After months of exhausting irresolution, Governor Arnold Schwarzenegger and Assembly Speaker Fabian Nuñez crafted the Schwarzenegger/Nuñez health-care bill, ABX1 1, which sounds like it requires batteries and a remote control. As it turns out, ABX1 1 requires $14 billion that California doesn’t have. 

A wonderful, awful idea.
    In a display of insatiable government spending during the giving season, the California Assembly has passed this bill despite an equally large $14 billion deficit.  Although well-intentioned, this proposal for the Golden State’s uninsured is not well-timed, and not well-planned.  Many of our legislators need to learn that spending and giving are not necessarily equivalent.  Instead, California should give citizens the gift of choice, savings, and health care freedom.

Then he slithered and slunk, with a smile most unpleasant, around the whole room, and he took every present!
    Though supposedly insuring more Californians, ABX1 1 takes many things in return.  It takes away the choice to become insured by mandating that almost all Californians obtain private medical insurance; it takes extra fees from employers to pay for medical insurance; and it takes away the practice of measuring health risk from insurers by mandating guaranteed issue.  It takes an estimated $2.3 billion from hospitals, which is only “supported” by The California Hospital Association (CHA) because it stipulates that hospital taxes must first go to increase Medi-Cal (Medicaid) payments to hospitals before helping California’s uninsured.

What a great Grinchy trick!
    Though Governor Schwarzenegger has given up his plan to lease the lottery to fund health care, he has agreed with Assembly Speaker Nuñez to hike tobacco taxes, estimated at $1.50 to $2 per cigarette pack.

He took the Whos' feast! He took the Who-pudding! He took the roast beast!
    We all remember California Proposition 86, which failed at the polls for a good reason.  It would have levied an excise tax of $2.60 per pack on cigarette sales.  Such a tax increases hospital dependency on tobacco money, an unreliable revenue source that’s already on the decline. What’s next?  We have already seen proposals to place moratoriums on fast food restaurants in Los Angeles.  Recently, San Francisco Mayor Gavin Newsom proposed to tax sugary drinks.

”Why, my sweet little tot,” the fake Santy Claus lied…
    More important, if tobacco funds in the current Schwarzenegger/Nuñez proposal go to enrolling more children in government-run health care, this bodes poorly for children by “crowding them out” of private health insurance, expanding government, and reducing families’ health care choices.

And the one speck of food that he left in the house ... Was a crumb that was even too small for a mouse.
    Tax hikes will not be productive if they support inefficient government programs. An example is the federally-funded Medicaid, which provides relatively second-rate care, and owes providers some $750 million in reimbursements. The Medicaid bureaucracy underpays so many physicians that increasingly fewer accept Medicaid patients, and some take none at all. Two long-term care facilities have already filed suits against the state of California for not providing requisite Medi-Cal payments. According to a study recently published in The Annals of Emergency Medicine, more Medicaid and SCHIP beneficiaries are going to emergency rooms for non-emergencies, and the uninsured are actually paying a higher proportion of their ER fees than Medicaid is reimbursing emergency departments.

The tags! And the tinsel! The trimmings! The trappings … Up the side of Mt. Crumpit, He rode with his load to the tiptop to dump it!
    Instead of increasing government power over smokers and patients, the state should deregulate the insurance mar¬ket by allowing insurers to modify premiums based on smoking, thereby motivating smokers to take more responsibility for the unhealthy consequences of their behavior.  The state currently forbids health insurers in the small group market from pricing the risk of smoking by increasing smokers’ premiums.
    Californians should have more health-care ownership.  We need to align state tax laws with federal laws by allowing Californians to make pre-tax contributions to Health Savings Accounts (HSAs), a kind of 401(k) for health.  Statistics show that between one third and one half of HSA owners were previously uninsured, a testament to their gradual but likely success.

But the sound wasn't sad! Why, this sound sounded merry!
    Among those who own HSA-eligible plans, patient behavior is changing.  Consumers are exercising prudence about health care overuse, closely observing their treatment procedures, demanding more information and transparent prices, and finally, experiencing a decreasing growth rate in health-care costs.

It started in low. Then it started to grow.
    Competitive retail-based health clinics are also slowly making their way to California despite strict state regulations that require physicians to supervise every four nurse practitioners.  (In many other places, nurse practitioners can work without a supervising physician.)  The state should reform “scope of practice” laws so that Californians, and especially the uninsured, can take advantage of this emerging market, which is the competitive answer to long waits in an emergency room for basic services.

And the minute his heart didn't feel quite so tight, He whizzed with his load through the bright morning light! 
    Free, competitive solutions to increase health care access are emerging, and they will thrive with fewer government restrictions.  Meanwhile, sweeping state taxes will take more than they give.  Instead, our legislators should reward Californians who take responsibility for their own health spending this holiday season.  This Christmas, we all deserve fewer government mandates, flexibility and freedom from an employer-based structure, more personal choice, and savings.