Big news yesterday for the seven million uninsured citizens of California: SB840, a bill designed to create a universal healthcare system for Californians, passed the house and went back up to the Senate. This is the first time in California history that such a bill has passed both houses. The bill is viewed as a major test for the governator, seeing as how this is an election year and many voters have pegged healthcare as a big issue. Apparently he doesn’t support the bill, but we’ve seen surprisingly progressive moves by Schwarzenegger before, showing that he seems to be a bit of a wild card when it comes to toeing the party line. With some leaning, he might be persuaded to pass it.

San Francisco recently implemented a universal healthcare system, which is being viewed by some as a model (and impetus) for a state-wide system. SB840’s proposed structure, however, varies slightly from San Francisco’s: the bill would eliminate all private insurance and create a state-wide California Health Insurance System. This is something that is viewed with suspicion by (surprise!) insurance companies and the lobbies that represent them. I think it’s fairly clear to all of my readers that insurance companies are inefficient, slow moneypits. I am all for throwing out a privately based system in favour of a solidly structured public one. Those who wish to pay more can, if they’d like. The rest of us want to go to the damn dentist already.

The bill claims that it would provide health insurance for all Californians while allowing us autonomy over our doctors and treatment centres. This would make sense–if everyone is covered under the whole system, every doctor, hospital, and treatment facility in California could become a preferred provider.

The bill would also pool resources (including an increase in payroll and individual income taxes) to pay for itself, as well as creating bargaining power for the state as a whole when it comes to getting prescription drugs and medical equipment. A separate panel would need to be formed to more completely create a funding plan, as well as additional legislation.

I’m excited. I would really like to see this bill pass, even though I know it would take several years to be implemented.

I also have several questions. The first surrounds what the plan will pay for. The plan is supposed to cover dental and vision as well as medical, prescription drugs, and hospitalizations. Will this also include psychiatric/psychological care? What about “alternative” providers such as massage therapists, chiropractors, energy workers, acupunture practitioners, and others, many of whom are currently covered under private insurance? I realize that California is viewed as a hippie-dippie state, but many of these practices have valid medical applications–how will this be dealt with under the universal system?

Will the plan have copays, or will health care truly be free to all Californians?

I also disagree with Phil Angelides’ stance on the bill. (Sorry, Phil.) He wants to move slowly towards universal health care by covering all children, and then forcing businesses to cover their employees.

I have several problems with this rationalization. The first is that I think we, as a state, need to take the plunge. The most efficient and effective way to do this is to go for it. I realize that coming from an impulsive person, this might not seem like great advice to follow. But I truly believe that some changes do need to happen in one fell swoop.

The next problem I have is that not everyone in California is employed. What about people working for themselves, or stay at home parents, people with other financial arrangements, or the homeless? When will they get coverage under this grand scheme? If employers are also expected to provide partner benefits (to all partners, in all relationships), this might cover some of these groups–but not all. This seems like it would require more bureaucracy than a straight up switch.

Finally, fuck the children. Children in California can get health care. There are a number of systems in this state aimed at getting health care to children from all walks of live, and I never suffered for health care when I was under 18. I knew that the resources were there when I needed them. What we should be worried about is the 18-25 year old working poor…a large and mostly uninsured sector of California’s society. We bust our balls for forty hours a week or more and hope we don’t get sick–that’s our current health care plan. In addition to representing a big chunk of the uninsured, we also represent a big voting bloc, so listen up, politicians.

Fast facts (and statements of bias):

I haven’t been to the dentist in 10 years. I ignore the pains in my teeth in the hopes that they’ll go away, and meanwhile I brush and floss. Under SB840, I could find out what the hell is going on in there, and perhaps get surgery on my receding gums before my teeth fall out.

My cats have health insurance.

I no longer do as of April of this year.

I have minimal coverage for one condition under a County of Mendocino program, and family planning benefits through the State’s Health Access Program (by fudging the numbers on my income significantly). I also have helicopter insurance through CalStar, and therefore fervently hope that the airlifting crew performs any major medical interventions on me, so I won’t have to pay for them. Alas, airlifting usually comes with a long (and expensive) hospital stay. For all other medical needs, I’m on my own unless my doctor takes pity on me and sneaks them into the billing paperwork for the Health Access planning (sure, she needs an x-ray of her ankle…it’s crucial to gynecaelogical health!)

My current glasses are a four year old prescription. I have difficulty seeing beyond five feet.

Were I to be in a catastrophic accident or have any other kind of health crisis, I would be financially devastated with no hope of repair, largely in thanks to the new bankruptcy laws that won’t allow bankruptcy in the cases of medical debt.

I’m not telling you these things to make you feel sorry for me, I’m telling you these things because they are facts, and because a lot of Californians are in the same position I am. Some are even worse off, without any kind of assistance whatsoever. Either they haven’t learned to work the system yet, or they can’t work it anymore. They are truly screwed–I’m only mostly fucked.

Most of my friends are in the same position I’m in. We read the Barefoot Doctor’s Manual and hope for the best–that’s all we can, and all we can afford, thanks to the society we live in.

My older and more financially stable readers might not face the same health care realities that I do. Perhaps you have insurance, and are able to get medical care when you need it. Perhaps when you break bones, you don’t have them set by friends on the kitchen table (true story, but it wasn’t me) and strapped in muslin until they heal…more or less. Perhaps if you have agonizing jaw pain, you call the dentist and make an appointment, and when your glasses start to go a little fuzzy, you call the optometrist.

More power to you. That’s awesome. I think everyone is entitled to good health care, wherever they are.

But maybe you’re like me, and most of the people I know. Maybe you think universal health care for Californians, and eventually Americans, and worldians, is a really good idea, because you know firsthand what it’s like to not get proper health care. Or maybe you’re just a bleeding heart liberal and it bothers you to think of people living in pain. Maybe you’re a pathologist and you’re horrified at the thought of untreated systemic disease.

So say something. Contact the governor to tell him you support health care for Californians. Look up your legislator, if you don’t already know who it is, and tell them you want to see SB840 pass. It’s an election year, kids: make ’em tremble!

[health care]