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All eyes were on California Monday as Governor Arnold Schwarzenegger (R) revealed the state's universal coverage plan. Given that the proposal requires the cooperation of so many interest groups--doctors, hospitals, insurance companies, employers and individuals--it's safe to say that Schwarzenegger's proposal faces a long battle and will undergo significant changes in order to appease everyone involved. Naturally, such an announcement sent the healthcare blogosphere abuzz with observations, criticism and analysis. Here are some of the highlights:

  • At The Health Care Blog, Matthew Holt congratulates Arnold for "being a proper flip-flopper with real moxie," noting that in 2004 the Governor urged voters to veto a Proposition 72 which mandated employers with more than 20 employees provide healthcare coverage. His new universal health proposal demands pay-or-play for companies with more than 10 employees.
  • In the healthcare industry, notes Tony Chen of Hospital Impact, it's not you, your doctors or hospitals that have the greatest incentive to keep you healthy. In fact, it's the health insurance companies that benefit most from healthy participants. Because of this lack of incentive, Chen thinks Schwarzenegger has an uphill battle and that "universal healthcare [won't] work in '07--no desperation, no crisis (yet), and thus, not enough political courage."
  • The Doctor Weighs In, and Arnold gets a pat on the back for his plan. "Kudos to the Governor for pursuing health reform at a time when many consider it the 'third rail' of politics...We will need to debate and tweak the details, but let's not tank the proposal out of narrow self-interest."
  • At the Health Care Policy and Marketing Blog, Robert Laszewiski urges stakeholders to look beyond their own interests and add to a constructive debate on the best way to cover uninsured Californians. "I am not here to tell you this bill should pass as it is. If it ever does pass, it won't pass as it is," says Laszewiski. However, he thinks we should "give the Governor of California a hand for putting a credible proposal forward--and telling everyone, 'Everything is on the table.'"

What's your take on the Governator's universal health proposal? Email me with your thoughts. - Maureen

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The only sensible way to reduce health care costs is paradoxically to limit the obscene profits of the insurers and give back something to primary care physicians. Maintain the incentive to enter a rewarding field by removing the fear of never making a decent return on time and money invested in becoming a doctor. Reducing insurers' profits puts billions back in the system. And their concern for profits leads to denial of covergae to the most needy. But as bad as the insurers are, National Health, as proposed by Kennedy, would be worse. Someone once said that Natinoal Health Insurance would have the compassion of the IRS and the fiscal responsibility of the Pentagon. Despite all this, the vast majority of heath care dollars still available after insurers' profits are used in the first and last year of life. Are we going to promote euthanasia, or prevent saving of infants less than a certain weight? Of course not. Is universal coverage a proper goal? Yes. But keep Kennedy and the People's Republic of Massachusetts away from the planning.

the cost of healthcare coverage has increased as the number of insurance providers has decreased by by-outs and take-overs. The spectre of monopoly looms; eg, kaiser has grown tremendously, however the premiums are no longer affordable unless covered by employment, and so with PPOs. How else can this be avoided unless there is only one payor?

I have posted a commentary on this issue citing both the California proposal and Massachusetts legislation on my blog, Healthcare Basics which is at the Trusted MD Network www.trusted.md.com

Please check it out under personal musings.

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