California’s Health Care Crisis

Nearly seven million Californians lack health insurance, or about every fifth person in the state.  Big papers such as the San Jose Mercury News and the Sacramento Bee are urging the state Senate Health Committee to pass the Núñez-Perata health-care reform bill, ABX1-1.  Gov. Schwarzenegger backs the speaker and senate leader’s bill, which the State Assembly passed in late November.

The 11 members of the Senate Health Committee, which Democratic Sen. Sheila Kuehl of LA chairs, held a hearing on ABX1-1 on January 23.  Assembly Speaker Fabian Núñez, Legislative Analyst Elizabeth Hill, and the governor’s health secretary Kim Belshe were three of those who commented on the bill.

The committee votes on the bill on January 28.  A yes vote would pave the way for Californians to decide the bill’s financing mechanism in the November election.

But the word is that ABX1-1 lacks the votes.  If in fact the bill fails in Kuehl’s committee, Núñez has two options.  He can return with amendments and request a reconsideration of the vote.  Or he can request a new vote on the health-care reform bill with no amendments, according to Carol Wallisch, Sen. Kuehl’s chief of staff.

A January 25 unsigned Sacramento Bee editorial blamed Big Tobacco and the California Nurses Association for the possible sacking of ABX1-1.  Under ABX1-1, the tobacco industry would see its tax bill hiked.  That would likely cut cigarette sales.  What horror!  The CNA, in contrast, opposes the bill because it doesn’t go far enough.  The CNA wants to boot private insurers from the health-care system altogether.  ABX1-1 only limits insurers to spending no more than 15 cents of every premium dollar on administrative costs.  (Administrative costs were 28 percent of California’s projected health expenditures in 2003, reported Drs. David Himmelstein, Steffie Woolhandler, and Sidney Wolfe in the International Journal of Health Services.)

Meanwhile, Kuehl’s SB 840 for a system of single-payer health care instead of the current system of multiple insurers is waiting to be heard in the Assembly appropriations committee.  That process will begin this summer.

At the same time, grassroots support is building for a California constitutional ballot initiative in which voters can decide the fate of a single-payer health care measure this November.  The California Health Security Plan is a single-payer system to provide every California resident with medical care: “no co-pays, no deductibles, and no premiums.”

And the Plan does specify a funding source: the state’s general fund and other sources like the federal treasury.  To qualify the measure for the ballot, backers need 700,000 valid voter signatures.  Visit for more information.

Seth Sandronsky lives and writes in Sacramento.  Contact: <>

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