California's Unhealthy Bill: Fake Healthcare Reform A Victory for Schwarzenegger -- And a Boon for Insurance Companies
In alliance with Gov. Arnold Schwarzenegger, Democratic leaders of the state Legislature, led by Assembly Speaker Fabian Nuñez are rushing to enact a substandard health reform plan that will not reduce the health insecurity of California families.
They're apparently even willing to jeopardize Sen. Barbara Boxer and their own party's slim hold on the United States Senate along the way.
Here's the deal: Nuñez and some other Democrats are actively working with Schwarzenegger to put together a "compromise" healthcare package.
Schwarzenegger, the main architect of that plan, gets to claim credit for supposedly solving the state's healthcare crisis using "bipartisan consensus." As collateral damage to Democrats, Schwarzenegger can tout this deal to boost his candidacy against Boxer in 2010.
Nuñez could then get the governor's support for extending his term as speaker.
This constellation of events may be dandy for a career politician or two, but it leaves behind a lot of other Californians, who will have to contend with a poor healthcare bill full of holes.
AB 8 does nothing to rein in rising insurance premiums -- up 87% nationally this decade -- or rising co-pays, deductibles and other health fees. Which means that costs, already unaffordable for far too many, would continue to spin out of control.
The bill fails to limit rising prescription drug costs, especially notable at a time when Schwarzenegger has just eliminated funding for his "voluntary" drug price restraints that were so ballyhooed last year by the governor and the authors of AB 8.
It is not universal, as many of the currently uninsured would remain without access to care. It fails to assure uniform, comprehensive benefits, and therefore perpetuates an increasingly multi-tiered health system based on the ability to pay.
It fails even to require insurance companies to provide insurance. They would not have to offer coverage to those with serious medical conditions -- those people would instead be dumped into a publicly funded high-risk pool, earning big insurance companies millions in additional profits while bankrupting the public pool with the sickest, costliest patients.
The bill does not even protect patients' choice of physicians, hospitals or other providers.
And, most critically, the plan reinforces and expands an insurance-based system -- the source of much of the present crisis -- thereby subverting real reform for years to come.
At the center of the plan is a mandate on businesses to either provide health coverage or pay taxes into a fund to buy it for their employees. The new tax would fall between the 7.5% of payroll costs favored by Nuñez and the 4% Schwarzenegger proposes.
No matter where the compromise figure ends up, it will be far less than many employers now pay for health benefits. One-fourth of all California businesses that provide health benefits currently pay more than 15% of their payroll for health premiums, according to the California Healthcare Foundation. As a result, businesses that now provide health coverage to employees would have an incentive to drop it.
Moreover, the mandate on employers is unlikely to survive a legal challenge; a similar Maryland bill was thrown out by the federal courts for violating federal benefits law.
Schwarzenegger continues to push his proposal to force most uninsured people to buy insurance or face severe penalties. So far, Democrats have resisted this proposal, but many expect them to accept some form of individual mandate as the final price for Schwarzenegger's blessing for the term limits initiative.
Last year, Democrats united behind SB 840, a single-payer-style, enhanced "Medicare for all" bill that would have provided guaranteed healthcare for everyone, controlled costs, eliminated co-pays and deductibles, guaranteed choice of provider, and gotten the insurance companies out of the way.
Similar systems are succeeding in every other industrialized democracy -- including Schwarzenegger's homeland, Austria. If the politicians in Sacramento are concerned about patient care, they will not now settle for a bad healthcare bill that will further degrade our healthcare safety net. A bad healthcare bill is worse than no bill.
Deborah Burger, RN is president of the California Nurses Association.
Follow Deborah Burger on Twitter: www.twitter.com/NationalNurses
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While I don't support the substance of the bill, for I think single-payer health care is the way to go. I will support this bill if it comes in the form of an initiative.
If that initiative loses, conservatives will claim that health care reform doesn't matter and shouldn't be pursued.
What the bill does include is the principle of universality. Establishing the principle of universality to me is the most important step in creating Universal Health Care.
The bill the governor supports will ultimately fail, but once universality is entrenched, single-payer health care will be more politically viable.
I see this compromise as a step on the pathway to what we need, not the obstruction as some others here do.
As weak is this proposal is, it is better than what we have now.
Take universality if it's offered. It's easier to modify the system once that principle is entrenched.
A GOP politician pushes a healthcare plan that benefits corporations at the expense of tax paying citizens. Standard GOP procedure. Why is anyone surprised, and who are the fools who continue to vote for the GOP?
