California needs voice in national health care reform

Gov. Arnold Schwarzenegger and the Legislature have abandoned any serious attempt at health care reform in California. Instead, they're waiting for President Barack Obama to push national reform through Congress - but that raises the question: How well will the president's concepts address this state's particular health care nightmare?

We can't leave the answer to chance. The state has a disastrous budget outlook and a history of doing a poor job of capturing federal Medicaid dollars for health care needs. Schwarzenegger, the Legislature and business leaders need to get into this game, engaging California's congressional delegation and helping to shape the nation's new health care policy. What works in other states may not work as well here.

The health care crisis is nowhere more urgent than in the Los Angeles area. Data from a statewide health survey just released by the UCLA Center for Health Policy Research showed the county's legislative districts have the highest levels of uninsured residents 64 years of age and younger.

In Rep. Jane Harman's 36th District, the number of residents without health insurance numbered 123,000, or 20.2 percent; the neighboring 35th District and 37th District had uninsured rates of about 25 percent. The 46th District, which includes the Palos Verdes Peninsula, came in at 17.3 percent. Those figures were based in data collected in 2007, so one can only imagine how high they are today, given the current recession.
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Obama seems headed toward some of the same pitfalls that doomed Schwarzenegger's 2007 health care reform initiative. While he says he wants legislation to move forward this year, he has not yet set out a proposal specific enough for lawmakers and the public to really debate. Without that, it's a challenge to start building the needed coalitions of support.

Instead, Obama is asking Congress to shape a plan that incorporates his core principles. The danger of this approach is that stakeholders with huge financial or ideological investments in the outcome could hijack the debate and make agreement impossible. These could include not only the insurance industry but also unwavering advocates of single-payer coverage and equally adamant opponents of expanding government health care programs.

But there are a few areas of potential agreement: Better management of chronic diseases such as obesity and diabetes would help control medical costs. And electronic medical records are a necessity to reduce deadly errors, one of the 10 leading causes of death. Obama included funds for this in his stimulus package. Tech-savvy California should lead the way in devising a system that cuts costs while protecting patient privacy.

The number of uninsured grows daily, and with it the cost to public hospitals - the most expensive way to care for people. Having failed to solve this problem on its own, California needs to have a seat at the table as the Obama administration crafts health care reform.