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Universal Health Care? Legislature Seeks Cure for Pain of Consumers

Posted on: Tuesday, 16 August 2005, 00:00 CDT

SACRAMENTO - As health-care costs continue to soar across the country, the state Legislature is set to consider more than a dozen measures aimed at aggressive reform and easing the crunch for Californians.

The measures - everything from providing universal health care to letting people comparison-shop prices of procedures at local hospitals online - have received little public attention amid the high-profile battle over Gov. Arnold Schwarzenegger's November special-election reform package.

But health advocates say the measures arguably are far more vital to taxpayers struggling to make ends meet. In California, health- care spending is expected to almost double in the next 10 years, from $184 billion in 2006 to $346 billion in 2015, according to a study by independent consulting firm the Lewin Group.

"When people talk about the issues in their daily lives, they're talking about how much they're paying for health care and concern about losing coverage they have - rather than about some of the more esoteric issues that the governor has focused on, such as how one hires or fires teachers, or how legislative districts are shaped," said Anthony Wright, executive director of the advocacy group Health Access.

One of the most controversial bills legislators will weigh is expected to be from Sen. Sheila Kuehl, D-Los Angeles, which seeks to create a system of universal health care in California.

Kuehl's bill would create a new state agency, headed by an elected commissioner, that would provide health insurance for every Californian. Every adult resident, except the indigent, would pay into the system, while existing health insurers would essentially go out of business in California, except for those that might offer supplemental coverage.

Kuehl argues that her system would reduce health-care costs by cutting down on redundant bureaucracy costs created by having multiple insurers and would provide health care to the poor at no additional costs to others.

"There's a lot of waste in the system," Kuehl said. "We have 7 million people who are uninsured, but we're spending $184 billion in the aggregate on health care in California. Most of that money is premiums, co-pays and deductibles.

"Twenty-five to 30 percent of it goes for administrative overhead. If you simply applied the same amount of money or even a little less in a more efficient system, you could provide very comprehensive benefits to every Californian."

Health insurers, of course, are not happy about the bill, which Kuehl said she expects to move to the Legislature in January after she works out more financial details.

Christopher Ohman, CEO of the California Association of Health Plans, said the uninsured can be taken care of through expansion of existing programs, such as Healthy Families and Medi-Cal.

Ohman said creating a new state agency that would replace the seven largest health plans and dozens of smaller plans in California is a "massive undertaking" that poses a serious financial risk to the state.

"It would be one very, very big gamble for the taxpayers of California to take," Ohman said.

"You could have the worst of all outcomes, and that is you could have health-care costs, both medical and administrative, increase even more rapidly because the organization that's created just can't handle all the complexities that are being put in front of it."

Assemblyman Keith Richman, R-Granada Hills, a general practice physician who ran a medical group before taking office, also opposes Kuehl's bill, saying the private sector can do a better job providing health care than the government.

"I trust the private sector more in dealing with health care than entrusting our entire health-care system to the government," Richman said.

Richman had co-authored a bipartisan package of health-care legislation earlier in the session, including a more moderate universal health-care proposal, but only two of his six bills are still active.

One bill, AB 1674, would create a state-funded think tank called the Center for Quality Medicine that would be charged with conducting research and developing guidelines on medical benefits, new technologies and pharmaceuticals in an effort to lower the cost and increase the efficiency of health-care delivery.

A second Richman bill, AB 1676, asks state agencies to develop new guidelines and provide new information about end-of-life care, such as advance instructions a person can leave if they were to end up in a coma.

Other health-care bills that could be considered in the next few weeks include several efforts to help Californians import drugs from foreign countries.

Assemblyman Dario Frommer, D-Glendale, is pushing a bill that would create a state Web site to provide consumers with information on how to obtain drugs from Canada, the United Kingdom and Ireland.

The pharmaceutical industry opposes attempts to allow consumers to import drugs from other countries, citing concerns by the federal government over the safety of such products.

They argue there is no way to ensure that a product shipped from Canada, for example, actually originated there, as opposed to originating in a Third World nation and passing through Canada on its way to California.

Meanwhile, while the Legislature considers the measures, voters will be asked to decide between two competing measures on the November ballot aimed at making prescription medications more affordable.

One is sponsored by a coalition of consumer groups and the other is sponsored by the pharmaceutical industry. Under state law, the measure that gets the most votes - above 50 percent - will become law.

In the ballot battle, both sides have spent millions lobbying for their proposition, both of which would cover uninsured residents of all ages who are not eligible for Medicaid.

The key difference between the measures, however, is the number of people who would be eligible to participate and whether drug companies' participation would be voluntary or not.

The industry-sponsored measure, Proposition 78, creates a voluntary drug-discount program for people at 300 percent of the federal poverty level.

The state would negotiate with pharmacies to sell drugs at discounted rates to those program participants, who would have to pay an annual $15 application fee.

Proposition 79, backed by consumer and union groups, would create a mandatory drug discount program for those at 400 percent of the poverty level, and charge a $10 fee to participants.

The consumer groups see the industry measure as a "smoke screen" to pre-empt their own measure and confuse the public, and say it will be ineffective because industry participation is voluntary.

The pharmaceutical industry argues that Proposition 79 could never become law because the federal government has never approved such a program that applies to people at 400 percent of the poverty level.

"(Proposition 78) will provide a workable drug discount program in California," said Denise Davis, a spokeswoman for the industry campaign. "Proposition 79 will never be approved by the federal government, so it will not provide drug discounts."

Wright, whose group is backing Proposition 79, said the measure would help more Californians, while 78 would be less effective because it is voluntary.

Ultimately, some lawmakers say finding solutions to the growing costs is crucial for the state.

"Health care is a very important issue for most Californians," said Richman. "People who don't have insurance are worried about getting it, and those who do have insurance are worried about the skyrocketing costs and are worried about losing coverage.

"I think it's critical we (in the Legislature) address the crisis in health care."

Harrison Sheppard, (916) 446-6723

harrison.sheppard(at)dailynews.com

Source: Daily News; Los Angeles, Calif.

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