Can Californians Reason Together on Where We Go From Here on Health Care Reform?


In the wake of yesterday’s defeat in the Senate Health Committee of AB 1X 1—a compromise bill between Speaker of the Assembly and Governor of California—and barring a miracle, California will not see comprehensive health care reform this year. There’s just no other way to make sense out of the bills in the legislative hopper, the negotiations that have taken place in the last year, and sifting through the welter of statements made after the committee’s vote, many of which we will be posting soon in a separate article.

Try as he may, Speaker Fabian Nunez’s characterization of AB 1X 1 as a “bipartisan” bill is illusory, unless bipartisanship means having one Republican (Arnold Schwarzenegger) supporting it and all Republicans in both houses of the legislature (without exception) opposing it. The bill was passed by the Assembly solely with Democratic votes.

Strip all the rhetoric aside consider the fundamentals of how legislation is enacted in California and how they played out with this health bill and any others that will come after it. You need passage by the legislature and a signature by the Governor. Refine that a bit, and include the proviso that anything signed into law can be held in abeyance if signatures are gathered for a referendum—which any powerful interest can secure with a couple of million dollars. Then you have an election on a ballot proposition, where more millions of dollars and negative advertising make it more difficult to get the voter’s approval.

It’s like one of those games where you maneuver a round object through a maze and if it falls through a hole you have to start all over again. As I described the different twists and turns of health care bills this year to my wife, a nurse by training who has followed this issue for decades, she told me that one issue or another was not entirely new and we had been discussing combinations of each since the 1970’s.

We’ve been down this road before in California. With a Democratic Governor, Gray Davis, the legislature passed SB 2 by John Burton, President pro Tem of the Senate in 2002, which would have created a $7 billion system providing health insurance to all working in Californians through their employer. The referendum against that, Prop 72, albeit by a narrow margin, killed it.

While most of the comments from Democrats and Republicans in the Senate Health Committee yesterday were complimentary of the efforts of the Speaker and the Governor—and of the process—there still is a very negative and poisonous residue from the attempt to cobble together a compromise. And I am not speaking of the reactionary forces that are truly opposed to real advances of any sort in the health care field.

The sniping on the left side of the spectrum–between proponents of single payer and the Speaker and others favoring compromise has been painful to watch. It has devolved into a nasty and personal set of accusations and counter charges. Good people who want to see more people have access to health care and who disagree as to tactics, strategy, and approaches—and who have significant differences—have not confined themselves at times to the merits of the proposals.

I am not interested in who threw the first rock—this goes both ways. I’d like to have a heartfelt family discussion as to where we go from here with frank acknowledgment that the hand that we have been dealt is a difficult one to play, and somewhere between single payer and the amalgam of the Nunez-Perata and Schwarzenegger proposals is where we need to go—if that chasm can be bridged. If not, we wait for a new governor (3 more years), an initiative placed on the ballot by signatures of the people (who despite everyone’s citation of polls to support their favorite plan are enough divided that passage is dubious), or a new President and effort nationally (but remember 60 votes in the U.S. Senate are needed for countrywide reform).

Given the conceptual proposal made by the Governor a year ago in January which was only much later put into legislative language in a bill that did not have a single solitary supporter in the legislature, Democrat or Republican. Given the Governor’s veto of SB 840, Senator Sheila Kuehl’s single payer bill in 2006. Given the veto that is sure to be wielded by Governor Schwarzenegger if and when the legislature passes SB 840 once again in 2008, I don’t see how one can fault the motives of the Speaker of the Assembly Fabian Nunez in trying to get traction on a bill the Governor would sign.

I understand the debate about whether the final product was one that deserved support and questions about strategy and tactics. But I don’t, for the life of me understand how this could have played out differently in 2007 and how it will in 2008. It certainly was not for want of effort on the Speaker’s part. He could have more easily said it just wasn’t going to happen and quit trying—but he surely would have been criticized for that.

There have been some strange bedfellows on this one this year. I received quite a few interesting emails and calls from my friends at the California Nurses’ Association and the Foundation for Taxpayer and Consumer Rights rightly characterizing the final bill as one supported by most of the insurance industry. From the other side came barbed comments about some of these progressive groups being aligned with big tobacco, Blue Shield, and the like. It was interesting to see some derisively call the final bill the Schwarzenegger bill as if the very name should cause one to oppose it.

The enemy of my enemy may be my friend. But politics is the art of the possible. One makes progress on a big and contentious issue such as health care reform where large amounts of money are at stake by splitting the opposition. This one fractured all around. Labor and progressive groups were split. Consumer groups were split. Business and other powerful interests generally opposed to any advances on government doing anything were split.

There are others who will cast blame. I am not Pollyannaish about the politics here. And I acknowledge that the situation is not entirely pure and simple. It is messy, as politics often is. But I wish my friends—all of you—could try to find the best in those you have said some harsh things about and recognize that we need to work with each other if we are to have any chance of making progress.

Behold the turtle. It makes progress only when it sticks its neck out.


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