California Special Report: The State Gets Serious About Reform
By: Laura Mecoy; Source: AARP Bulletin Date Posted: 2007-05-23 16:57:00-04:00
By Laura Mecoy
May 2007
As the Terminator, Arnold Schwarzenegger blew up buildings, cars and people onscreen. Now that he's governor, the former actor is blowing open doors on public policy with his $12 billion plan to overhaul California's health care system.
It's an audacious and controversial proposal aimed at insuring all Californians. Conflicts over such issues as costs, fees for doctors and hospitals, the extent of coverage and how it will all work could threaten his plan.
But his proposal also holds the promise of restraining skyrocketing costs, ensuring access to quality care and improving the overall health of Californians by encouraging preventive measures. The leaders of the state Senate and Assembly have each written their own prescriptions for the state's ailing medical system, and Democratic leaders and the Republican governor agree that now's the time to work together for reform, using the various proposals as a starting point.
Schwarzenegger recently told a group of consumers and health professionals that he wants to "really show the rest of the nation and ... the federal government that we can do it here in California. And if we can do it here ... other states can do it, and the federal government can also do it."
While AARP hasn't endorsed any of the plans circulating in Sacramento, the association has jumped into the debate with an unprecedented statewide effort. AARP is working in the capital and around the state, recruiting volunteers and staging events to urge legislators to expand health care access. "AARP will be a strong advocate to ensure that Californians of all ages can get the health care they need when they need it," says Tom Porter, director of AARP California. [See sidebar]
The presidential candidates are already discussing health reform, and it's no wonder, given the magnitude of the problem. In California alone, more than one in six residents are uninsured; yet 85 percent of them work. Most seek care in emergency rooms or clinics, limiting access to these services and straining hospital budgets. In the last decade, more than 65 emergency rooms in California have closed.
"This is a crisis," says JoAnn Lamphere, national coordinator for AARP's state health and long-term care team. "It's not just a story about the uninsured. It's a story about 'life happens.' You become divorced or downsized from a job and find yourself without insurance." She says people ages 50 to 64, who aren't old enough for Medicare, often can't qualify for insurance because of pre-existing minor health problems.
Most analysts expect that lawmakers will ultimately decide on a compromise reached between Schwarzenegger and the Democratic leaders, Senate President Pro Tem Don Perata and Assembly Speaker Fabian Nuñez. So far, the three agree on expanding coverage to all children; requiring employers to provide health insurance or pay into a state fund for the uninsured; and changing the rules so fewer people could be denied coverage.
But they differ in their approaches, and each faces opposition on several fronts. Republican lawmakers have rejected the governor's plan and put forth their own. Some groups aligned with the Democrats back a single-payer health care plan. And long-running debates about taxation, small businesses, the role of government, and immigration could threaten to scuttle even the most popular element of reform—insuring all children.
"It will be a real test of the governor's mettle to show he can translate all that political interest into a winning proposal," says Robert K. Ross, M.D., CEO and president of the California Endowment, a private health care foundation. Ross expects only "incremental" change but says "incremental is not a bad thing" if it means more Californians get health insurance. However it turns out, he says, we should all grab a bag of popcorn and a front-row seat to watch the former Terminator take on his latest foe: California's health care crisis.
Additional Related Links
Healing Our Health Care System (March 2007)
Poll: Health Care Myths (March 2007)
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