CALIFORNIA NURSES ASSOCIATION·
San Francisco Chronicle on December 8, 2017
With House Speaker Paul Ryan pledging to push major Medicare cuts to reduce the added $1 trillion in federal debt created by the huge tax gifts for corporations and the super-rich proposed in versions of the House and Senate tax bill that Republicans are working to reconcile — the urgency mounts for state action to protect the health security of Californians.
The Medicare cuts are just one sign of the health care threats posed by the expected final bill. Among other provisions that could be in the final bill are:
Elimination of the mandate to buy insurance, which analysis suggests would prompt insurers to levy new double-digit premium hikes; and,
An end to tax deductions for people whose medical expenses exceed 10 percent of their income, which would punish millions of people with severe health problems such as cancer and certain chronic illnesses.
Fortunately, there’s an alternative for California, a state bill that would guarantee health coverage to all, SB562, and will be eligible for legislative action again early next year. It builds on an illustrious history in our state, dating back more than a century to legendary California reformer Hiram Johnson.
In 1912, then-Gov. Johnson was the running mate for former President Teddy Roosevelt’s insurgent, though unsuccessful, campaign to return to the White House on a Progressive Party platform that prominently included a universal system of social insurance to protect all Americans from the “hazards of sickness.”
It was an early version of what became more than a century of national efforts to assure health care for all as a public responsibility and moral imperative.
Johnson continued that push by appointing a Social Insurance Commission in 1915 to study state solutions.
It proposed a state constitutional amendment that went before voters in 1918 to develop a system for universal coverage for California. The private insurance industry, joined by a large group of doctors, led the opposition, a pattern that would recur again and again.
It would be the first of repeated efforts over the past century by some of California’s most legendary political figures, joined by nurses and other reformers to guarantee health care for all Californians. They were not deterred by critics, like those today, who insist California must wait for a federal solution, rather than act here to protect our own people.
The honor roll over the years included such notables as Johnson; governor, soon to be Supreme Court chief justice, Earl Warren; martyred San Francisco Mayor George Moscone; and Democratic Party icon John Burton.
Bill after bill laid out frameworks that show a striking parallel to what the California Nurses Association and activists have proposed in SB562.
These include a single-payer-type structure with a new state agency to administer the funding from existing revenue and new state revenue to be paid to private providers for care delivery.
Nearly all featured universal, guaranteed coverage, without forcing Californians to be bankrupted by huge medical bills or skip the care they need due to the high cost, and comprehensive benefits, from hospitalization to physician services, dental, mental health, prescription drug coverage, and long-term care.
All those elements are the basic framework of SB562 as well.
Here’s Gov. Culbert Olson in 1939: “It is no longer seriously debated that a fundamental change is needed in the method of meeting the costs of medical care and the risks and loss of sickness, especially for wage earners and others of small or moderate income.”
Warren initiated at least four legislative efforts, starting in 1945 with an effort to provide universal coverage for all Californians modeled after similar European systems.
In his 1947 gubernatorial inaugural address, Warren noted it is “not sufficient to have medical services, hospitals, clinics and laboratories … unless the people have economic access to them.”
Burton, who retired in May as chair of the California Democratic Party, pushed his own plan as an Assembly member in 1961 for a prepaid health service system.
Three years before his election as San Francisco mayor, state Sen. George Moscone sponsored the Consumer Health Protection Act of 1972 to provide single-payer, universal coverage with no co-pays or deductible payments — a reminder that SB562’s plan to eliminate co-pays and deductibles also has a long precedent.
Virulent opposition, led by those who profit from sickness and suffering, and their allies in elected office, has blocked proposals, but not slowed efforts for a social insurance system to safeguard Californians.
In 1994, a single-payer initiative, Proposition 186, united CNA with major senior, small-business, consumer, women’s and progressive doctors’ groups. The initiative lost only after being outspent by insurance companies by about 10-1.
California came even closer to achieving this goal in 2006 and 2008 with single-payer bills by former state Sen. Sheila Kuehl, also sponsored by CNA, that twice reached the governor’s desk, only to be vetoed by Gov. Arnold Schwarzenegger.
Those bills, like SB562, featured public administration, the use of existing federal, state and local health care spending with new revenue, comprehensive benefits and universal coverage.
We don’t have to reinvent the wheel, a proud legacy of California leaders and activists has lighted the way.
RoseAnn DeMoro is executive director of the California Nurses Association. (With thanks to a 2007 research paper, “Ninety Years of Health Insurance Reform Efforts in California,” by Michael Dimmitt.)