Universal health care dead in CA: implications

The plan to provide universal health care in CA, a bipartisan effort led by Republican Governor Schwarzenegger and Democratic Assembly Speaker Núñez, was voted down Monday 7-1 in the Senate Health Committee. In the end it faced opposition from both Republicans and Democrats, as well as from powerful special interest groups like the tobacco industry.

Below, some quotes from this summary and brief thoughts on implications.

The bill was killed yesterday by Senate Democrats, who argued that it would burden consumers, dig a deep hole in the state's deficit-ridden budget and provide a windfall to insurance companies. They joined Republicans in a 7-1 vote by the Senate Health Committee against the legislation.

The defeat of a bill that promised to cover 3.6 million Californians illustrates the difficulties of passing a compromise, centrist plan in a polarized Legislature. The vote effectively ends any chance for major health care changes this year.

This result illustrates the importance of being able to overcome political polarization. Even this compromise bill was too hot politically to get through -- Republicans called it a tax increase, Democrats called it an insurance giveaway. Both were partially right, but there were points of agreement too that got lost in the usual partisan posturing. To pass universal health care in any reasonable form will require leadership that can unite liberals, conservatives, and independents behind a solid bill.

Supporters of proposed health system overhaul called the vote a missed opportunity.

“It's incredibly disappointing,” said Anthony Wright, executive director of Health Access, a union-backed group that pushes for expanded coverage. “There's millions of Californians who have lost hope for getting coverage.”

Health care is an urgent issue, one that impacts millions of Americans every day. It needs to be dealt with on a national level. The next President needs to come to the table with a broad coalition of support in order to pressure involved parties to hammer out an equitable and effective solution. We can't afford to let this chance slip away because opponents of reform are able to demagogue against it with cries of "socialism!" -- we need this effort to be led by someone who will be relatively immune to such smears.

Schwarzenegger wanted to fix a broken system that has suffered from soaring insurance premiums, a growing number of uninsured and increasing congestion in the state's emergency rooms.

[...]Schwarzenegger and his allies cobbled together a coalition that included consumer groups, the AARP, Safeway and other large corporations. He could never persuade GOP lawmakers to join because of their opposition to taxes.

Let's be honest, any universal health care proposal is going to be characterized as a tax increase by opponents. Schwarzenegger tried to sidestep the inevitable accusation by saying Californians currently pay a hidden tax by subsidizing the cost of the medical treatment received by uninsured persons visiting the ER. This didn't go over well with the GOP, but it illustrates the correct approach to such charges: discuss the current costs of our broken system when opponents say that reform will be too expensive, and point out the future savings in both human and economic terms.

Even some sympathetic to the plan suggested the initiative could have lost by a large popular vote, which they feared would set back the cause of health care reform.

Democratic political consultant Garry South said he isn't surprised that Democrats defeated the plan because many distrust insurers.

“The fatal flaw in this thing was requiring people to buy health insurance without controlling the costs of a policy,” South said. “That could be a windfall for insurance companies.”

Two points here. First, failed attempts to pass health care reform hurt that cause. They make it appear that there is insufficient support, when in fact polls show that Americans desperately want health care reform. They make it appear that special interests cannot be defeated, when in fact a broad political coalition would overwhelm and rebuff the targeted influence of their lobbyist dollars. They make it appear that those proposing reform don't really know what they're doing, undermining confidence in future attempts. We can't afford another costly failure.

Second, mandatory coverage is not sufficient. Policies have to be affordable or the plan will simply compel working Americans to spend money they don't have.

There are some useful lessons for us, as we go forward and attempt to change health care on a national level, in what happened recently in California.

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We have been privileged to have three strong candidates running on three strong plans for universal health care, and I want to particularly acknowledge Edwards' role in emphasizing this issue. Here is a speech by my preferred candidate that I believe indicates he can deliver health care reform, that he understands the most important challenges and that he possesses the political skills to make this happen:

We have reached a point in this country where the rising cost of health care has put too many families and businesses on a collision course with financial ruin and left too many without coverage at all; a course that Democrats and Republicans, small business owners and CEOs have all come to agree is not sustainable or acceptable any longer....

Today I want to lay out the details of that plan - a plan that not only guarantees coverage for every American, but also brings down the cost of health care and reduces every family's premiums by as much as $2500. This second part is important because, in the end, coverage without cost containment will only shift our burdens, not relieve them. So we will take steps to remove the waste and inefficiency from the system so we can bring down costs and improve the quality of our care while we're at it....

when I'm President, we're going to make drug and insurance companies compete for their customers just like every other business in America. We'll investigate and prosecute the monopolization of the insurance industry. And where we do find places where insurance companies aren't competitive, we will make them pay a reasonable share of their profits on the patients they should be caring for in the first place. Because that's what's right....

The time has come for affordable, universal health care in America.

(Also in orange )
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Come, my friends. 'Tis not too late to seek a newer world -- Tennyson