Health care wishful thinking exposed

Californians can always count on nonpartisan legislative analyst Elizabeth Hill for a healthy dose of fiscal reality. And on Tuesday, the very day before the Senate Health Committee was due to send out the $14 billion health care expansion plan for a full floor vote, Hill sounded a stark warning that within five years the program would likely cost the state between $300 million and $1.5 billion per annum.

Hill suggested it was largely wishful thinking that the plan, already approved by the Assembly, could provide low-income persons with subsidized coverage for $250 monthly. And that was hardly the worst-case scenario. California’s annual drain could top $3 billion if other trends also occur; such as higher medical inflation, a recession increasing the number of uninsured, loss of anticipated federal funds or diminished tobacco tax revenues as more people give up smoking.

As a result, following a six-hour hearing on the financial risks of the measure, the 11-member Health Committee postponed voting until Monday. The delay was requested by Senate President Pro Tem Don Perata, who presumably will use the interim to attempt raising additional support. With Democrats Leland Yee and Sheila Kuehl announcing their opposition to the measure and the committee’s four Republican members in a united front against it, one more “yes” vote is needed to keep the health plan from dying.

Theoretically, Perata has the power to gain that additional vote by changing the membership of the committee. But he has told interviewers he will not do so. Perata’s support for the bill has been considerably more lukewarm than that of Gov. Arnold Schwarzenegger and Assembly Speaker Fabian Núñez. In fact, he delayed Senate action until after release of the legislative analyst’s report he had sought — a tactic some have suspected might be related to the governor unexpectedly supporting the Proposition 93 term limits measure.

With California now facing a $14.5 billion overall deficit, this is hardly the time for state politicians to continue relying on their familiar lazy trickery of smoke-and-mirrors budgeting based on wishful thinking. Few people would dispute that the health care coverage in California — and of America as a whole — is too expensive to adequately meet the needs of a substantial percentage of the public. We have a flawed medical payment system and a better way must be found.

Typically enough, California seeks to lead the way in showing the nation how to fix a knotty problem. That would be fine if the state weren’t already $14.5 billion short of being able to afford all its other obligations; or if the health care expansion could truly pay for itself, as its proponents claim it will.

It took the legislative analyst’s even-handed report to force the debate away from fantasy thinking and make it impossible for lawmakers to avoid dealing with the sticky financial questions. Any California health plan must not only work, but it also must not drag the state into genuine bankruptcy.

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