You generally figure a thirteen point poll deficit will set a campaign looking to scare up a little excitement out on the hustings. So when California Senator Sheila Kuehl delivered Democratic gubernatorial candidate Phil Angelides' trailing campaign a hot issue, in the form of universal health insurance bill that has everything but a governor willing to sign it into law, a lot of people might have thought he'd grab at it. But so far he's acted like it's too hot an issue for him.
The "single-payer" health insurance bill Senator Kuehl, D-Santa Monica, introduced just a few years ago has moved with surprising speed, arriving on the governor's desk this year – far sooner than most expected. Not surprisingly though, Governor Arnold Schwarzenegger plans to veto it. But maybe the biggest surprise lies in the fact that thus far his challenger, who is currently the state's treasurer, hasn't said that Governor Angelides would sign it either.
Although Kuehl's Senate Bill 840 (the California Health Insurance Reliability Act) will save "the state almost a billion dollars," in the view of Assembly Speaker Fabian Nunez, and is "responsible ... achievable and ... what we need to do to fix the health care system in California" in the words of Senate President pro Tem Don Perata, it hasn't gotten this far because a few people in Sacramento think it's good public policy. And certainly its success doesn't come from having big money behind it. What it does have is grassroots support in legislative districts – the bill claims the backing of hundreds of organizations around the state.
This was not lost on the legislature's Democrats, all but one of whom – out of both branches – voted for the bill. Kuehl believes a veto would "hang the albatross of bad health care around the governor's neck.." Angelides, though, seems none too eager to tie the knot. So far he says only that he will work "hand in hand" with Kuehl "to move toward universal coverage."
We've grown so accustomed to Democratic candidates running cautious campaigns as of late – even when they're behind – that there's a tendency to just look away as Angelides shrugs off the big issue and hope that maybe he can light a fire under his potential base on something else, even if there are no obvious alternatives. After all, he's already considered out there on tax issues in that he's willing to say that there are wealthy Californians who actually ought to pay more in taxes – which qualifies as brash talk these days. And for sure we know that single payer's opponents will always call it a tax increase, even if it would save Californians bundles.
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Why then has the Democratic legislature so eagerly embraced the bill, we might ask. The answer is that there's nothing rash about SB 840. While it commits the state to the "single-payer" approach, the specific, crucial details of funding it are to be developed in a public process. The "single-payer" would be a trust fund consolidating all existing public health programs – currently accounting for nearly half of California's total health care spending – and replacing premiums, co-pays and deductibles currently paid to insurance companies with a premium paid into the trust fund.
The savings potential of breaking the log jam of paper work created by all of the fine print generated by all of the competing players in the private health insurance industry is stupendous – to the point where a streamlined claims and reimbursement system could provide comprehensive medical, dental, vision, hospitalization and prescription drug coverage to every California resident for what we are already spending, and with individuals choosing their own doctors as they do now. And if all this seems too good to believe, the bill does not require you take it on blind faith. SB840 is no plunge into the unknown; it establishes a panel of experts to sort through the facts and arguments and propose a specific system to the legislature by 2009 – which the legislature would then pass, fail, or amend, and send on to the governor – or not.
So the Kuehl bill is a seriously thought out plan. Its signing would set the nation's largest state on a course that avoids the dead end of the Clinton plan which was based on the folly of leaving the core of the problem – the private health insurance industry – intact while adding on a new layer of government bureaucracy. California would take a giant step toward dealing with out-of-control health care costs nationwide.
Up to this point, the primary impact of the recently ended California legislative session upon the gubernatorial race has been to provide Schwarzenegger the opportunity to garner kudos for all of the Democratic bills that he is signing. But he won't sign this one. Right now, Angelides is giving this landmark piece of health care legislation the elephant-I-don't-see-in-the-room treatment. But if he hopes to see the elephant's party leave the governor's office any time soon, he may need to set himself more earnestly to reminding people why they need a Governor Angelides.