Thoughts Turn To Health Care

by David Dayen [courtesy of Calitics - Front Page]

With the budget resolution, the clock starts for the rest of the legislative session in Sacramento.  The Assembly and the Senate have until September 14th to pass bills before them and send them to the Governor's desk for signature.  And obviously the centerpiece of the session is health care reform.  AB8 will be the organ for Democratic legislative leaders and the Governor to come to an understanding about how they want to fix the state's health care crisis.  And the people are weighing in and saying that their preferred solution has a different bill number; SB 840.

Over...
Frank Russo reports:

36% of California voters support a new government run system--like Medicare--up from 24% in last December's survey. At the same time support for making "reforms with the framework of the current health insurance system, with shared responsibilities by government and individuals" has dropped from 52% to 33%. Reliance on "free market competition to improve the health insurance system" draws only 14%, down from 18% previously.

So after months of all actors in the health care debate talking to their constituents, more people want to see health care for all than a shared responsibility framework that keeps the current for-profit system in place.  And the vast majority want to see something changed over the status quo.  Frank Russo teases this out, and exemplifies why I think the aggressive strategy by groups like the California Nurses Association has moved the goalposts:

Only eight short months ago in December 51% of California voters described themselves as satisfied with the current system. That number has dropped to 28% while those responding that they are dissatisfied has risen to 69% from 44% previously. The numbers who are very satisfied with what we have now has dropped to 7% from 13% previously and those who say they are "very dissatisfied" is now the largest response with 42%, up from 20% in that category before.

Table 4 in the poll shows the direct correlation of dissatisfaction with the health care system and those who want single payor. It also shows that the largest proposition of Democrats (47%) and "non-partisan/others" (39%) support single payor, while for Republicans the largest response is to reform the current system with insurance and "shared responsibility" (37%).

While it is not surprising that 55% of "liberals" support single payor, perhaps one of the more salient points of the Field Poll is that self described "middle-of-the-road" voters are split between these two options at 34% apiece and with only 10% saying they want to rely on a free market approach. While 31% of "conservatives" support the free market approach, 35% want to reform the current insurance system and 19% even support single payor.

This focus on not-for-profit health care has made reform of the current system completely reasonable, EVEN TO CONSERVATIVES.  Change is now demanded rather than sticking with the status quo.  Of course, Republicans are not needed to pass health care reform.  But they still have to vote on it, and so this can be a significant club to beat Republicans with in the next election, on the biggest domestic policy issue facing Americans.

As for how this will effect the actual legislation, it's clear that this ups the pressure for SOME reform.  Democratic leaders should be emboldened by this, and should hold firm on the positive amendments that have already been added to the bill:

AB8, the Democratic plan, has been undergoing some work under the hood. Several amendments will hopefully be made to increase the affordability of health care, among those include a prescription dug purchasing pool that will have about 3-4 million participants. That will make it 2-3x larger than CalPERS. There is also talk of creating a public insurance program that everyone will be able to participate in. This is similar to a few of the Democratic presidential contenders plans to ensure there is an affordable option for health insurance for all residents. These amendments will be considered in hearings over the next few weeks.

It's obvious that the public wants as progressive a proposal as possible.  The consequences of failure to reach a compromise are bad for everyone, but especially the governor.  He's staked his entire year on this.  So let's see a health care reform discussed out in the open so that everyone in the state knows where the main actors stand.

And the FIRST thing the Governor can do is to call the President and tell him to stop this campaign to deny children health care.  The onerous new S-CHIP rules must be abandoned.  If the Governor is serious about providing health care for all Californians, he must stand up to the President and live up to that responsibility.  DFA has started a campaign on this; you can call the Governor and tell him:

"President Bush's new rules which reduce the availability of the Children's Health Insurance Program for uninsured kids must be repealed. Governor Schwarzenegger must call President Bush today and demand a complete rollback of the new rules. Can I count on the governor to stand up for our kids?"