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Healthcare's moment

There's bipartisan consensus in California on the need for reform; now it's time to stitch together a deal.

September 20, 2007

If appearances can be believed, this has been a hopeful week for healthcare reform. On Monday, presidential aspirant and onetime healthcare laughingstock Hillary Rodham Clinton received a warm reception for her proposal for nationwide universal coverage -- a plan that resembles the system Gov. Arnold Schwarzenegger wants for California. The governor projected optimism on healthcare too, dropping by Wednesday to talk with The Times' editorial board about his plan and its prospects for passage in the Legislature's special session.

He touted endorsements the plan has received from the California Hospital Assn. and the Los Angeles Area Chamber of Commerce -- two interest groups that initially were skeptical of reform. He reiterated his belief, backed on this page, that an individual mandate -- a requirement that every Californian have health insurance -- could produce significant savings on medical costs for businesses and consumers alike. Asked whether voters will resist funding the new system, he pointed to polls showing that a majority of Californians want change on healthcare. "We're doing something the majority of voters are for," he said. He's right, which makes this an important moment in the debate over this vital issue.

There was, however, a missing element in his pitch: those pesky details. Yes, the special session has been conspicuously underway for several days. But the governor and legislators still must figure out how much policyholders, taxpayers and business should each pitch in for universal coverage, which will cost billions of dollars. The governor is sticking by his calls for businesses to pitch in 4% of payroll; Assembly Speaker Fabian Nuñez, by his bill's steeper 7.5%. The parties haven't yet hammered out how to make health insurance affordable for lower-income Californians either. Or, if subsidies are called for, how the state will pay for them. Schwarzenegger's proposal hasn't even been introduced as a bill yet. As one healthcare expert who's been following the negotiations put it: "Everyone's asking when the special session will end. I'm wondering, when does it begin?"

"What we are saying is that in the end, everybody benefits," the governor said Wednesday. He's right about that too. But everybody benefits only if a bill -- a workable bill -- passes out of the ever-shortening special session. This is a rare opportunity for California to capitalize on bipartisan agreement that healthcare demands fixing; it would be a tragedy to waste it.

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