Former U.S. Representative Nancy Johnson (D-CT) was a master of deception for the insurance companies. Of course, being from CT, the insurance companies have had her in their pocket for some time.
She betrayed American seniors by passing legislation that helped the pharmacuetical industry more than seniors. She lied to he constituency. As a result, the national prescription care for seniors is little more than a sham.
When America wakes up, and people disregard the propaganda against a national health plan, then we can move ahead.
We are contronted with an uninformed electorate who base their votes on propaganda and sound bites fed to them by the Republicans.
Most of the candidates for president have a plan similar to this for the whole country. They are all bad! The rest of the world has found that the system that works best is a free, universal, single-payer, not-for-profit, health care system. If the "insurance" companies are involved in a new system, they will rob us again. Unfortunately for the voters, these Corporate sponsored candidates are not allowed to speak against their owners. The only candidate offering positive change is Dennis Kucinich, as an added bonus he will end the war too..... Medicare for All
Sick people can not fight a oppressive regime.
I began reading SB 840, the plan Deb Burger says the dems united behind which is a single payer system. The bill opens on the very first page with the announcement of new bureaucracies: Consumer Protection Office, Inspector General, Public Health Planning Office, etc.
Funny, I didn't know that Medicare established all those bureaucracies.
Funny, isn't it, how Dems and Repubs take turns
offering up objectionable plans that don't make it because the objections are baked into the plan. Yes, Deb tells us that the Gov's plan won't even pass constitutional muster. It'll be thrown out by courts. And I threw the Dems plan in the garbage can on reading page 1, right on top of Hilary care.
I am for universal health care run privately and paid for by a single payer, like medicare.
The premiums (not taxes, as Repubs call them) will be paid by all through payroll deductions at work just as our old age annuity premiums are currently deducted (also know as social security). The premiums will be paid out to health care providers according to a scale of fees, just as the insurance companies do now. the scale of fees will be set by a medical commission with half membership elected by doctors, half minus one appointed by President, plus one chairman elected popularly.
Recently medicare - not insurance companies - began declining payments to hospitals for medical care for injuries sustained during falls in hospitals. The hopsitals got the message. The insurance companies were unable to deliver that message because they compete with each other in the market place. The invisible hand of Adam Smith had decided that patients falling and injuring themselves would most efficiently allocate resources in the medical market place. Do you really agree with Republicans that medical care is a commodity??
Sounds like California is continuing to do stupid these days. Between this faux healthcare reform (first passed in Massachusetts) along with the proposed Electoral College reform, Californians are proving themselves to be among the most gullible and stupid people among the electorate. That's saying something when you figure that they have to compete with States like Kansas and South Carolina.
"Insurance" isn't. It has evolved to serve itself and not those in need. The word and concept of insurance has been successfully inserted into the public discussion by those who have placed themselves inside the money flow because that's where the money is. The noble nature of mankind to help those in need does not require a third party to pass our money along to those in need and pocket a good chunk for itself. Corporate models do not have moral compasses to guide them. Them's the rules. So why do we trust corporations with our noble nature?
I urge all nurses, doctors, and all those in the battle to reform our health care system to conscienciously eliminate the term "insurance" from their reform vocabulary. It is health care "coverage" for all. Insurance isn't.
Full Medicare coverage requires that you actually contributed to society during your life (i.e. you or your spouse worked).
Why not have the same requirements for everyone?
Sure, you can exempt children, but everyone of age should have to demonstrate that they or their spouse is gainfully employed, in good standing at a college or trade school, etc.
This would force all the leeches on society to pay their own way.
Also, we should have astronomical costs for any non-resident. That's what they do for college tuition. They give a deduction to those people who have lived in the state and contributed to it. If you're from out of state, you pay through the nose.
So, if a Mexican or Canadian comes into the hospital, they will have to pay the regular cost, plus a large premium on top of that to cover the fact that they have not contributed to the country. If their government happens to have insurance coverage for them, all the better, we can bill the country directly.
Deborah Burger's name is well-known outside California as a powerful voice in the union movement, as a champion for universal heath care, and as a role model for women activists on all issues nationally. I was VERY excited to see this post on the home page.
Without denigrating Ms. Burger's fine work in the areas mentioned above: I have to say I've never been more disappointed in a posting here on Huffpo.
