Advocate, Governor’s Aide Square Off on Health Reform
The Los Angeles Times online last week featured a debate on Gov. Arnold Schwarzenegger's (R) health care reform proposal between Anthony Wright, executive director of Health Access California, and Daniel Zingale, senior adviser to Schwarzenegger and chief of staff to First Lady Maria Shriver.
Summaries appear below.
Fundamentals of Schwarzenegger's Proposal
- Anthony Wright: "[O]ur biggest concern is that the governor's proposal does not include 'shared responsibility' for many Californians who don't qualify for public subsidized programs or employer-based coverage," Wright writes. These individuals "would be forced to purchase coverage without consideration of ability to pay, without a defined and meaningful benefit, without the power of group purchasing," according to Wright (Wright, Los Angeles Times, 2/26).
- Zingale: "[W]e are lucky to have a governor who hasn't forgotten we can do anything if we have the political will," Zingale writes. "His comprehensive approach that relies on wellness and preventive care, as well as insurance for everyone and shared responsibility, can help fix this problem once and for all," Zingale concludes (Zingale, Los Angeles Times, 2/26).
Individual Coverage Mandates
- Wright: "[W]e can't support" the governor's "efforts to place the legal and financial burden of health coverage onto individual consumers all alone, as with the proposed 'individual mandate,'" Wright states. The system works when coverage is comprehensive and the cost is "shared with a broader group," according to Wright. "And that's the premise to build on in reform this year," he concludes (Wright, Los Angeles Times, 2/27).
- Zingale: "[T]he only way to achieve universal coverage is by pursuing the individual mandate that is a key part of the governor's plan," Zingale writes. "The individual mandate ... is a more realistic approach to getting everyone covered than simply imposing the entire burden on employers," according to Zingale (Zingale, Los Angeles Times, 2/27).
Coverage for Undocumented Immigrants
- Wright: "I don't disagree with the governor's point about the 'hidden tax,' that having so many uninsured creates a strain on the health system as a whole, and that we all have a stake in health reform," Wright writes. "But don't think the uninsured don't want coverage, or that they get off with free care and without consequence," Wright concludes (Wright, Los Angeles Times, 2/28).
- Zingale: The governor is "trying to move [undocumented immigrants] out of costly emergency rooms and into clinics," Zingale writes. "Requiring everyone to be covered, including undocumented immigrants and healthy people who think they don't need insurance, is the only way the rest of us can stop being charged billions of dollars a year to subsidize the uninsured," Zingale concludes (Zingale, Los Angeles Times, 2/28).
Preventive Care, 'Shared Responsibility'
- Wright: Schwarzenegger "appropriately talks about prevention, and how it is cost-effective for Californians to get care up front, before it becomes a bigger and more expensive problem," according to Wright. "But these plans won't provide coverage for the preventive care known as disease management that really will save money with the big-ticket health costs: asthma, diabetes, obesity, heart disease," Wright concludes (Wright, Los Angeles Times, 3/1).
- Zingale: "What Gov. Schwarzenegger means by shared responsibility, including individual responsibility, is each of us maintaining health coverage we can afford," Zingale writes. "Significant increases in Medi-Cal reimbursement, tax incentives and a host of other affordability measures will all help to ensure a more competitive, functional health care system and will stop runaway double-digit increases in premiums," Zingale writes (Zingale, Los Angeles Times, 3/1).
A State Model for National Reform
- Wright: "[T]he most effective way to win national (health care) reform is to start the momentum at the state level," according to Wright. "But when something gets passed this year, it will not be the governor's proposal, or that of any specific legislator, but it will be shaped by the actions we, the public, take," Wright writes (Wright, Los Angeles Times, 3/2).
- Zingale: A "national approach (to health care) can only work if it is put into action, and Washington is a long way from implementing positive reforms," Zingale writes. "Nonetheless, the governor's plan does include a strong partnership with the federal government," according to Zingale. "With the federal government as a partner and all stakeholders involved, we can lead the way to a healthier state and become a model for the nation," Zingale concludes (Zingale, Los Angeles Times, 3/2).