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Fits the prescription

It may not cure our ills, but the healthcare bill is a good first step for California.

January 28, 2008

Able politicians from Harry Truman to Earl Warren to Richard Nixon to Hillary Rodham Clinton have tried and failed to reform healthcare. But this year, somehow, Gov. Arnold Schwarzenegger and Assembly Speaker Fabian Nunez (D-Los Angeles) have come close. The bill that has emerged from their yearlong negotiations is no panacea for California's ills. Nonetheless, the Senate Health Committee should approve it when it comes to a vote today. Failing to do so could delay reform for yet another generation.

If ABX1 1 passes and voters approve its funding in November, 3.6 million uninsured Californians would get access to coverage, much of it subsidized. As a result, fewer people would visit emergency rooms for routine care, which would reduce overall healthcare costs. Under the bill's individual mandate, more healthy people would join insurance rolls, making it more cost-effective for insurers to cover older and sicker people. Insurance companies could no longer deny coverage because of age or existing medical conditions. They would have to spend 85 cents of each premium dollar on care.

The bill has its flaws. It doesn't provide universal coverage. Affordability protections would be in place for many Californians, but they wouldn't apply for everyone, which could put some consumers in a pinch. Cost-cutting provisions would not be sufficient to slay the healthcare inflation beast. The bill could face legal challenges from businesses that believe its employer mandate violates federal law.

And, of course, there's the $14.9-billion price tag, to be paid for with tobacco taxes, hospital taxes and employer payments. Last week, the Legislative Analyst's Office reported that some of the plan's assumptions may be too rosy and that cost overruns of billions of dollars might "create pressure on the general fund." That's nothing to sneeze at, in a state grappling with a $14.5-billion budget shortfall. Californians should consider this when voting on the funding initiative in the fall.

But the report also acknowledged that any attempt to mitigate the healthcare mess is going to involve risk and expense. This is precisely why the Senate Health Committee must approve ABX1 1 and must pass it along to the full Senate for a vote. No healthcare legislation will be perfect. This bill would help millions of Californians in great need and would still allow the state to backtrack if the experiment doesn't work. At the very least, passing ABX1 1 would commit our elected leaders to keeping the discussion going. Even better, it could be a first step toward a healthier future for California.

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