Doctors Debate Prospects for State-Run Health Plan : Politics: Proposition 186 is cheered for its promise of coverage from cradle to grave. But critic says it can’t work.

ORANGE —  Two Orange County doctors made emotional pitches for and against Proposition 186 Thursday, debating whether the bill that would create a state-run health insurance program will mean better health care or worse, or even life-threatening inefficiencies.

Calling the passage of the initiative historically comparable to American women winning the right to vote, Dr. Nancy Greep told the audience of about 40 health care and social activists that a state-run program would help solve the problem of spiraling insurance costs and provide critical care to the state’s underinsured and uninsured.

As medical director of the North Orange County Community Clinic, Greep said she often cares for patients whose private insurance companies fail to cover critical services.

Proposition 186 “would allow me to practice medicine again with dignity and not in a system that is always closing its doors in our patients’ faces,” Greep said during the conference, which was organized by the Health Care Council of Orange County at St. Joseph’s Center.

But Dr. Cristina Rizza called the proposed program “socialized medicine.” She warned the audience, which included many senior citizens, that if the state takes over the administration of health coverage, the elderly will suffer most because of bureaucratic inefficiencies and shortages.

“You will be sacrificed because you are old and expendable,” predicted Rizza, co-founder of the Orange County-based Americans for Free Choice in Medicine.

Proposition 186 would provide cradle-to-grave health insurance for all 31 million Californians by imposing taxes and through existing government financing.

A single state fund administered by an elected health insurance commissioner would pay all medical bills, mental health coverage, prescription drugs and long-term care, including nursing homes.

Rizza, who was born and raised in Italy, said its socialized medical system, which is plagued by shortages, led to her parents’ premature deaths. Her mother was turned down for critical medical tests and her father was denied intensive care because of long waiting lists, she said.

“Maybe you think that couldn’t happen in the U.S., but the universe is governed by cause and effect, and if you enact the same principle you’re going to get the same effect,” she said.

Greep countered that the bill prohibits the rationing of important medical services. It also would cap administrative costs at 4% to control bureaucratic growth and eliminate waste, she said.

The state-run program would be offered as an alternative to private health insurance. Instead of the premiums now paid by individuals, corporations and their workers, the state would collect a 2.5% surtax on all taxable income up to $250,000 for individuals and $500,000 for families. The tax would be 5% at higher income levels.

Corporations would pay a payroll tax of 4.4% to 8.9%, and a $1-per-pack cigarette tax would be imposed.

Supporters claim that, despite the increase in taxes, most Californians would end up paying less for health coverage by avoiding insurance premiums and deductibles.

In a Times poll earlier this month, about two-thirds of likely voters statewide said they had not heard enough about the measure to form an opinion. After the measure was described to voters, the initiative trailed by a wide margin, 23% to 63%.