This cure’s faulty
The governor’s proposal to reform health care relies on the very forces responsible for its problems
It is not OK, the proposal for health-care reform from Governor Arnold Schwarzenegger.
But let me give his proposed reform its due. He starts out right by acknowledging the growing problem of health-care affordability and availability. Californians generally pay more for health care and have shorter life expectancies than people in Canada and England. By this measure alone, our health-care system is inefficient in the extreme. Across the state, companies big and small, plus folks of various backgrounds, are struggling to pay for health care.
Crucially, though, Schwarzenegger’s reliance on a market-based approach to fix health care is faulty. With his plan, the very market forces that are causing the problems of spiraling costs and delayed/denied treatment remain central players in his game.
On the surface, the governor’s plan to mandate health-care coverage sounds great. He would require Californians to buy insurance and get a card to receive medical services. The cost would correlate to the services consumers receive, but the devil lurks in the fine-print details. Well-heeled consumers would get better care than those who buy cheaper plans.
Here is economist Gerald Friedman with the Center for Popular Economics in Amherst, Mass., on how the market for health insurance works:
“That 80 percent of health-care costs are associated with 20 percent of the population means that you can dramatically lower costs if you can identify the sickly 20 percent and get them out of your insurance pool. Insurers have learned that they can achieve these dramatic cost reductions even without directly denying coverage to the sick, by discouraging them from remaining in the system by harassing them with bureaucratic regulations, pointless paperwork, and by refusing coverage for particular procedures or drugs.”
This refusal of health-care coverage based on a plan’s cost would continue under the governor’s proposed reform.
On September 5, 2006, workers walked off their jobs over whether they or Sacramento County would bear the rising cost of medical care—increasing faster here than in any other industrialized nation—in their five-year contracts. That same day, Schwarzenegger vetoed Senator Sheila Kuehl’s single-payer plan to provide all Californians with high-quality, comprehensive health care. The governor explained why: “SB 840 relies on the failed old paradigm of using one source—this time the government—to solve the complex problem of providing medical care for our people.”
Two days later, a Sacramento Bee editorial urged county workers to swallow health-care costs, noting that they are rising for “everyone.” The Bee didn’t mention the governor’s veto of Kuehl’s bill, which would have done away with a main force driving up the costs of medical care: private health insurance.
The main flaw in the governor’s health-care reform is that the people did not push for it. In my view, that means his proposal by definition benefits power and wealth. Individual consumers lack both.
There is no magic formula to forming a popular struggle to win universal care in California. That slow mobilization is in motion. Resisting it are the ruling circles of power that fund political candidates and their campaigns, with the governor one of many elected officials who fit that bill. Schwarzenegger’s proposal attempts to get out in front of a popular groundswell of dissatisfaction with our health-care system.
This is the current phase of a long fight to shift control of health care to the people. We have a word for this process, and it is democracy. There is no shortcut to it.
The governor would have voters believe that he has the best plan to fix health care by mandating its purchase. This proposal fills the void of a mass movement statewide for a change to the status quo. He can’t give the majority more humane health-care, however, people in unity can fight for that.