Audacious First Aid

More than 7 million people still lack health insurance in California, nearly twice the population of Ireland. The enormity of the crisis leaves many to conclude grimly that the state can do nothing to solve it. An audacious new bill may disprove that fatalistic conclusion.

A conservative physician in the Assembly, Keith Richman (R-Northridge), and a liberal senator, Liz Figueroa (D-Fremont), have set forth some powerful reasoning in a bill that could reach Gov. Gray Davis’ desk as early as this week. Assembly Bill 32 would enroll more than half of the state’s uninsured population in CalHealth, a program that would combine the state’s existing Healthy Families program for children and the Medi-Cal program for the working poor and the disabled.

At first glance, AB 32’s price tag--up to $1.8 billion a year--will cause heart palpitations among the budget-conscious. But a raft of public health research makes it clear that the bill would pay for itself by reducing the $6 billion to $7 billion that the state and counties now spend treating sick people in hospitals and clinics.

As Richman says, “Ear infections that are ignored can turn into lifelong hearing loss; untreated diabetes can lead to amputations, and undiagnosed high blood pressure often leads to strokes.”

By providing millions with preventive care, AB 32 would reduce the numbers of uninsured who show up in emergency rooms with life-threatening conditions. By making low-cost health insurance pools available to small businesses, it would encourage employer participation. And by asking President Bush to grant California a waiver to use some of its $855 million a year in Healthy Families funding to cover not just children but also their parents, it could aid counties that currently shoulder health care costs without help from Washington.

Davis advisors fret that AB 32 could drag the state into a money pit. They worry that the Bush administration may not support the sort of health care expansion the bill proposes. A rational fear. Just last month, President Bush’s health secretary retreated from candidate Bush’s pledge to spend $28 billion over three years to help states provide health coverage to the working poor. But AB 32 erects a solid guardrail to keep the state from stumbling into that money pit--a provision saying the bill will take effect only if Bush approves the waiver.

Even if the governor signs the legislation and Washington fails to come through with the cash, the state will have made progress. It will have blazed a trail. California will have distinguished itself by making a powerful bipartisan statement: The broken health care system can and must be fixed.