Posted on 02/07/2007 9:42:12 AM PST by NormsRevenge
SACRAMENTO - Gov. Arnold Schwarzenegger's health care plan was molded by a team of staffers as politically varied as California itself - a fact that could accelerate the ambitious proposal's journey from idea to reality.
While Schwarzenegger faces plenty of opponents a month after unveiling the plan, their tone has been more conciliatory than confrontational. This, analysts say, is no accident.
By stuffing his health advisory team with staffers who represent the often conflicting interests of employers, medical associations, insurers, unions and patient-advocacy groups, the governor has been able to pre-empt a lot of the criticism that could have doomed the plan. It's also an example of the governor's new style of "post-partisan" governing.
"(There) were often very robust policy debates, out of sight of the governor and sometimes in front of the governor," said Daniel Zingale, one of Schwarzenegger's key advisers on health care. "He has an Arthurian style of governing, where he likes people to disagree in front of him. There was more of that than I've ever seen anywhere."
The rancor that might normally accompany such a far-reaching and expensive plan - addressing one of society's most pressing problems - is so far absent.
In fact, a number of medical groups - including many that object to his proposed fees on doctors and hospitals - said this week that they will form a coalition to support the governor's principles, if not his exact plan.
Diversity in action
The governor's policy team is "a very diverse group" representing most of the major points of view, said Barbara O'Connor, director of the Institute for the Study of Politics and the Media at California State University, Sacramento.
"Having them vet the plan up front and then work it along the way I think produces things like this (medical group) coalition and pre-empts a lot of partisan coalitions (in opposition)."
Schwarzenegger's policy team was led by Health and Human Services Secretary S. Kimberly Belshe, and Zingale, a senior adviser to the governor who also serves as chief of staff to first lady Maria Shriver.
Working with them were Cabinet Secretary Dan Dunmoyer and health policy staffers Herb Schultz, John Ramey, Richard Figueroa and Ruth Liu.
Zingale is a Democrat who was once a senior aide to former Gov. Gray Davis, while Belshe is a moderate Republican who previously worked under Gov. Pete Wilson. Dummoyer is a more conservative Republican who previously worked for the Assembly Republican caucus and was head of an insurance industry trade group.
'Give and take'
Members of that team had fought on opposite sides over a previous major health care proposal, Senate Bill 2, a labor-backed effort that required businesses to provide health insurance for employees. Schultz and Zingale both worked in the Davis administration to support and craft the measure, while Ramey was hired by the California Chamber of Commerce to help repeal it through Proposition 72 in 2004.
"We have very candid and robust conversations about the policy strengths and weaknesses," Belshe said. "The plan reflects a lot of back and forth, a lot of give and take."
Schwarzenegger started laying the internal groundwork for the health plan in early 2006, when he indicated to his staff a renewed interest in tackling the issue, Belshe said, even as publicly he was focusing on promoting his infrastructure bond proposal.
Reaching out
To get the effort started, he held a health summit in the summer of 2006 with experts and interest groups and then assembled the policy team by the fall. The team first met as a full group in early September.
Over the course of assembling the plan, the team also sought feedback from a variety of groups, including potential critics such as the California Medical Association and the California Chamber of Commerce.
"They reached out to us as they did a lot of groups, from consumer groups to health care delivery people to hospitals, to unions," said chamber President Alan Zaremberg. "I think the governor was pretty inclusive in reaching out to everybody. But it's his own plan."
They also reviewed past health care proposals and plans from other states such as Massachusetts, where a Republican governor and Democratic Legislature last year agreed on a plan for nearly universal coverage.
Ambitious plan
The $12 billion plan they ultimately came up with seeks to insure nearly every Californian with the following key provisions:
Require every Californian to purchase health insurance.
Expand Medi-Cal reimbursements to health providers.
Expand government health insurance programs.
Require insurers to issue coverage to all.
Pay for the plan primarily through a 2 percent of revenue fee on doctors, a 4 percent fee on hospitals and a 4 percent of payroll fee on businesses that do not provide insurance for employees.
Expand wellness/preventive efforts to prevent diabetes, obesity and other health problems.
When it came time to unveil the plan, the governor chose to highlight his collaborative style in an unusual format. Rather than a typical press conference in which only supporters were allowed to speak, he invited more than a dozen interest groups - including the chamber, the CMA, organized labor, health insurers, outside experts and major employers such as Safeway Inc. - to participate in a panel discussion before the media.
I'm sure they'd be here to defend their man if they weren't all in the Rudy threads... berating and lecturing.
"Post-partisan"? Is that the new euphemism for Democrat?
You noticed that too, huh?
Progressives are such a joy to be around. They've already coronated the new King and we haven't even had a vote yet.
Their past efforts and results should make folks sit up and pay attention to their ways.
