The Health Care Crisis in California

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.

Comments

[TRex86]

California is a quirky state that thrives on a heady mix of self-righteousness and contradiction. The medical association put forth an initiative in 1992 that would have covered the uninsured (with no additional taxes) by combining programs and carefully defining the benefits package. The HIAA "Harry and Louised" it the last week of the campaign. (BTW, the single payor advocates refused to support it due to its idealogical impurity). In California nothing is better than something.

Anyone that lives in California is rightfully worried that a state run system will become The Son of Medi-Cal, an underfunded, over-regulated pathetic excuse for poverty medicine. The injustices of California health care are too numerous to mention, but one neck-snapper is the endgame of Gov Reagan's destruction of what was the nation's best mental health system. Now, for example, in LA county six times as many mentally ill receive care through the jails as through the mental health system. Way to go, Ronnie.

But the left gets its share of blame too. A few years ago, in the face of 6.5 million uninsured and similar numbers of underinsured on Medi-Cal the voters handed $3 billion (six billion after loan repayment) of tax dollars to a handful of entrepreneurs and researchers to fund the unproven science of embryonic stem cell research. (This kind of basic research is best done through the NIH, a task for the post-Bush federal government, which BTW would not need anywhere that amount of money for the current level of valid inquiry). California's funding exceeded the scientific merit of this enterprise, about which no legitimate scientist will claim that any benefits for decades--if ever. In effect, people that were desperately sick and dependant on expansion of state-funded care were tossed on the junk heap to finance a speculative fantasy of miracle cures with no realistic prospect of benefit long into the future. If it ever pans out it wil be a form of treatment that only Howard Hughes could afford. That's life in the Golden State of Contradiction.
Rex

[TRex86]

Balderdash. There is no basis to claims of billions spent on undocumented workers for health care and other services. Moreover, they provide tremendous economic benefits to the state--and pay taxes. Are your kids eager to go pick strawberries next spring? All this immigrant bashing is causing significant damage to the agriculture industry.

[Cranbot]

This country should have a vested interest in the health of its citizens. Less sick time used at work, etc. The big businesses such as the auto industry have started to rumble on the cost of health insurance vs. locating in Canada, but for the life of me I can't see why all these profit first republicans don't want to ease the burden on the companies so they can make even greater profits.

Pay more in taxes in order to have universal health care (NOT INSURANCE)...hell yes. I'd be willing to bet I'd be paying a lot less in taxes than I would in health insurance premiums.

The insurance companies will fight to the death, but instead of our deaths - it should be the death of their vulture like policies.

[K-Dog76]

I have no answer to to the healthcare issue. But would like to know how people about the crumbling of socialized healthcare in Canada. Many Canadians requiring certain types of emergency care or advanced cancer treatment are coming to America. I'd like to know where the balance is? Obviously improvements need to be made, but to lose privatized medicine could spell the end of quality healthcare and higher expenses for millions who currently have coverage. Thoughts?

[cynara]

There is another option on the table in California. There is a single payer plan, sponsored by State Senator Kuehl, that is basically medicare for all. It passed both houses of the California legislature before being vetoed by governor Schwarzenegger. It is backed by California Teachers, Nurses, and the Democratic party.

Here is the website for more information:
http://www.onecarenow.org/

[CLR]

What about using the BILLIONS we now spend to provide health care for ILLEGALS on our own citizens?

[CLR]

What about taking the BILLIONS we pay to educate and provide health care for ILLEGALS and using it on our own citizens?

[plutorage]

National Security is centralized and Health Security should be centralized as well. The efforts to have 50 different plans for 50 different states is misguided tho I am sure one can find something good to say about it.

On balance, our health should be a national effort.

Repubs like to say that health care is not a right. But when you begin questioning them they admit that nobody is denied healthcare.
They are trying to maintain a selfcontradictory system.

If a person is dragged unconscious from a car by police after a traffic accident, that person is taken by law to a hospital and treated. In effect, there is a right to healthcare. The question is whether that person has paid premiums. The best way to insure that the person has paid premiums is to levy premiums the same way we levy social security. End of story.