The right healthcare deal

In the next 15 to 18 days before the Legislature adjourns, the narrow window of opportunity we have to achieve healthcare reform in California -- reform that expands access for those who don't have health coverage and keeps costs down for those who do -- will start to close. If history is a guide, we can expect an anything-goes campaign in the next few weeks to delay, derail and demonize healthcare reform. We need to focus on some basic truths to keep that campaign from succeeding.

First, 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. Yet you can count on opponents saying, "We're moving too fast; let's slow down." Practically speaking, what they are really trying to do is kill 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.

There are two main proposals on the table. One is written by myself and Perata, and one is from the governor. Let me explain why I think that the Nuñez-Perata bill is the only one that can succeed so we can begin to deliver what Californians need.

Basically, our legislation would call on employers to spend at least 7.5% of their payroll on worker healthcare, with employees also contributing to the premiums. The state would subsidize insurance for the poor. This plan builds on the current employer-based system and only requires a majority in each house of the Legislature for passage.

The governor's plan, on the other hand, would require everyone to have insurance, and funding for it would come from a levy on doctors and hospitals in addition to employer contributions. That levy would count as a new tax, according to the legislative counsel, and new taxes require a two-thirds vote in the Legislature. That in itself is a backdoor way of killing healthcare reform because it requires more bipartisanship than can be delivered. The governor's inability to get Republican senators to vote for his state budget -- and that's more a knock on them than him -- shows the folly of trying to win support from the hyper-partisan right.