The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

California Health Care Reform: A Few Slices is Better Than None

Posted by Alan on December 6, 2007

After months of wrangling, the odds of a negotiated compromise on comprehensive health care reform this year is looking dim. Governor Arnold Schwarzenegger still talks optimistically about fashioning a deal and Speaker Fabian Nunez continues to hold out hope. But most observers, and I am reluctantly among them, have grown increasingly skeptical.

The work done to date will no doubt serve as a starting point for the next push for health care reform. Hopefully that push can begin next month. It would be a shame if the issue is completely pushed aside in 2008. There will be plenty to distract lawmakers next year, but the human cost of delaying meaningful health care reform will hopefully justify carving out some time to try to bridge the remaining gap.

In the meantime, the effort that’s gone into trying to fashion a compromise during the current special session need not go to waste. There’s substantial, bi-partisan support for cost containment measures that could be enacted independently of wider reforms. There’s a recognition that California should not have the lowest Medicad reimbursement rates in the country — the California Hospital Association is even willing to help fund an increase. If the President and Congress ever end their shameful delay in reauthorizing the State Children’s Health Insurance Plan (SCHIP), California should find a way to improve outreach for its Healthy Families program.

These are slices of the loaf, but they’re far more than crumbs. Any effort to make coverage more affordable — as containing costs would do — will make more comprehensive reform easier to achieve later. Increasing federal health care dollars coming to the state, as improving Medicaid reimbursements would do, makes sound financial sense. And providing more children access to health care is not only sound public policy, but also pays financial dividends in the long run.

Settling for mere slices when you’ve worked so hard for the whole loaf is disappointing. Yet enacting pieces of the larger package makes political sense, too. Otherwise, after all the talk and pain, there will be nothing to show for the past year’s efforts other than  … well, talk and pain.


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