The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

The Great Health Care Reform Coalition of 2007 — Maybe

Posted by Alan on September 16, 2007

Governor Arnold Schwarzenegger and Speaker Fabien Nunez held a press conference on Friday (September 14th) in support of comprehensive health care reform (a video of the complete press conference can be viewed at the Governor’s web site). They were joined by a diverse group of stakeholders, something the Governor gladly pointed out. “When we started down this road last December, everyone said health care was too complicated to fix. They said we could never unite all the interests groups with a stake in the issue. but look who is standing with us today — groups that were against us and against each other when I stood here last December are now standing together for reform.”

It was an impressively broad and substantial group of leaders:
• Lloyd Dean, president and CEO, Catholic Healthcare West
• Annelle Grajeda, president, SEIU Local 721
• Renee Fraser, past president, National Association of Women Business Owners – Los Angeles
• Dr. Richard Frankenstein, president elect, California Medical Association
• Mario Molina, CEO, Molina Health Care
• Robert Warnagieris, Ed.D., executive council member, AARP
• Barry Arbuckle, chair-elect, California Hospital Association
• Diana Dooley, CEO, Children’s Hospital Association
• Richard Cordova, president and CEO, Children’s Hospital Los Angeles
• Don Crane, CEO, California Association of Physician Groups
• Theresa Brown, president, California Association for Nurse Practitioners
• Dr. David Feinberg, physician
• Liz Helms, founder, Chronic Care Coalition
• Debra Cherry, executive vice president, Alzheimer’s Association California Southland Chapter
• Erin Pak, CEO & executive director, Korean Health Education Information and Research
• Lupe Alonzo-Diaz, executive director, Latino Coalition for a Healthier CA
• Rose Yu, Allergy and Asthma Foundation of Southern CA
• Bill Dombrowski, CEO, CA Retailers Association
• Laura Yamanaka, President, National Association of Women Business Owners – Los Angeles
• Blair C. Salisbury, California Restaurant Association Board Member and President CEO, El Cholo / Barn Burner BBQ / Dona Rosa
• Tyrone Freeman, president, United Long Term Care Workers Union
• Ben Chu, CEO, Kaiser Southern California
• Howard Kahn, CEO, L.A. Care Health Plan
• Karen Vigil, senior vice president and CEO, Blue Shield of California, Individual, Small Group and Government Business Unit
• Jay Gellert, National CEO, Health Net
• Dave Anderson, CEO, United Health Care, Southern California

The Governor described the group as “big supporters of our health care reform — of our proposals.” There are two interesting aspects to all this. First, as was acknowledged by Speaker Nunez, the group was supporting the effort for comprehensive health care reform without knowing what the final package looked like. This can be dangerous for both lawmakers and the endorsers. It also means the stakeholders standing behind the Governor were there primarily to show a shared commitment to passing meaningful health care reform during the upcoming special session.

Second, the gathering demonstrates the broad support available to the initiative likely to be required to fund whatever legislation comes out of the special session. And an initiative will be required. There is virtually no chance of getting the two-thirds vote of the Legislature required to pass new taxes and fees. So the only path available to the Governor, Speaker Nunez and Senate President Pro Tem Don Perata is to seek approval of the funding from the people.

Yet it’s always tough to get new taxes and fees passed. Especially substantial taxes and fees like those required to fund health care reform. Substantial taxes means substantial opposition. It will take a coalition like those at the press conference to overcome this opposition.

So the question is, how real is the coalition? Can it survive the reality of health care reform legislation? If it requires an individual mandate will the unions at the press conference still back it? If it requires a fee on doctors, will the California Medical Association stay onboard? If the legislation assures a death spiral in the individual marketplace, will the health plans in attendance still support the package?

There’s no way to know now, but time will tell. For the present, the participants at the press conference is a testament to the political strength of the Governor and the strong momentum behind comprehensive health care reform. That’s all, but as the special session draws nearer, it’s a good start.

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