Towards Better Healthcare

When the Massachusetts legislature passed an initiative to guarantee healthcare to almost all of the state’s uninsured, it knocked the first crack into the dam holding America back from universal healthcare. This week, California’s governor, Arnold Schwarzenegger, set the stage for the bulldozing of that dam by proposing to grant health coverage to all 6.5 million Californians who currently lack it. As with past Schwarzenegger acts, this venture has caught the public eye, and we hope it stimulates further national and state debate on how to fix the broken healthcare system in the U.S.

Massachusetts’ plan is the closest thing to universal healthcare in America, compelling people to invest in a health insurance by subsidizing it heavily for the poor and penalizing people who choose not to purchase it through higher state income taxes. Due to be fully implemented by June 1 of this year, the plan draws funding from a variety of sources, including businesses and the Federal government.

California’s proposed plan mimics the one already in place here, distributing widely the responsibilities for both providing and funding coverage. As in Massachusetts, all but the smallest of businesses would have to pay to cover their employees, though the California plan would require employers to pay 4 percent of their wages toward healthcare, which could far exceed the $295 per employee maximum fee Bay State businesses pay toward healthcare.

Under Schwarzenegger’s proposal, hospitals and doctors would also be required to pay a percentage of their revenues toward treating patients covered by California’s state Medicaid system, Medi-Cal.

Because of its size—California has as many uninsured as Massachusetts has citizens—the Schwarzenegger plan leaves no funding source untapped, and in so doing, ruffles a lot of feathers. The plan has some controversial points, such as covering the children of illegal immigrants and diverting money from state-financed charity care programs. Opponents of the proposal have noted rightly that making health insurance partly dependent on employment puts the most vulnerable in society at greatest risk of slipping through the cracks, even through a supposedly improved safety net. The last thing a recently fired worker would want to deal with is having to realign access to healthcare. California, with its high percentage of agricultural and undocumented workers will need to confront this problem with ingenuity and determination.

Schwarzenegger’s proposal is no more than a skeleton at the moment, and it will need to be filled in and fleshed out through vigorous debate in California. While some groups may feel aggrieved by the proposal’s initial details, we think its general structure—and the support it will provide to the state’s poor and uninsured—is worthy of praise and duplication.

In a country that spends more money per person on healthcare than all other developed countries, and with the federal government seemingly content to perpetually drag its feet on healthcare reform, bold plans such as Schwarzenegger’s will have to carry the flag of progress. We applaud the Governator’s goals, and hope that through informed dialogue and hard-nosed compromise, they will result in much more than just hype.