB
8) and enable the Governor to sign it into law claiming he was following the will of the people?
After outcries from meeting sites around the state, the organizers agreed to let us discuss Single Payer at the end of the day if we would “play along” and vote on their questions even though many issues would be irrelevant under a single payer plan.
In the end, we discussed and voted on a single payer system. Statewide, 87% supported this proposal. Supporters wanted cost controls, freedom to choose doctors, and quality of care ensured for all. The only measure to receive more support during the meeting was one to expand the government’s role in health care access (93%). The majority who supported this measure, however, wanted a single payer system. There is little doubt that had we been offered the opportunity to choose between the three pending proposals Single Payer (SB 840) would have won by a landslide.
Now, the question is will the final report of this “town meeting” adequately reflect the people’s priority for a single payer plan and will our political leaders in Sacramento act on it?
Joel M. Moskowitz, Ph.D., directs the Center for Family and Community Health in the School of Public Health at the University of California, Berkeley. He was randomly selected to participate in this forum. The background materials and preliminary report are available at http://www.californiaspeaks.org
http://www.indybay.org/newsitems/2008/12/18/18555394.php
Postscript
The final report for CaliforniaSpeaks acknowledged that 51% of participants supported an expanded government program “if it were a government-run program (a.k.a. a single-payer program) and insurance companies were kept out of it.” An additional 5% of participants supported an expanded government program under any conditions. (“CaliforniaSpeaks: The public weighs in on current health care reform proposals”; pg. 7; URL: http://tinyurl.com/3u6bgt ). Thus, the majority (i.e., 56%) of 3,500 randomly selected people who participated in a full-day discussion about health care reform conducted in eight locations across the state of California supported a single-payer system.
Unfortunately, this result was buried on page 7 of the 20 page final report. A subsequent evaluation of CaliforniaSpeaks concluded that “The most common critique, which was received from multiple locations, was in the handling of the single payer option” (“An assessment of the impact of CaliforniaSpeaks on health care reform in California” URL: http://tinyurl.com/4pwx7r). Even though the organizers tried to prevent a discussion of the single-payer option, at the end of the day, the majority of participants supported this option.