Most Americans believe that (perhaps second ONLY to ending the war) providing health care to ALL Americans should be the first priority on the national agenda. Millions of us OUTSIDE California are watching carefully to see if the Governor's proposals and the compromises necessary to enact something Concrete and Practicable in the real world might hold promise as a model for a national system.
The lingering animosity between the C.N.A. & Gov. Shwarzenegger is also pretty well known outside the state.
I'm a great admirer of Sen. Boxer but to frame the debate about something so critical nationally around the Senators campaign of 2010 and the electoral prospects of one Fabian Nunez (a name I became aware of 5 minutes ago while reading this post) is simply preposterous.
I would have expected much better from Ms. Burger than this "inside baseball/California politics" posting which seems largely concerned NOT with health care reform but with who gets the credit and/or blame for this or that legislation.
Perhaps some commentors or even Huffpo Bloggers who are California residents might be able to shed some light on the actual contents of AB8, SB840, as well as some other alternatives being discussed out there rather than the same old "We're the CNA & we hate the Governor.
tm
Tommy, I find it an amazing analysis of humanity that two people can read the same article and get something completely different out of it. I even re-read the article after reading your post to make sure I wasn't missing something.
My impression of Ms. Burger's posting was that this bill just plain fails miserably as a compromise to universal health care and will be a disaster for Californians. I fervently hope that this type of health care legislation will never see the light of day, it fails on every level to provide more efficient coverage for more citizens. "Efficient" should be the operative word in crafting better heath care, for it is the profit margin that undermines efficiency, therefore denying care to millions of citizens. We simply can't piss billions of dollars into an industry that doesn't know an aneurism from an aspirin and call it efficient health care. Thus, legislation favoring insurance companies and their profit margin cannot be the answer (they are pretty much the problem, all they do is push paper and count money).
In the world of politics, we elect representatives that are supposed to enact policy in the public's best interests. When they fail to do that, or enact policy that diminishes the public's ability to improve their lives, the only recourse for the public is to elect another representative. So, throwing Schwarzenegger under the bus for this dreadful piece of legislation is not only warranted, it is the duty of one as knowlegable as the author. I don't give three farts if the CNA likes or dislikes California's governor, and didn't really feel this was significant to the article.
"And, most critically, the plan reinforces and expands an insurance-based system -- the source of much of the present crisis"
Ms. Burger, agree that the paln is bogus but you are barking up the wrong tree. The California State Contoller's office published an investiagtion, now deleted, on thier website about the impact of hospital mergers and aquisitions on healthcare costs. The numbers and conclusions are the dirty secret of this political football.
Also, the non profit status of hospitals is a ruse. The profits in a non profit are simply distributed at the disgression of the corporate board, out of sight of the public.
Think about where the bulk of expense is incurred in healthcare and who does the least accounting. Hospitals charge $3,000 a day for care and their per procedure expenses are not in line. State mandated care for indigents is an excuse, predicated on inflated costs to defuse exploration of true costs. Most of it is M&A and board member compensation.
This isn't even close to a compromise.
It's a total sell-out.
Nunez and company are dreaming if they think this is a viable alternative to SB840.
That a term limit proposal is wrapped up in this deal is the epitome of self-serving corruption.
Anyone involved should be removed from office.
As a California resident and voter, I want it to be known that I oppose this stupid bill. And stupid is really the word for it.
Better no law than this one, because it kills chances for SB40, a proposal that guarantees universal health care and has the studies to prove it is affordable.
Universal health care for all. A small decuctible should be paid. A certain percent of weekly healthcare payment should be ducted from the paycheck. The percentage should be for every employee the same. Regardless how much they make. People who don't work , should be given the opportunity to sign up for healthcare.
dora,
Sounds good.
I'm disabled, and have been out of work for two years.
I'd be thrilled to have "a certain percent of weekly healthcare payment should be ducted(sic) from the paycheck", since the last time I tried to pay out of pocket it was approaching $1K/month.
A payroll deduction is MUCH more to my liking.
Thank you!
And everyone participates regardless of income. Everyone pays something. No optional coverage plans for rhose who can afford them. Insurance should be detached from employment. Frankly, I'd be in favor of burning the present system to the ground including Worker's Compensation. Healthcare should be managed for patient welfare not profit and if this means we don't get as many technological wonders then so be it. I'm not convinced that we need the private sector to develop our medical toys. Research can and should be conducted at universities and medical schools with no option for going private sector to make a fortune. I'm sick of seeing anyone make a bundle from the medical miseries of so many.
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