Democrats Aim for Common Health Care Reform Proposal
Assembly speaker Fabian Núñez (D-Los Angeles) said he would work with Senate President Pro Tempore Don Perata (D-Oakland) to reconcile their respective proposals to re-work California's health care system, the Oakland Tribune reports (MacDonald, Oakland Tribune, 3/18).
Núñez in December 2006 proposed requiring businesses to provide health insurance to employees or contribute to a state fund from which workers would purchase coverage. The plan also would extend coverage to all children in California, including children of undocumented immigrants.
Núñez's plan also calls for the state to extend coverage within five years to the estimated 2.5 million unemployed, low-income or childless adults who lack insurance coverage.
The week before Núñez's announcement, Perata released a similar plan that requires employer and employee contributions for health insurance. Perata's plan would require employees to show proof of health insurance on their state tax returns, while Nuñez's plan does not require proof but indicates that employees must accept the coverage offered by their employers.
In addition, Perata's plan would not extend coverage to all children (California Healthline, 12/22/06).
Speaking at a forum in Oakland, Núñez said that the ultimate goal of health care reform efforts should be to make coverage available to everyone, but he added that the state needs "to take incremental steps because of the political realities."
According to the Tribune, many of the forum's attendants were members of the California Nurses Association and Service Employees International Union/United Healthcare Workers and support legislation (SB 840) by Sen. Shelia Kuehl (D-Los Angeles) to establish a single-payer, state-run health care system (Oakland Tribune, 3/18).
Regardless of the outcome of the current health care reform debate, some doctors in the Los Angeles area expect the health care system to move away from health insurance and toward a practice that more closely resembles "concierge medicine," the Los Angeles Daily News reports. At some concierge medical practices, members pay an annual fee for unlimited access to their physicians, who do not accept health insurance.
Albert Fuchs, an internist in Beverly Hills, said he expects the care delivery model to be adopted by the middle class in coming years. Most concierge practices currently cater to upper-income patients.
However, some health care stakeholders remain concerned that such a care model would make health care services less accessible to low-income patients (Correa, Los Angeles Daily News, 3/17).
A UC-San Francisco professor is calling for a health care system that combines elements of private health insurance and government-administered health care, David Lazarus writes in his San Francisco Chronicle column.
In a paper in the Journal of the American Medical Association last week, Harold Luft of UCSF called for the creation of a "universal risk pool" that would guarantee health insurance coverage for people with catastrophic or chronic conditions, Lazarus writes. Other conditions would continue to be treated using the current PPO model under Luft's plan.
Luft says that his plan "is not a fully-formed, fully-vetted proposal" but adds that he has more faith in such a system functioning well than a state-run, single-payer system, as proposed by Kuehl.
"I'm not sure [Luft is] right about that," Lazarus writes, concluding, "But his ideas merit consideration" (Lazarus, San Francisco Chronicle, 3/18).