Healthcare moves to center stage

Now that the Governor has milked his green credentials for as much as the public and media will bear, he’s finally come back to the state he’s supposed to be overseeing. With his media exploitations overshadowed by the tragedy in Virginia and the meltdown of the country’s chief law enforcement officer in a web of poorly concealed prevarication, Arnold isn’t front page news anymore so he’s folded his circus tents and headed back to the state that calls him Governor, for better or worse.
For those of us who think his leaving the state to those with more commitment to it and less to their own personal glory and aggrandizement is a good thing, there is sadness or at least melancholy that he’s back. For those who think he should try to help mold the state he claims to serve, his return is vitally important to move important issues forward.
And for those who are following the health care debate, the Governor is a quixotic presence in the whole discussion. He has been expounding on his vision for “universal health care” (although his plan doesn’t cover everyone, as the phrase “universal” would require). As touted throughout the country this past week, his plan would cover all California’s 6.5 million uninsured. It would do so by requiring doctors, hospitals, health plans, individuals, employers and the government to contribute into the system or suffer risk of tax penalties. Whatever his proposal ultimately entails, it doesn’t even have an author and so isn’t even in legislative form. In other words, as a legislative reality, it is a figment of his large and oversized imagination. Or so one would think.

In fact, it is expected that he will have a substantial role in shaping health care reform in spite of his failure to generate enough conceptual support to find an author to shepherd it through the legislative process. But following the rules has never been Arnold’s interest or strong suit, so he’s purportedly got his staff working hard on the details of his plan while waiting out the legislative measures that he intends to hijack at the end of the process.
So where are the specifics of his plan and where is Senator Sheila Kuehls Medicare-type single payor system, SB 840, the best proposal of the lot, in this discussion? The answer is that it isn’t in the debate, period. Although her measure is by far the best and frankly only real UNIVERSAL plan, the governor has already vetoed it once and has promised to do so again. He simply won’t remove the insurance industry from the equation. After all, he receives millions from his friends who are taking 35-50 cents of every health care premium dollar and using it for overhead and profit. In spite of this outrage, he’s committed to keeping them in the game and forcing the rest of us, even those who lack the financial ability, to keep the insurance companies fat and happy.
Without SB 840 as a viable option under this Governor, legislators have been moving fast and furiously to come up with some kind of workable, albeit much more modest reform of our dysfunctional healthcare system.
While Speak Out California has highlighted Assemblymember Dave Jones bill which will require justification before insurance companies can continue raising their rates (and their profits), the leadership of both houses has also been hard at work to fashion “compromise” legislation.
Although neither of their measures cover everyone, Senate President Pro Tem Don Perata’s plan would cover all working Californians and their families by requiring employers as well as employees to bear a portion of the cost.
Assembly Speaker Fabian Nunez’s plan requires employers to contribute to health insurance and wouldcover all the state’s children. Again, the insurance industry remains intact. Neither of these plans goes the distance in reaching all of California’s people who lack health care or can acquire more than bare-bones coverage.
So where is all this headed?
Although both legislative leaders measures are due up for hearing over the next week or two, the governor’s proposal will not be subjected to the public scrutiny required of legislation. Committee hearings are open to the public and participated in by the public and all stakeholders. Public scrutiny and transparency are why we have a legislative process that some would see as repetitive and tedious. Well, it is. But it is designed that way to allow input and criticism in the hope and expectation that what ultimately results will serve the best interests of the public while not injuring relevent groups more than necessary to accomplish the desired purpose.
So what is the play for the governor in this? The bottom line here is that all these healthcare bills, if they survive their committee and floor challenges, are most likely to end up in a Conference Committee where public scrutiny is limitied. It is at this point that the governor’s people will enter the room and make certain demands, trying to fashion the bill as the governor wants it, while avoiding those kleeg lights that the Governor likes to save for his bombastic persona alone and not for detail or substance.
Of course, as governor, Schwarzenegger has the ability to veto whatever he doesn’t like. He will use this obvious power to try to inject his vision of health care reform into one or more of these bills to achieve his goal–keeping the insurance industry happy while being able to head back out to the rest of the country and claim California has taken great steps in the battle to overhaul the healthcare system.
We’ll have to wait and see how this all plays out ultimately, but we know whatever happens, the first one to proclaim victory will be our governor. Hopefully, the people of California turn out to be the winners in all this, but without some form of Medicare-like single payer/universal coverage, the biggest winners are again most likely to be the governor’s biggest supporters—the insurance industry. We have a ways to go, however, to see whether there are any winners in this battle. We’ll be watching, kleeg lights or not.