Much as I hate to admit it, those of us who believe that patients should control the dollars spent on their health care do not hold the high ground in California. Actually, I think only the Endangered Species Act keeps us alive!
The real “struggle” is between those who want to immediately impose a single-payer, government-monopoly and those who want so-called “universal” coverage via a mix of government programs (Medicaid and the like) and compulsory private insurance. Call it fascism versus communism. But is it really struggle, or just a show?
State Senator Sheila Kuehl and allies in the California Nurses Union and other groups have long advocated imposing a government monopoly, eliminating health plans and taking over hospitals’ capital and operating budgets, as well as forcing doctors to send their bills to the state for payment. The bill is SB-840, and the unions who want to take over your health care keep churning it through the legislature, despite Governor Schwarzenegger’s veto.
Gov. Schwarzenegger, like former Massachusetts Governor Romney before him, advocates the notion that the state should order every resident to either buy private health insurance or enroll in a government program. He has brought the Democratic majority in the Assembly onside, with ABX1 1, but the state Senate still balks. Senator Kuehl promises to hold the Mother of All Hearings if and when the bill arrives in the Senate. Senate President pro tem Perata, previously enthusiastic for mandatory coverage, has decided to move ABX1 1 to the back burner. Surely, he can’t be too upset that this bill imposes only a 6.5 percent payroll tax, instead of the 7.5 percent he favors!
Later this month, PRI will publish a paper explaining what I hope many already understand: that ABX1 1 will make such a mess of health care in our state that Californians will cry out for single-payer, government-monopoly, health care, due to a sort of post-traumatic stress disorder. I have long suspected that single-payer advocates know this. However, they also know that most Californians don’t want the government to decide what health care they get, but find the idea of “universal” coverage appealing.
How to move the ball down the field? Crank out some analysis that shows how “universal” private health insurance is good for business, makes California more competitive, and demonstrates American values of fairness and equity by “covering the uninsured”. Convince some business leaders (like Steve Burd of Safeway) that you’re right, and you’re off to the races!
But when someone tells the people that you’re en route to government-monopoly medicine, you’ve got a problem building that coalition. You need a backstop: You need to keep your loonie-left offside, opposing your “moderate” reform, so that decent, limited-government folks (like Fresno Mayor Alan Autry) don’t see through the act.
I am probably just a deluded Canadian immigrant who wants to make sure that the U.S.A. doesn’t make the same mistake we did in the 1960s; but what if Senator Kuehl and her gang are fighting ABX1 1 for exactly this reason: to fool ordinary Californians (including Governor Schwarzenegger) into thinking it will stop a government-takeover, instead of advance it?
Well, check this out. This morning, I had the pleasure of spending an hour debating ABX1 1 on KQED, the largest NPR radio affiliate in Northern California. Being NPR, all of the callers advocated single-payer health care, and attacked all of the panel, even the supporters of ABX1 1, for not backing SB-840.
Here’s what Peter Harbage of the New America Foundation, the author of the analysis that Governor Schwarzenegger used to launch his reform, had to say to those callers:
I think all the callers asking about single payer ask a good question, and I think that what we really need to be careful of is that we do have an opportunity to move forward on health reform here in California, and what we have to do is look at what we can get done and what can get done right now. So, for all the folks who want single payer I’d really encourage them to look at the discussion to see where the momentum is headed and asking themselves: “Is this the step that we have available today, is this a good first step towards moving towards health care reform?”
You be the judge: Am I suffering from a bad case of conspiracy theory, or have I called it right?