Everybody who is (justifiably) skeptical of or hostile to the Governator's health care plan **still** needs to address the underlying issue, which is that the US spends a higher percentage of our GDP on health care than any other industrialized country for measurably, provably crappier results.
Ignoring the lessons of history is the one thing progressives have a genuine knack for. Especially when it's their own history.
Ignoring the lessons of history is the one thing progressives have a genuine knack for. Especially when it's their own history.
-----
It is because they keep reading the same old socialist playbook over and over again. And until the morons amongst the voting public finally wake up to their agenda, it will keep working with at least 50% of the voters....
bump
Let's all take a moment to welcome Mr. Soros to the forum.
Even though a "lib" said it, Moynihan was absolutely correct: We are all entitled to our own opinions, but not to our own facts.
Fact: The US spends a higher proportion of its GDP on healthcare than any other industrialized country.
Fact: Americans, as a whole (and even when controlling for race, gender and income) are less healthy than their counterparts in most other countries.
Your opinion notwithstanding.
Prove it.
> Prove it.
Disease and Disadvantage in the United States and in England
James Banks, PhD; Michael Marmot, MD; Zoe Oldfield, MSc; James P. Smith, PhD
JAMA. 2006;295:2037-2045.
Context The United States spends considerably more money on health care than the United Kingdom, but whether that translates to better health outcomes is unknown.
Objective To assess the relative heath status of older individuals in England and the United States, especially how their health status varies by important indicators of socioeconomic position.
...
Results The US population in late middle age is less healthy than the equivalent British population for diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer.
...
http://jama.ama-assn.org/cgi/content/short/295/17/2037
QED
C'mon, I know university studies are the end-all be-all for Enlightenment buffs... but you're going to have to do a little better than that.
Check The Lancet, I'm sure they'll have something you can use to bolster your case. It's like the Home Depot for constructing socialized medicine talking points.
Another broader measure used to compare health in countries is Healthy Life Expectancy. This is the basic indicator of population health used by the World Health Organization and published each year in The World Health Report. This indicator measures the equivalent number of years in full health that a newborn child can expect to live based on current death rates and current rates of illness and disability. Improvement in healthy life expectancy is also the first goal of Healthy People 2010 for the United States. Today, 27 countries have healthy life expectancies for males and females that exceed the United States (Table 11).
http://www.unitedhealthfoundation.org/ahr2006/OtherNations.html#Others
A better question: do you have any reason to believe (besides serious cognitive dysfunction) that the health of Americans is even comparable to that of similar folk in other countries?
I do. Moreover, I have reason to question your analysis of the data. Data -- provided by the United Nations -- that always seems to come up in the context of these socialized medicine discussions, conveniently enough.
Dr. Robert Cihak wrote an excellent syndicated article on the subject two years ago, where he took a closer look at the infant mortality rates which, as you know, greatly impact the HLE numbers.... the ones you're now using in the context of this socialized medicine thread.
Anyone who would like to read Dr. Cihak's article can find it HERE. I suspect you've already read it, and know exactly where to find the materials necessary to discredit it.
If I appear dense, I do apologize. It's just that I've seen your argument, I don't know, maybe a hundred times since the last WHO report was released. I just don't have my heart in it anymore.
Dr. Cihak raises excellent points, and there is always a danger in comparisons like these of comparing apples and oranges.
That kind of disparity in data is precisely what the first study I mentioned clarifies:
Based on biological markers of disease, not just self reported illnesses, US residents are much less healthy than their English counterparts and these differences exist at all points of the socioeconomic distribution.
Yet America spends twice as much of her gross national product on health care.
Something is grossly wrong with this picture.
> I just don't have my heart in it anymore.
Maybe that's because you know you're wrong.
PS I am not advocating "socialized" medicine. I firmly believe that NO situation is so $#@*ed up that the government isn't ready, willing and able to make it worse. That does not mean that I'm willing to put blinders on and ignore the FACT that our system is broken.
What the first study confirms to me is that Americans have terrible eating habits. We have the highest obesity rates in the world. We're the fattest, richest, most decadent culture the world has ever seen and it catches up with us in our middle ages. And somehow we still have comparable actual (not "healthy") life-expectancy rates to our counterparts around the world (Great Britain is 77.8 vs 77.1 in the US). So the American health care system is effectively, though not efficiently, keeping a bunch wantonly unhealthy people alive. It has to work harder than the British system, but in the end, it produces the same results with sicker patients.
I'm not blind to the problems. We have a quasi-socialist, quasi-capitalist system the seems to combine the worst of both worlds at an unsustainable cost. And on top of that, we have a population of cheeseburger-scarfing couch potatoes committing suicide-by-diet. The system is broken because it's reflective of a broken culture. The first step towards fixing it is to start taking better care of ourselves.
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