On December 31, 2006, the health insurance I purchase through a group of freelance artists and writers cost me $4715/year. On January 1, it jumped to $12,268. That's $1.40 per hour. I watch a Dodgers game, and I'm down $3.50 by the 7th inning. I go to sleep, and I've paid another $11.20 for health insurance by the time I wake up.
Like so many people in California, then, I've been watching with high hopes this year as the Democratic legislature and the Republican governor both try mightily to pass a health-care reform bill. This is California, after all -- the state that's decided to unilaterally stop global warming. We love to pave the way for everyone else.
The bad news is that Schwarzenegger and the legislature have proposed moderately different plans, and are battling fiercely to prevent passage of the other. The worse news, unfortunately, is that both plans fail miserably to tackle two major causes of the health care crisis -- the link between insurance and employment, and the major economic and managerial role for private insurers. These competing plans aren't worth a seed-spitting contest, much less the raging foot-stomping political brawl.
The governor and the Democrats, rather, are duking it out to add modest regulations to a system that the majority of Americans say is radically broken. California seems dead-set on showing the rest of the country how to continue to keep us all in a state of mass anxiety about how to get and pay for health care.
The centerpiece of both plans is that employers are required to spend a minimum percentage of their payroll to cover their workers -- 4 percent in Schwarzenegger's plan, and a massive 7.5 percent in the other. So both strengthen, rather than sever, the current disastrous reliance on employers -- an accidental artifact of the post-World-War-II economy, when companies started to use health coverage to compete for workers. Both pave the way for how to perpetuate a system that restricts Americans' career choices and discourages self-employment. The plans burden smaller and lower-profit businesses, especially. And Americans who become too sick to work will continue to lose coverage at exactly the moment when they most desperately require health care.
By keeping decisions and profits in the hands of private insurers, the Golden State also aims to demonstrate how this country can continue to tie up the costs of health care in the earnings of companies that maximize profits most efficiently by minimizing health care-CIGNA, for example, which cleared $1.63 billion in profits in 2005 and earned a 37 percent return for shareholders. Which paid its CEO $28.8 million -- $54.83/minute, and 6,117 premiums at my rate that year. And which does not bother to prioritize, much less mention, health care in its self-described purpose (in its annual reports) as a company "that focuses on our control environment [whatever that is], risk management and shareholder return."
Schwarzenegger's plan does require everyone to buy insurance, while the Democrats' doesn't (though to be fair, he vetoed the Democratic single-payer bill last year). And both sides propose to control the cost of premiums, and to prohibit denial of coverage to people with health problems. However, neither plans imposes clear-cut regulations on insurance rates and extent of coverage. It's a good thing, therefore, that both sides promise to subsidize the poor, since the financial strain of unafforable premiums and uncovered medical costs should make many people sufficiently impoverished to qualify.
Yes, California will lead the way to leave Americans' health care in these companies' hands, since, as Assembly Speaker Fabian Nuñez has assured us this year, "We're not trying to turn this state into Cuba or Canada." They'll show us how not to do something so un-American as prioritizing the health of many over the profits of a few, which is a priority that other prosperous democratic countries (all of them, actually) embrace. They'll patriotically lead the charge to support a free-market health-care economy that increasingly has stripped Americans of the basic everyday freedoms of deciding what careers they can pursue, and whether they can move to another town or state, and even how many children they can realistically think about being able to afford.
In sum, California's political leaders, who are pioneering the way to global re-cooling, are inexplicably and pusillanimously leading the way toward health care reform that will cover some more people and provide moderate cost reductions. And it will energetically preserve a system in which the extreme difficulty of getting and paying for health care will undemocratically restrict the most essential choices in our lives, and will remain an omnipresent source of anxiety.
Or to put it another way -- a night of sleep in California might soon cost slightly less than $11.40, but in any state that follows California's lead, a good night's sleep will continue to be exceptionally hard to get.