Pursue Health Reform Carefully, Not in a Rush
 
In light of recent polls indicating many Californians are dissatisfied with the health care system, it should come as no surprise that it’s an issue under much scrutiny.  Now that the Governor has called a special session to focus on this area, the state legislature will have an opportunity to address this issue directly. Virtually everyone agrees that some kind of health care reform is necessary, but, as with much that government attempts to do, the devil is in the details. 
 
The Democrats’ proposals range from Senator Kuehl’s full-fledged single-payer plan to variations of universal health care that burden employers and hospitals with onerous new taxes or – wink, wink – “fees.” The Governor has vowed to veto Kuehl’s SB 840, but other proposals, such as Speaker Nunez’s AB 8 still threaten small businesses with the burden of higher taxes. 
 
More to the point, AB 8 offers no remedy for the core problems vexing the state’s health care system. It throws a lot of money – someone else’s, naturally – at the issue without reducing costs or improving the quality of care or access to it. The Governor’s plan isn’t much better, requiring every business with ten or more employees to provide health benefits while taxing hospital and physicians’ revenue.
 
Senate Republicans introduced our own comprehensive health care plan earlier this year. Contrary to the Governor’s assertion, echoed by legislative Democrats and some in the media, we were actually quite eager to be included in the debate. 
 
However, Speaker Nunez’s statement that health reform “really comes down to three people, let's be honest,” belies the assertion that Republican Senators had any power over whether health care was tackled this year or not. So to does the fact that Democrats long ago secured an unusual Legislative Counsel opinion determining that the fees AB 8 would impose are not taxes and, thus, are not subject to the two-thirds requirement that would make any Republican support necessary for its passage.
 
Meanwhile, our plan, dubbed CalCare, languished in a committee all year without so much as the courtesy of a hearing, which is a shame because it actually would address some of the issues driving cost increases in the present system.
 
In addition to providing inducements for hospitals and private industry to create new clinics, Senate Republicans sought to adjust physician oversight requirements in order to allow registered nurses and other highly qualified health providers to run primary care clinics. By increasing the availability of such health care facilities, particularly in rural and underserved areas, California could provide a more convenient and less expensive alternative to overused emergency rooms. 
 
CalCare also advocated conforming California’s tax laws to federal guidelines governing Health Savings Accounts. Health Savings Accounts are modeled after Individual Retirement Accounts, allowing people to put aside savings, tax free, for future out-of-pocket medical expenses. While these savings are not taxed by the federal government, they are taxed in California, creating a disincentive to use such funds and a bookkeeping headache if they are. Senate Republicans also recommended regulatory changes allowing insurers to offer more flexible health care plans, in order to give consumers greater options in the coverage they actually need. Unfortunately, neither Democrats nor the Governor have paid these modest reforms much heed. Instead of taking a realistic step forward and establishing some common ground to build upon next year, they appear determined to rush radical action through at the last minute.
 
Ten years ago, the legislature passed an eleventh-hour bid to deregulate electricity, which while well-intended, ended up contributing to the energy crisis that nearly crippled California. The lesson we should have learned then is that hastily action does not equal sound reform. 
 
Of course, health care policy is not as arcane as the ins and outs of energy markets. It’s about people and their quality of life – all the more reason to pursue reform thoughtfully and honestly. 

The recently concluded budget stalemate undoubtedly left everyone in Sacramento a little bruised and worse for wear. Some believe a comprehensive health care reform package would certainly help the Governor and some legislative leaders save face.  It would be a terrible mistake, however, to push a flawed and half-baked proposal on the people of California just to say something – anything – was done.

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