Why insurers love the new health plan

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OPINION If you're one of the 6.5 million Californians without health coverage, get ready to find a lot of hands in your pocket.

Gov. Arnold Schwarzenegger's much-trumpeted health plan is the most ambitious overhaul of the state's health care system since ... well, since SB 840, the far simpler, more universal, more comprehensive, single-payer health plan sponsored by Sen. Sheila Kuehl, which the governor vetoed last September.

Unlike a single-payer system, with one entity that pays for everything using existing private hospitals and doctors and offers one standard of quality care for all, the Schwarzenegger plan is a mishmash likely to saddle more Californians with unaffordable, inferior coverage while opening a new gilded age for insurers and banks.

Once the legislature prunes away the proposed new tax on employers, hospitals, and doctors (which is likely) and eliminates the laudable pledge to assure coverage for the undocumented, the governor's plan is apt to end up stripped down to its worst elements — a mandate that all individuals have to buy health insurance and the dubious promotion of a Bush administration scheme, health savings accounts.

Individual mandates turn the whole purpose of health care on its head — they criminalize people, rather than helping them. If you don't sign up for a plan, you could become ineligible to get a job and enroll your child in school or face tax penalties.

With no controls on skyrocketing premiums, comprehensive plans will be out of reach for millions of Californians. Most could end up with junk insurance, with up to $10,000 in out-of-pocket payments for any medical care, meaning the average person will likely pay for all his or her medical expenses on top of the premiums. And many may forgo any medical care, risking worse health problems and greater health costs down the road.

Even lower-income people who qualify for the state subsidy could end up paying out 6 percent of their income. Presumably, they'll just cut back on food or rent — at the same time that the governor has announced plans for welfare cuts.

Then there's the $2 billion now used for indigent care at mostly public hospitals that will be siphoned off into the pool for buying insurance, ravaging our public health social safety net.

But the insurance companies will suddenly get millions of new customers, who will be buying insurance at gunpoint. No wonder Blue Shield CEO Bruce Bodaken says of the plan, "There's a lot to like."

If nothing else, the Schwarzenegger plan — and the lite versions proposed by the Democratic leaders of the Senate and Assembly — should be a call to action for the rest of us to press harder than ever for the enactment of the soon-to-be-reintroduced single-payer Kuehl bill. *

Zenei Cortez

Zenei Cortez, RN, is the vice president of the California Nurses Association.

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