The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Hasty Health Care Reform a Bad Idea

Posted by Alan on August 29, 2007

I’ve written ad naseum on the danger inherent in the Legislature hastily passing health care reform. The unintended consequences from enacting changes in something as complicated as health care without thoroughly vetting the ramifications could make matters worse, not better.

I’m not alone in this concern:

  • “I hope that none of these ill-conceived, quickly thrown together plans will pass this year,” said state Sen. Sheila Kuehl, the Santa Monica Democrat who chairs the Senate Health Committee and advocates a single-payer system. “Because really, that is not good for California.” (from ABC News).
  • But State Senate President Pro Tem Don Perata (D-Oakland) admitted, “Time is working against it … When we try to do things fast around here, we usually make mistakes that we regret.” (from NBC News).

They are both right. Ill-conceived reforms leads to seroius problems. What’s amazing is that there is no need to rush a bill — any bill — throught the process. Yes, if it’s put off until 2008 health care reform will have to compete for legislators’ attention with other bills — and with elections. But the momentum for reform is strong and getting stronger. Yes it would make it tougher to be a lawmaker. But it’s their job to deal with difficult issues under pressure, even during election years.

Senators Perata and Keuhl is not the universal view, however. Offering another viewpoint is Assembly Speaker Fabian Nunez. In a Los Angeles Times op-ed piece  that ran Monday (“Healthcare reform — now”), he says those seeking a delay are simply trying to derail any reform. “… delay means death to controversial big-issue legislation. Given more time, the forces against healthcare reform will find ways to take more potshots at the proposals. We don’t need a special session of the Legislature later this year. We don’t need to punt to the 2008 election year.”

I suppose one person’s warning is another’s potshot. But does the Speaker really mean to imply his chamber cannot consider legislation in even-numbered years? 

The reality is, Speaker Nunez’s legislation, Assembly Bill 8, is seriously flawed (another topic on which I’ve written ad naseum).  The Speaker claims “… for nearly 10 months now, the reform proposals I put forward with Senate President Pro Tem Don Perata have been vetted in the legislative process, fiscally analyzed by academics and scrutinized by the media.”

Really? Did I miss something? I remember the bill coming before various committees, but it seems to me they were passed through fairly quickly and with little changes.  The only real change occured when Senator Perata’s health care reform legislation, SB 48, and AB 8 were merged — but that didn’t result in substantive policy changes; different sections of the two earlier versions were simply grafted together).

One of the problems with the health care reform debate this time around is how little real dialogue there has been. Most of the time the debate seems to be about what legislation can pass, not what legislation should pass. To their credit, the Administration and the Legislative Leadership have met with a number of people, but I don’t see much of what they’re hearing being incorporated into any proposals. It’s as if ideas not generated within the State Capitol aren’t given credence.  How else do you explain AB 8’s inclusion of a mandate for carriers to accept virtually all applicants without a requirement for all individuals to be insured? I don’t know anyone who has studied the issue who believes this won’t raise premiums as it has done in New York and New Jersey

My pesonal opinion is that there’s been too much politics and not enough public policy in the legislative vetting process to date. If a special session or a delay to 2008 allows for a meaningful dialogue on health care reform, then it’s worth it. Otherwise, we’ll all wind up regretting the results of quickly thrown together plans.


2 Responses to “Hasty Health Care Reform a Bad Idea”

  1. Alan said

    John: you make a good point. There are clearly some practices the carriers and agents could address which would make the current health insurance system less painful for consumers. And they wouldn’t require legislation.

  2. John Pack said

    The American public is so fed up with the high costs of health care and exorbitant health insurance rate increases that they will grasp any alternative plan without closely examining the consequences. Universal health care has proven to raise premium costs substantially, and in this writer’s opinion, is a “rob Peter to pay Paul” situation. However, this is the most politically correct position, so the politicians will make this a major issue in a pre-election year.

    What is very alarming to me is that there is little focus on forcing the insurance companies to clean up their act and improving a private sector market which will lead to more competition and keep costs lower than universal health care. No uniform disclosure legislation has been inacted to force insurance companies to disclose benefits and exclusions of health plans in a similar manner, and consumers wind up purchasing coverage that may have glaring omissions such as a lack of any ceiling on financial liability protection. Affordable health insurance exists today in the private sector; the consumer simply needs to understand what they are purchasing and how they can assume more risk in order to lower premiums. There also needs to be more consistent medical underwriting of pre-existing conditions and more latitude in issuing individual plans to those with minor health conditions.

    Until the powers that be focus on the correct issues, we will all continue to struggle within an imperfect system that can be improved to provide adequate private sector coverage at affordable prices.

    John Pack

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