Why is ABX1 1 Still Alive?

Health coverage is just like other kinds of insurance – it’s only available when you don’t need it. When you do, it’s nowhere near as helpful as you paid it to be. 

Last year was the year of Health Care and Water in the White Sepulcher known as our state Capitol. (Would that bills on those two subjects were the only things lawmakers approved in 2007.) 

My vote would be: 2008 — Year of Scotch & Water. But that darn health care bill the governor and the Assembly Speaker like so much just won’t go away. 

Today, there is the “Mother of All Hearings” on the bill, a characterization of the Senate Health Committee chair.  A welcome but potentially painful change from the committee’s usual policy of allowing only two testifiers, two minutes each. 

Somewhere in America’s political past, health care got relegated. Or maybe the pols just had to punt. Whatever the reason, health insurance doesn’t get to hang with the A-Team of FREE Public Education and Safety-From-Criminal Attack. Health care somehow didn’t make the cut. 

Harry Truman tried to elevate America’s commitment to ensuring its citizens were tended to when they were sick or — even better — tended to before they got sick. He failed. The Great Society made great progress until Vietnam siphoned the money. 

Health care is way complicated. Providing coverage to the uninsured sounds nifty but find buy-off on anything when every special interest chiseler in the Capitol has a juicy stake and a diametrically opposed view to their fellow chiselers. 

When was the last time doctors, nurses, hospitals, employers, unions, insurers, health providers and lawyers agreed on anything? If the HMOs told the docs the sky was blue, the docs would get a second opinion. 

That degree of loathing and distrust – and the heft of the loathers involved – makes creation of legislation as sweeping as ABX1 1 downright astounding. Whatever you’re position on the bill. 

You’d think any one of those special interest chiselers could have throttled that bill any number of times before now. Sooner, if they worked together. (In a bipartisan spirit of cooperation, presumptively) 

Maybe the bill is still around because the unions are divided on it. As a bloc, in a Democratic majority Legislature, unions are pretty much unstoppable. Less omnipotent when chewing on each other. 

Maybe the bill is still around because this is the umpteenth time businesses have mouthed the same hoary horrors of the alleged economic tragedy spawned by providing insurance to their workers. Heard it so many times it’s just a big snoozer now. Geez, employers opposed to increased costs to the bottom line? Who knew? 

Maybe the bill is still around because it is opposed by the flagitious tobacco industry, which generously allows itself to serve as the Capitol’s Snidely Whiplash. Whatever the Merchants of Death hate has got to be good, right? 

And even if what they hate ain’t so hot, what remarkably convenient hobgoblins the Tar-And-Nicotine Boys are when it comes to diverting attention. Look over there Mister, Snidely is tying Nell to the railroad tracks! 

Maybe the bill is still around because health providers won’t have their costs ratcheted down and can continue charging $7 for aspirin. Maybe in the brave new health care world this bill purports to create they won’t be able to charge $7 but there sure isn’t any money in wellness. 

Maybe the bill is still around because it is 134 pages long and dense, even by legislative standards. Perhaps if more Democratic legislators understood what premises this new fangled health care delivery system is built upon the “aye” votes would be fewer. 

(And, in the immortal words of John Burton: “You can never get in trouble voting “no” on a big bill.”) 

Maybe the bill is still around because the folks who hate the thing have an ERISA lawsuit in their quiver ready to twang at the bill’s heart the second it appears close to becoming law. 

Maybe it’s still around because lawmakers think passage of anything purporting to improve health care is positive even if it doesn’t actually lead to real improvement. In politics, perception routinely trumps reality so saying health care will be improved improves it. Can’t hurt to look like you’re doing something if you’re an incumbent legislator a couple weeks before the vote on Proposition 93. 

(How about that hunky firefighter on the new pro 93 commercials? The nexus between him and the proposition eludes me but Katrina was such a Four Star, All World cluster you’d think a politician who’d been in office 15 minutes or less would know how to avoid its replication. We must really love fire fighters.) 

Maybe the bill has gotten as far as it has because everyone knows that the feds aren’t going to back their dump truck into California’s driveway and pile up $2 billion to expand Medi-Cal, a central part of the health care proposal. Nor are the feds likely to hand over a fistful of critical policy-change waivers required to make the health care system fly. So why not vote for it? The director of the Department of Finance will never certify there’s enough dough to make it happen.

Best of all worlds: Did something about health care without doing anything about health care. 

Hey, maybe the bill is still around because insuring 3.7 million, mostly lower income Latino Californians is important and positive and long overdue. 

Maybe it’s a good first step to require people to buy health insurance. 

Maybe its high time insurers insure everyone who needs it instead of just those who won’t. 

Maybe this is that much needed public policy reform we’ve heard so much about for oh so many years. 

Maybe this is the extra shot of espresso talking.

 

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