From small changes to BIG changes…

Wednesday, July 4, 2007

* Organizations line up to support SB840; Partisan debate over merits
* Other health bills on children’s coverage & drug trials are voted on in Assembly committees

New on the Health Access WeBlog: More on High Deductible Health Plans; Polling on Health Reform; Paris Hilton Update; International Comparisons; Border Health; San Francisco Starts Enrolling; Bush Opposes SCHIP Expansion; Tom Tomorrow Cartoon; Statehouse Reporters

Tuesday was the last day for Senate health-related bills (aimed to be passed in 2007) to be heard in Assembly Health Committee. The Committee heard testimony into the evening.

SB840: First among the bills considered was SB840, Sen. Shiela Kuehl’s universal, single-payer health reform measure. “If you don’t have single payer, someone is going to get left behind,’’ said Kuehl, in calling on lawmakers to support her legislation.

IN SUPPORT: The Assembly Health Committee approved SB840, but not before the regular stampede of dozens of organizations showed up to support the bill.

Of the many organizations that mentioned their support for SB840 were: California Nurses Association, Western Center on Law and Poverty, Health Access California, California School Employees Association, California Physicians Alliance, City of Berkeley, California Catholic Conference, California Labor Federation, Congress of California Seniors, Gray Panthers, Service Employees International Union, California Faculty Association, Planned Parenthood, Consumer Federation of California, California Federation of Teachers, California Association of Retired Americans, California Professional Firefighters, Health Care for All, California Primary Care Association, United Nurses – AFSCME, Consumers Union, California Senior Legislature, Friends Committee on Legislation, Senior Action Network, United Food and Commercial Worker retirees, Breast Cancer Action, American Association of University Women, California Foundation for Independent Living Centers, Richmond Commission on Aging, City of Berkeley, Wellstone Democratic Club, League of Women Voters, California Teachers Association, Latino Coalition for a Healthy California, California Commission on the Status of Women, CalPIRG, American Medical Students Association, Green Party, and consumers who said they were victims of “insurance company malfeasance.’’

One poignant testimony came from a cancer patient who was about to have her short-term policy run out, and was being denied renewal of that policy, given her condition.

IN OPPOSITION: The usual bevy of insurers and business groups opposed SB840 using some very familiar arguments.

Michael Shaw from the National Federation of Independent Business, a faithful opponent of SB840, said that a single-payer system would mean “government rationing of care’’ and that doctors and hospitals “would not be paid for the services (they) are giving.’’

Shaw’s assertion did not acknowledge the issue of nonpayment in the current system – by health insurance companies. Providers spend about $10 billion a year (nationally) on lawyers trying to recoup costs for services they’ve provided, but health insurance companies have denied. Insurers spend an additional $10 billion on lawyers trying to keep providers from getting their money.

Steve Lindsey from the California Association of Health Underwriters also opposed SB840, making arguments that elicited derision from the audience. “One of the ways single-payer controls costs is by denying care,’’ said Lindsey. Coincidentally on Tuesday, the Los Angeles Times had another article detailing how the Department of Insurance had found that Blue Cross mishandled more than half of the cases in which the company unilaterally cancelled policies on consumers who paid them premiums and expected health coverage.

Lindsey was put on the spot by Assembly Health Committee Chair Mervyn Dymally, who asked him, “Of the top 8 countries, can you name the ones that don’t have a comprehensive health system?” He was forced to response that “America does not have one.’’ “Right,’’ said Assemblyman Dymally, succinctly.

DISCUSSION BY LEGISLATORS: Republicans legislators Nakanishi, Gaines, Huff, and Strickland went through the usual litany of reasons that they do not support a universal, single-payer health care reform: They argued that the US has the best health care in the world, allowing for research and innovation, and any change would harm the good elements of our current system. They said that under such a system, the health care industry will have little incentive to invent new technologies, and countries with single-payer have long lines and care is rationed. They claimed that people from other countries come to the US for care, and that businesses will leave the state. Nakanishi reminded Kuehl that the state has a budget deficit. Huff asked, do you really want the people in charge of DMV or CalTrans running health care?

Assemblywoman Audra Strickland, R-Moorpark, attempted to blame the uninsured for not having coverage, naming undocumented immigrants and those between jobs. Strickland also said that some uninsured “make well over the poverty level’’ and “choose not to buy health insurance.’’

Poverty level is $17,170 for a family of three. While it’s unclear what Strickland meant by “well-over,’’ three times the poverty level is a family of three earning more than $51,510. According to the California Health Interview Survey, only 3.6 percent of individuals earning three times poverty actively decline coverage when it’s offered to them. For the remainder of the 96.4 percent of uninsured, they’re ineligible, not offered, or can’t afford coverage.

A calm Kuehl, in closing, rebutted arguments.

* On the U.S. being the best health care in the world: “We don’t have the health care in the world. It’s ranked 37th by the World Health Organization.’’
* On how single-payer would lead to rationing: “That’s what we’ve got here is rationing.’’
* On long waits: “We have long waits here. I can’t get an MRI tomorrow. I’m told I can get it in four weeks. The waits that people go through are expected. Of course you don’t get into surgery the next day.’’
* On the cost and increased taxes and innovation: “Stop wasting 30% of health care dollars on administration (which insurers use to try and deny care), that money is not going toward innovation. SB840 actually has a much better shot at encouraging innovation because it’s built into the budget.’’

In closing, Kuehl acknowledged that all lawmakers were trying to do something to improve the health care system we have currently. “Let’s talk about humanity. This state and this country is struggling to do what’s right. The reason I think this is the best is because it actually takes into account what people need.’’


Other bills of note to health and consumer advocates were considered in various committees, including Assembly Health Committee, Assembly Judiciary Committee, and Assembly Insurance Committee. They included:
* SB350 (Runner) PASSED. Makes technical amendments to last year’s AB774, which bans hospital overcharging.
* SB32 (Steinberg) PASSED. Would extend Medi-Cal and Healthy Families coverage to all children under 300% of poverty. Support.
* SB474 (Kuehl) PASSED. Technical bill that allows hospitals that receive federal funding for uninsured patients to continue receiving it. Support
* SB606 (Scott) PASSED. Requires drug companies selling products in California to make clinical trial results publicly available. With amendments, this got bipartisan support. Support.
* SB972 (McClintock) FAILED. Would have allowed small employers to create health insurance co-operatives that would have little state oversight, and could have ignored state consumer protections. Oppose.


Wednesday, July 11 will be the last chance for Assembly bills to be heard in the Senate Health Committee. Health Access will provide a full update of the outcome of AB8 (Nunez/Perata) the Democratic leadership’s health reform bill.

Health Access California promotes quality, affordable health care for all Californians.
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