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From Stethoscope To Gavel: Pediatrician At Center Of State’s Health Care Debates

Dr. Richard Pan, a pediatrician and Democratic state senator representing Sacramento, recently took the helm of the powerful Senate Health Committee. (Pauline Bartolone/California Healthline)

Personally, Dr. Richard Pan is deeply entrenched in medicine. He’s a practicing pediatrician and husband to a dentist.

Politically, the Democratic state senator from Sacramento is immersed in health concerns, too. As a former chairman of the Assembly Health Committee, he has earned a reputation as a thoughtful if wonky lawmaker who delves deep into the weeds during debates.

Now, Pan, 52, has assumed another powerful role as the chairman of the Senate Health Committee, a position that carries significant power — particularly as the state responds to Trump administration attacks on the Affordable Care Act and other policies and funding.

“He’s very measured, very well-respected, and he’s very well-established in the field of medicine,” said Mike Madrid, a Republican political strategist. “Nothing will get through that committee without his deciding it’s going to get through that committee.”

Pan is up for re-election for a second term in the Senate in November, running against Eric Frame, a left-leaning, 26-year-old small-business owner in Sacramento. In the June primary, Pan won 66 percent of the vote, while Frame, who is running as an unaffiliated candidate, received 13 percent.

If Pan prevails, he will likely preside over major health care debates when California’s new governor takes the helm in January — such as whether the state should adopt a costly single-payer system (which is unlikely in the near term because it would require Trump administration approval to benefit from federal funding).

Pan already has taken on other big health care fights. He co-wrote a controversial law that requires most schoolchildren to get vaccinated. The bill sparked Capitol protests, and Pan was threatened with violence. He was likened to a Nazi by detractors, and survived an unsuccessful campaign to unseat him.

But last year, he abstained on the now-stalled single-payer bill that would have created one public insurance program for all Californians. In a recent interview with California Healthline, Pan said achieving universal health care — not necessarily via single-payer — is one of his priorities. He also said he wants to improve care for special-needs children with public insurance, and plan for the state’s future long-term care needs as its population ages.

Stephanie Roberson, a spokeswoman for the California Nurses Association, which sponsored the single-payer bill, said the union will propose another such measure next year — and hopes to bring Pan on board.

Frame, Pan’s opponent in the November race, said single-payer advocates can count on his vote, as long as the proposal supports the use of natural and alternative therapies.

“Dr. Pan is sort of for the status quo,” said Frame, who canvassed for progressive presidential candidate Bernie Sanders. “I would just shift the dialogue to … include proper health care as a human right.”

Despite his busy schedule at the Capitol, Pan still sees patients about once a week at a WellSpace Health clinic that primarily serves low-income Medicaid recipients and uninsured people.

“I’m still a physician first,” he said. “I love medicine.”

The following interview has been edited for length and clarity.

Q: Why didn’t you support the single-payer bill last year?

Not only was the financing mechanism not realistic, but essentially the bill said we would move back to a fee-for-service system universally. I’m not sure that’s really the right approach.

A strict “will-pay-for-anything-that’s-billed” approach is a bit retro, actually. It goes back to the ’60s, and it’s something that would cause health care costs to potentially skyrocket.

Q: Is there a type of single-payer program that you would support?

The goal we will try to achieve is universal access to quality health care for everyone. Instead of being wedded to only one approach, we need to look at a variety of different approaches and see where we can come up with the political will to make it happen. Let’s look at the Medicare program. Medicare allows people to take their dollars and purchase a health plan as an option.

In the strict definition of single-payer, it only talks about financing [by] one payer. There are a lot of details that have to be worked out in terms of how it operates.

Q: The federal government will kill the Affordable Care Act’s penalty for not having insurance, starting next year. Why haven’t California lawmakers introduced a state-based mandate requiring residents to purchase insurance?

When we implemented the Affordable Care Act, the governor indicated that we didn’t want to have a state individual mandate law at the time. Right now, there’s a little bit of a wait-and-see approach. If we see during this open-enrollment period that [the Covered California exchange’s] risk pool is sicker, that will then raise costs for everyone. I certainly think that’s a policy option that we need to explore.

Q: What are your patients’ primary concerns?

There’s tremendous anxiety because … they hear that their Medi-Cal may be limited or go away. They hear that if someone in their family uses Medi-Cal, that someone else in the family may get deported [as an undocumented immigrant]. They’re concerned that if they need an appointment, they can’t get a doctor or specialist.

Q: What about your constituents? What are their health care priorities?

People want to have access to affordable health care.

One concern that comes up is [the] proportion of their compensation that goes to health care. We have workers who … haven’t seen more money in their pocket because their compensation is going to keeping their health care.

Unfortunately, the federal government is actually … raising the cost of care. But we’re a big state. We’re going to figure out how to push back against that and actually try to improve access, improve quality and lower cost.

Q: You keep saying we need to “look at” or “figure out” policy solutions. Are there any specific proposals you hope to pursue?

There will be a new governor starting next year. We’re also dealing with a federal government that’s seeking to undermine access to care, has taken many administrative steps to destabilize the insurance market, which is raising premium rates, [and is] trying to impose changes in the Medi-Cal program. So those uncertainties make it challenging to talk about exactly what we’re going to do because the landscape is shifting.

Specifically, I’m interested in looking at opportunities for investing in prevention. We should be looking at things while our economy is strong that will help us save money in the long run. We need to look at improving chronic disease care.

Related Topics

Cost and Quality Elections Insurance Medi-Cal Spotlight The Health Law