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California insurance exchange chief has health reform 'in his bones'

Peter Lee's father and uncle fought for then-controversial Medicare 50 years ago. Now the Covered California chief must enroll millions in Obamacare, and his performance may set the tone for other states.

September 28, 2013|By Chad Terhune
  • Peter Lee, center, executive director of Covered California, visits with dad Peter, left, and uncle Philip in Pasadena.
Peter Lee, center, executive director of Covered California, visits with… (Gina Ferazzi, Los Angeles…)

Republicans in Congress are railing against the healthcare law as a government takeover of medicine. The massive program will harm patients and cost far too much, critics say. Supporters are being branded as socialists.

This isn't just the latest political theater in Washington. It mirrors the scene 50 years ago during the contentious debate over Medicare.

Two brothers, Peter and Philip Lee, fought on the front lines back then, bucking the medical establishment to guarantee healthcare for seniors.

Now another Peter Lee — Peter's son and Philip's nephew — is carrying on the family tradition. He's in charge of enrolling millions of Californians in Obamacare.

President Obama and the fate of his signature law have a lot riding on Lee's performance here in the nation's biggest market.

Full coverage: Obamacare rolls out

Opponents are ready to pounce on any stumbles as evidence the law should be scrapped. Conversely, high enrollment, satisfied customers and stable rates in California may silence some detractors and even persuade fence-sitting states to join in.

"Peter has the weight of the country on his shoulders," said Gerald Kominski, director of the UCLA Center for Health Policy Research. "The overall success of the healthcare law depends a great deal on California."

As enrollment in the new health insurance marketplace begins Tuesday, Lee admits to feeling the pressure as California tries to sign up more than 2 million people through next year, the most of any state.

But he says he finds comfort from digging through his father's old files and seeing the acrimony surrounding Medicare as it launched in 1965.

"Medicare was incredibly controversial, and it was rocky" at the beginning, said Lee, executive director of Covered California, the state's insurance exchange. But he saw the tide turn. "A huge percentage of seniors said, 'I actually want healthcare.' "

The Lee family has been at the intersection of healthcare and politics for decades. Lee's grandfather, Russel, founded the well-known Palo Alto Medical Clinic and pushed for national health insurance as a member of President Truman's Commission on the Health Needs of the Nation.

Lee's father was a professor of medicine at USC and raised his family in Pasadena, a few houses from the former Wrigley mansion.

Lee often joined his father when he visited patients on weekends at L.A. County-USC Medical Center.

During the annual Rose Bowl parade, his parents served homemade chili to politicians and dignitaries. For one summer vacation, the family visited former California governor and Supreme Court Chief Justice Earl Warren at his home in Washington — and borrowed his car to see the eternal flame for John F. Kennedy.

When Kennedy pushed for Medicare legislation, Philip and the elder Peter Lee were among a handful of doctors nationwide to speak publicly in support. The American Medical Assn. and other physician groups were adamantly opposed, fearing it would result in inferior care and too much government control.

In 1962, Philip Lee stood with Kennedy in the White House Rose Garden to press for more doctors to back the bill. That same year, leaders of the Los Angeles County Medical Assn. complained about his brother's vocal support of Medicare and called for his ouster from USC.

"A group of USC medical alumni went to the dean asking that I be fired for supporting socialized medicine," said Peter Lee, the 90-year-old father. The dean refused, so the doctors took their demand to the university president. The university defended his right to free speech.

Philip Lee, now 89, endured a similar backlash after squaring off in debates against other prominent doctors across the country.

"The San Francisco Medical Society called me a communist," the uncle said. "They were calling it the end of Western civilization back then. It's such a flashback to today."

In 1965, shortly after the Medicare program was enacted, Philip Lee went to Washington as assistant secretary for health and welfare to help implement the newly signed law. Some of the early obstacles he encountered are similar to what his nephew faces, including a potential shortage of medical providers as an influx of patients seek care.

Philip Lee returned for a second stint as assistant secretary for health in 1993 and served as a top advisor to President Clinton's ill-fated run at health reform.

His 54-year-old nephew also has shuttled between California and Washington. Lee attended UC Berkeley and later earned a USC law degree. His honors thesis at Berkeley explored the extent of gay political power.

By the mid-1980s, the AIDS epidemic was starting to touch some of his closest friends. The 1986 death of Bill Kraus, an aide to Harvey Milk and mentor to Lee, was a major turning point.

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