Single-payer system offers health care for all

CTA is putting its muscle behind efforts to pass a piece of legislation that will provide fiscally sound, affordable health insurance coverage to all Californians. The California Health Insurance Reliability Act (CHIRA), proposed by state Sen. Sheila Kuehl (D-Santa Monica), would put everyone into a "super pool," and institute a single-payer system based on the Canadian model.

As Kuehl envisions it, Senate Bill 840 would eliminate waste and control health care costs by consolidating the administrative duties currently relegated to insurance companies under one roof — the California Health Trust — and making the state the "single payer" for medical care bills as well as the sole purchaser of prescription drugs and medical equipment.

Even though the bills would be paid by a public entity, health care delivery would remain in the private sector. Consumers would retain the freedom to choose their care providers. Patients and their doctors - not administrators - would make medical decisions. Everyone would have comprehensive benefits, including prescription drug coverage and mental health care. Physicians and medical facilities would receive fair reimbursement for all covered services they provide, and hospitals would be able to afford safe staffing levels for registered nurses.

Under CHIRA, no California resident would ever lose his or her health insurance because insurance premiums became unaffordable, because he or she changed or lost a job, or because he or she had a pre-existing medical condition. The nearly 6 million uninsured residents would be covered.

The plan calls for no new spending. It would rely on federal, state and county monies already being spent on health care, along with modest insurance premiums: A 3.8 percent payroll tax would be levied on workers, replacing all existing insurance premiums, deductibles and copays. An 8.2 percent payroll tax would be levied on employers, replacing all current health care benefits paid for workers, dependents and retirees.

With no deductibles or out-of-pocket costs, California families could save from $300 to $3,000 per year and businesses from $300 to $2,000 per employee. Employers now offering health care benefits would save an estimated 16 percent.

Currently, it's estimated that half of every dollar spent on healthcare is squandered on clinical and administrative waste, insurance company profits and overpriced pharmaceuticals. Reduced administrative costs could save California $20 billion in the first year alone. Another $5.2 billion could be saved by enabling the state to use its full purchasing power to negotiate systemwide bulk purchases of prescription drugs and durable medical equipment. More savings could come from coordinating capital expenditures.

Since all payments would be made by the trust, data from providers would be funneled to one place for maximum efficiency and fraud prevention.

CHIRA would establish a nonpartisan commissioner of health to oversee how the money is spent, along with a health policy board, a network of consumer advocates, and community-based "Partnerships for Health" to identify and help solve local service problems.

CHIRA can avoid the long waiting lists for medical services that Canadians put up with, according to Kuehl. "Canada spends about a third as much as we do per capita on healthcare and uses waiting lists to manage limited resources. California spends more than enough to avoid waiting lists, although we will have to plan our resource use carefully."

This is Kuehl's second attempt to legislate universal health care, and she's vowed to keep trying every year until it passes. Senate Bill 840 passed the Senate Health Committee in April with all the Democrats on the committee voting in favor and all of the Republicans opposed. On May 31, it passed the state Senate on a vote of 24 to 14. It's now being considered in the state Assembly.

CTA's State Council of Education has voted to support the bill.

"The good news is that SB 840 is a two year bill, so we have time the rest of this year to build up momentum," says Council representative Mark Rendon, a member of the Oakland Education Association and chair of the Green Party Caucus.

"This bill will benefit everybody," he maintains. "It will benefit all of our students who are uninsured and underinsured. It will mean that our students will do better in school, attend school more often and be able to get glasses and hearing aides if needed."

"The environment we're in has almost reached a boiling point,"says Lois Shive, a member of CTA's Health Benefits Task Force. "It's time to turn the heat down on us and turn it up on the providers to make sure everyone is covered. And we need to include the entire state because trusts can't do it alone anymore."

The Central Valley Trust, she says, recently raised rates for members by 12 percent and retirees by 24 percent.

"If we can unite under one umbrella, real change can be accomplished," adds Shive. "The larger the group, the more we have the ability to drive down health care costs."

If it's going to happen, it needs to happen soon. By 2010, nearly half of California's working adults will be working for employers who will not fund health insurance, according to a UC Berkeley study.

The United States is the only industrialized country that does not provide universal health care, says Chris Szczepaniak, who visited Italy and was surprised by the quality of health care provided the residents there.

"They have better health care than we do,"says Szczepaniak, a member of the El Monte Union Educators Association. "Members of the European Union have universal healthcare. It's not a perfect system, but no one goes without health care."

"To me, medical care is a necessity, not a luxury," he adds.

Kuehl anticipates that insurance and drug companies will wage all-out war against CHIRA to protect their interests. "When they do, I plan to raise questions about the obscene profits these companies are making,"she told the San Francisco Chronicle, "I love a good fight."

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