The health-care wars: Coming soon to a ballot near you?

With two major setbacks–the repeal of an employee-mandated health-care
system in 2004, and the pending veto of Sen. Sheila Kuehl’s
universal-health-care proposal–advocates for increased health-care coverage
are figuring out their strategy for the 2007 legislative year, and perhaps
the 2008 ballot.

Meanwhile, Gov. Schwarzenegger has said that if he is re-elected, health
care will be a central legislative focus for his administration, beginning
with the State of the State address in January.

Angie Wei, spokeswoman for the California Labor Federation, which led the
fight in support of the employer-mandate plan, said “health care remains a
No. 1 priority for our union. We are committed to do something in the Legislature
in ’07 and, if needed, the ballot in ’08.”

And while the labor federation prepares to introduce the “Son of SB 2,” the
employer-mandate bill that was repealed at the ballot box in 2004, Kuehl has
said she will reintroduce her universal health care and hope for a better
result from a Democratic governor–though even Phil Angelides expressed some
doubts about Kuehl’s health-care plan.

Schwarzenegger has expressed interest in a plan similar to one signed into
law by Republican Gov. Mitt Romney in Massachusetts. Earlier this summer,
the governor convened a meeting of health-care officials in Chicago, with
the Massachusetts plan at the heart of the discussions.

The Massachusetts plan is a so-called “individual mandate,” legally
requiring all residents to carry insurance. Businesses also are required to
help pay employee health-care costs. People who do not carry coverage will
be fined $1,000. The state will provide health care for poor and low-income
residents.

The sponsors of both SB 2 and Kuehl’s proposal say individual mandates would
not work in California. They say they would oppose any individual-mandate
proposal made by the administration.

“That is an approach that would exacerbate the problem. We would oppose
that,” said Chuck Idelson, spokesman for the California Nurses Association
(CNA), which sponsored Kuehl’s bill. “That criminalizes people who can’t
afford health coverage. It’s full of holes. And what’s been apparent in that
approach is that the main achievement of that has been to further enrich an
already wealthy insurance industry.”

Kuehl’s measure aimed to provide universal coverage for all Californians.
The measure would have done away with private medical-insurance plans and
establish a statewide health-insurance system.

The CNA has been pushing universal care since Proposition 186, which was
defeated by voters in 1994. And CNA appears ready, if necessary, to head
back to the ballot box.

Just what a health-care initiative may look like is still unclear. Wei says
her union supported Kuehl’s bill, but is more firmly behind the solution
proposed in SB 2. Idelson says the nurses’ preferences would be for
universal coverage.

But having two health-care proposals on the ballot would be self-defeating,
advocates argue. “I think we’re all going to go in with resources, we’re
going to make sure we have one only ballot initiative,” says Wei.

First, both groups say, they’ll try to get a bill signed by the governor,
whether it be Phil Angelides or Schwarzenegger, in 2007.

Other groups also are making plans for the 2007 legislative year.

There have been preliminary discussions between a number of groups–including
the California Restaurants Association, California Medical Association,
hospitals and health plans–trying to come up with some sort of solution that
may be palatable to a wide variety of interests.

Sources familiar with those discussions say the plan would partially
resemble the funding mechanism of the Massachusetts plan, with the
government, employers and individuals all picking up a piece of the costs
for health-care coverage.

“There’s at last some realization that we have a very short time to come to
a compromise on a health care everybody can support, otherwise we’ll
continue to have fights at the ballot box,” said Dustin Corcoran, vice
president of government affairs for the California Medical Association. The
question is whether people can put aside their own preferred solution to the
problem and honestly negotiate a new solution that shares responsibility”
among individuals, employers and government.

That concept of shared responsibility also has been endorsed by
Schwarzenegger. While no major health-care proposals have come out of the
administration, the governor’s diagnosis of the health-care crisis in the
state was similar to the diagnosis offered by the business community.

“I don’t believe that government should be getting in there and should start
running a health-care system that is kind of done and worked on by
government,” Schwarzenegger said in July at a speech at the Commonwealth
Club. “I think that what we should do is be a facilitator, to make the
health-care costs come down. The sad story in America is that our
health-care costs are too high, that everyone cannot afford health care.”

Vince Sollitto, a spokesman for the state Chamber of Commerce, said
skyrocketing costs are at the heart of the state’s health-care problems.
“The best way to increase the number of Californians who have health
insurance is to focus on affordability and cost containment. That will allow
more employers to provide health insurance and more employees to take
advantage of it,” he said.

Sollitto praised the governor’s veto of Kuehl’s bill. “Before adding a new
mandate like SB 840, i.e. government-run health care, the Legislature should
focus on the effect of ever-increasing mandates in coverage which prevent
insurance providers from tailoring their plans to the individual needs of
the marketplace.”

Idelson said Schwarzenegger’s promised veto shows the limits of the
governor’s political centrism. “I think what’s apparent is that this
governor has abandoned California. What’s really striking is that you have
all this talk about how Arnold Schwarzenegger has become a moderate, and yet
here you have an issues that couldn’t be more central to health and safety
of residents of our states, and he’s against it.”

Kuehl teed off on the governor this week, saying he “has not read the bill,
doesn’t understand the bill, or is being completely misdirected by his
handlers.”