Health Care in California: Arnold Comes Out Swinging

Without a health care plan of his own that any legislator would back, Arnold Schwarzenegger is left to mold the Democratic leadership plan in his image. He came out strong yesterday in the opening salvo in the negotiating process.

Gov. Arnold Schwarzenegger took a firm stand Wednesday against the Democratic healthcare proposal moving through the Legislature, saying for the first time that he would not support an expansion of medical insurance if it were financed solely by new requirements on employers.

The Democratic proposal would require employers to spend at least the equivalent of 7.5% of their payroll on their workers' health. The governor insisted that the plan also must require all Californians to have insurance, an idea at the core of his January proposal.

Democrats omitted that concept, believing that many people would be unable to afford the premiums.

Schwarzenegger's program would have given employers the option of providing insurance or paying into a state fund that would offer it to uninsured workers and those who couldn't afford individual policies. It also would have spread the responsibility of paying for expanded healthcare to doctors and hospitals, an idea that was rejected by Democrats as politically infeasible.

Schwarzenegger essentially wants MassCare, with its individual mandate, along with a buy-in from doctors and hospitals along with individuals and employers. This is what he calls a fee but is probably a tax, which means Republicans would have to get involved because it would require a 2/3 vote. But that doesn't matter; he'd rather have no health reform at all than one without an individual mandate:

Schwarzenegger has said repeatedly that all parts of society -- including healthcare providers, individuals and businesses -- must make sacrifices if all Californians are to be insured. Nearly 5 million residents lack coverage at any given time. The Democratic proposal would cover 69% of them. Schwarzenegger's comments were even more pointed earlier in the day, when he told the Sacramento Bee editorial board that he would veto a bill that failed to spread the costs around.

"If anyone over there thinks that I will sign a bill that . . . has only employer mandate, they shouldn't," he said, according to an account posted on the newspaper's website.

"I won't sign it. It won't happen," he said.

My favorite part of the article is the part where Schwarzenegger just ignores reality.

The idea of scrapping private insurance altogether and enacting a state-run program -- an idea championed by Sen. Sheila Kuehl (D-Santa Monica) in the Legislature and Michael Moore in his film "SiCKO" -- has gained support: The poll found that 36% of Californians now prefer this approach, up from 24% nine months ago.

Schwarzenegger, however, reiterated his opposition Wednesday.

"It's very clear people don't like government running their healthcare system," he said.

Yes, so clear that it's the most popular proposal before the people.

This is bluster from an action hero, and I'm not sure it should be taken seriously by Don Perata and Fabian Nuñez. Schwarzenegger wants a ready-made market for the insurance industry, and his plan had no floor on coverage and no ceiling on costs. That individual mandate starts to look like a gun barrel under those circumstances. And I'd rather see nothing enacted than something that holds up California's indigent and forces them to pay through the nose.

The guaranteed issue part of his proposal, whereby nobody could be denied insurance, should be retained. As we move toward an eventual not-for-profit system, setting up some public framework, as the new AB8 is rumored to strengthen, is crucial. And clearly, the Governor shouldn't be saying a word about healthcare until he fights the callous Bush Administration proposal to deny coverage to children by tightening S-CHIP eligibility.