Guaranteed Healthcare

Maybe I’m seeing things too optimistic, but stepping back from the details of the healthcare reform movement, and looking at the big national trends, there is reason to hope that the movement in California for guaranteed healthcare will lead the nation along a path to progress.

Obviously in many ways the situation is different…labor unions are stronger in California than they are nationally, (and led the way in defeating the insurance industry-backed fake healthcare reform bill offered last year by Arnold Schwarzenneger and former Speaker Fabian Nunez), and the healthcare grassroots might be more developed as well.

But the underlying economics are the same…workers, families, employers and the state budget alike are all being crushed by out-of-control costs for insurance premiums, deductibles, and co-pays, all for a service that places us last in the industrialized world, and to subsidize a health insurance industry that plays no role in the delivery of patient care.

So let’s just take a look at the evidence that suggests California is leading the nation:

1. Goodbye mandates and insurance-centered coalitions!

Arnold Schwarzenegger’s bill contained an individual mandate, that is a provision that every resident buy insurance from one of the big health insurance companies…no matter the cost or quality.  Supporters of the bill argued that the mandate could be softened by giving subsidies to lower-income people; in other words that the people of the state should send billions of dollars in subsidies to insurers, and guaranteed them millions of new customers.  That’s a non-starter, and not popular among the public.

On the national scene, Hillary Clinton made this mandate her main critique of Obama’s healthcare plan, and the idea has largely dropped of the national agenda atter her loss.

It won’t entirely go away, either in Cali or nationally, as it is marketing heaven for insurance companies and they will push it every chance they get.

The other blowback from Schwarzenegger’s big loss was that the idea of an insurance industry-centered healthcare coalition was discredited.  Schwarzenegger tried to bring together a coalition of progressives with the insurance industry. At the end of the day, the financials simply did not work to both cover everyone and to guarantee all these new profits to insurers, so this coalition blew up. 

On the national level, one hopes that the debate over healthcare  will happen outside of the industry coalition, and that is why it’s so important to marginalize AHIP.

2. From SB 840 to HR 676

Sen. Sheila Kuehl’s bill SB 840 is one step ahead of John Conyers’ HR 676.  Both would transition in a system of Universal Medicare, like every other industrialized democracy can boast of.  Kuehl’s statewide version has now passed the California Legislature twice, and been vetoed by Gov. Arnold twice.  Good news: She’s introducing it again, even if it might not pass till there's a Democratic governor in 2010.

Every health reformer reading this should take a second and read Sen. Kuehl’s words about what she’s doing and why.  The woman is the real deal, and she has shown us how to pass these bills.

I believe we are going to solve our healthcare crisis with Universal Medicare, aka the  single-payer health model, because every other industrialized democracy has shown this to be how we fix the problem. 

At the federal level, Rep. John Conyers bill HR 676 has not gotten as far as SB 840, but is following the lead of lining up co-sponsors and supporters.  HR 676 now has 91 co-sponsors, more than any other health care reform bill enjoys.  It has the support of over 400 different labor organizations, as well as almost the entire  grassroots health care movement.  (No one wakes up and says, “I am ready to go fight for a compromise with the insurance industry today.”) 

Eventually HR 676 will pass, because our health system is broken and the insurers can’t fix it, and this is important work on the way.

3. Cracking down on insurers in the mean time…

You may have heard that LA City Attorney Rocky Delgadillo has made himself a progressive rock star by suing Blue Shield and Blue Cross for their illegal recission of patient policies.  The suits charge that the blues are systematically denying care to patients who deserve.  Delgadillo has sued them for $1 billion and even recommended criminal charges against some of these guys.

That got their attention fast.

Quicker than you can say fundraising payback, Arnold Schwarzenegger jumped in to broker settlements with the companies.  Under the state terms, the companies have to pay back $10 million and re-instate 2,200 policyholders who got kicked off the rolls.  Chump change.

Delgadillo blasted the Schwarzenegger administration:

"They will not make the victims of this insidious practice whole, they will not require that the companies disclose their wrongdoing, and, in my opinion, they will not adequately punish the companies for their shameful conduct."

Fortunately, Delgadillo’s suits are still on-going. 

Even more fortunately, Rep. Henry Waxman is now following Delgadillo’s lead and promises to hold hearings on the insurers’ practice of recission.  He says:

“...insurers are using technicalities or trumped-up ‘misrepresentations’ to rescind policies after individuals get sick and accumulate hundreds of thousands of dollars in medical bills.”

One way we’ll get to guaranteed healthcare is by actually holding companies responsible for their crimes.

What do you think?