Over the past few years, Californians have become increasingly aware of the long list of ailments plaguing our health care system: unaffordable premiums, diminishing physician reimbursements, rising numbers of uninsured, crowded emergency rooms, harsh denials of needed care and downright refusals to offer coverage.
Beneath all of these symptoms lies a deeper problem. Health insurance costs have increased four times faster than wages since 2000 and overall premiums have increased 87 percent during the same time. Over the next decade, spending will increase so fast that health care will soon eat up one out of every five dollars we produce – a rate of growth in health care spending that is double that of nearly every other industrial nation in the world.
As America struggles to keep up with rising costs, we are helplessly watching the dismantling of our health care system and a downward spiral for health care access and quality. Most people in the United States are shocked to discover that a substantial part of our health care system provides substandard care even to those who have insurance. Repeated studies by the World Health Organization, the U.S. Institute of Medicine, the Commonwealth Fund and countless other peer reviewed scientific studies all come to the same sad conclusion: Americans are more likely to die or to have negative health care outcomes if we become sick, even if we have insurance, than the residents of any industrialized nation.
In 2006, the California Legislature became convinced of the need for single payer universal health care and made history by voting in favor of Senate Bill 840, the California Universal Healthcare Act and sending the governor the first truly universal health reform plan passed by a state Legislature. The plan sent to the governor is a plan that has been proven to cover everyone, contain costs, and improve health care quality. Under SB 840, every Californian would be covered by an affordable, comprehensive benefit package, and be allowed to choose any doctor or healthcare provider they wish. The provision of health care would remain private and more competitive than it is today. Yet, in one disappointing knee-jerk response, the governor vetoed the bill.
The following year, facing widespread criticism for killing universal health care but offering nothing definite, the governor declared that 2007 would be "the Year of Health Reform." The following January he proposed a rough outline for a health reform proposal that would have required every Californian, on pain of penalty, to have health insurance. It capped what employers would have to pay but included no such limits on premiums, co-pays, or deductibles for individuals or any requirement that premiums be affordable. In addition, there was no floor set on how minimal coverage could be.
Under the governor's proposal, Californians would have been forced to buy a product that would inevitably have become increasingly unaffordable. The governor's proposal attempted to label the fact that he would allow insurance companies to offer greatly reduced coverage as "cost containment." His proposal was strikingly similar to Mitt Romney's ill-fated proposal in Massachusetts and was little more than a guaranteed windfall for insurance companies. The plan evolved considerably over the course of the year. Assessing the likely financial underpinnings of the final iteration, California's legislative analyst estimated that the plan would be under-funded within five years – and that taxpayers would be on the hook for the balance.
Such a plan, it was clear, would only exacerbate the problems plaguing our health care system, which extend way beyond simply covering the uninsured. The truth is we will not be successful in covering the uninsured until we face the simple fact that the insurance company's idea of cost containment is simply dismantling our system – doctor by doctor, denial by denial.
Senate Bill 840, which I promptly re-introduced at the start of our current legislative session, is the only proposal that can easily be achieved within the boundaries of our current health care spending, personal, employer, state and federal. It would use the money wasted by the insurance companies on bloated administrative overhead to provide comprehensive insurance, to all Californians, without co-pays or deductibles, for one affordable premium each year. The bill is alive and well in the Assembly Appropriations Committee and legislative deadlines for passage don't roll around until August 15. In the meantime, we are continuing to successfully build the kind of broad movement in support of single payer that is needed to achieve true universal health care in California. For more information on how to bring universal health care to California visit http://www.onecarenow.org.
State Senator Sheila James Kuehl (D) represents the 23rd District, which includes portions of Los Angeles and Ventura counties.