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Sacramento Bee
By Fabian Núñez
January 7, 2007
Last week a Field Poll showed widespread support for
government action to help address the roughly 6.6 million
Californians with little or no health insurance. To help
set the parameters for that action, I announced last
month the Assembly's "Fair Share Health Care" proposal
to make health care in California more available, accessible
and affordable.
We Assembly Democrats believe in emphasizing prevention
and wellness; cutting out red tape and government from
medical decisions while empowering doctors and patients;
offering credible evidence that reforms will cut costs;
and understanding the special circumstances of small
businesses.
Above everything else, we believe all California children
should get the health care they need. When it comes to
children in this state, the document I care about most
is a clean bill of health. That's why we are proposing
expanding public coverage for low-income families through
MediCal's Healthy Families Program.
If any of us need to take our kids to an emergency room,
do we want them to have to wait for treatment behind
kids who are there because that's the only health care
their families have access to? Each dollar spent for
an immunization saves $13 in treatment. Absences to care
for sick children cost the nation's employers between
$2 billion and $12 billion each year.
It's clear that insuring all kids is the practical and
the moral thing to do. I can't imagine any legislator
wanting to stand up and block a child from getting access
to medicine or preventive treatment.
The Field Poll showed strong public support for expanding
employer-based coverage. This makes sense. Most California
employers offer coverage and most Californians get their
coverage through their employers.
The Assembly plan, which will require both employers
and employees to contribute a fair share to the cost
of health coverage, is designed so employers who already
provide coverage will encounter little or no change in
their current practices. That way, the relationships
most California families have with their doctors and
nurses won't be disrupted.
California is about innovation and entrepreneurship,
and the Assembly is looking at ways to help small businesses
during their crucial incubation periods. We provide exemptions
for firms with one or two workers or payrolls of $100,000
or less. By including employer responsibility as part
of the mix, we also ensure that businesses -- small and
large -- don't face unfair competition from businesses
that don't provide coverage.
Fixing the system must also include some changes in
the way insurers work. People are tired of seeing insurance
companies boosting their profits while providing less
to California businesses. Our plan streamlines the medical
underwriting process to make it faster and cheaper. We
want uniform benefit packages so employers and consumers
can compare and choose. In our plan, the state -- through
its Managed Risk Medical Insurance Board -- will serve
as the statewide pool purchaser of health coverage and
also serve the highest-risk community.
Tapping into technology is another way to cut costs.
Our plan incorporates using successful Web-based medical
records technology, advocated by Kaiser and others, that
allow records to be shared with doctors -- saving thousands
of dollars in new, unnecessary tests.
On a time line, the children's coverage, insurance reforms
and the shared employer/employee responsibility should
be in place by 2008. Then we can gradually expand to
reach unemployed single adults within five years.
This won't be easy. There will be months of negotiations
and discussions to build a workable solution.
However, coming off the historic bipartisan year the
Legislature and the governor just shared, and with public
support for health care action growing, I'm confident
this tall order can be filled.
Fabian Núñez is the Speaker of the
California State Assembly.
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