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Health-Insurance Mess

February 25, 1988

The need for national legislation to require health insurance for American workers is nowhere better demonstrated than in California.

Efforts to create a state health-insurance program have been roundly defeated in the California Legislature. The only legislation that is alive in this session would create a risk pool to provide, at enormous cost to the individual, limited major medical benefits to those who are unable, because of prior illness, to obtain comprehensive health insurance. The best that can be said about the proposal is that it is better than nothing.

To make matters worse, the risk-pool major-medical bill is being used as leverage by the insurance industry to kill a state law that prohibits specific AIDS testing for those applying for health insurance. If that were to succeed, thousands who now test positive to the AIDS virus would lose comprehensive health insurance and gain access only to the costly major-medical protection until they were sufficiently pauperized to qualify for Medi-Cal benefits.

The U.S. Senate Labor and Human Resources Committee has now approved, over the objections of the Reagan Administration, legislation by Sen. Edward M. Kennedy (D-Mass.) that would require employers to provide minimum health-insurance protection to their employes. That is the way to go. It would not protect all of the more than 30 million Americans who are currently without any health insurance, public or private, but it would protect the great majority of them. It would be a constructive step forward, placing the burden where it belongs--on employers who have been evading a responsibility that most employers already meet by providing access to health insurance for their workers.

Opponents of the new legislation argue that it would be ruinous to small business. They said the same thing when a minimum wage was proposed. There may be a loss of some marginal jobs, but the expansion of health services in themselves would generate new employment at every level. The United States, virtually alone among the industrial nations, continues to argue that it cannot afford this minimum basic protection. That is ridiculous.

Dr. Otis Bowen, secretary of health and human services, opposed the bill for imposing "an unduly intrusive and centralist solution," and urged solutions on a state-by-state basis instead. The frustrations in Sacramento illustrate the difficulty of doing that. And if California--which could readily afford and would obviously benefit from such legislation--cannot pass an appropriate measure, one can only imagine the travail in smaller and less competitive states. Indeed, an obvious advantage of a national program is that no state would have an economic advantage over another, just as the national minimum wage has assured at least a basic standard for all workers in every state.

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