Improved prognosis

THE PROSPECTS for fundamental change in the healthcare system improved Monday when three dozen businesses, including some of the country’s largest employers, announced their support for universal health insurance. The new Coalition to Advance Healthcare Reform plans to lobby lawmakers (particularly in Sacramento and Washington) for a market-based approach that makes insurance available to all while attacking the spiraling cost of medical care.

The group is hardly the first to call for sweeping changes in the healthcare system. Nor is it a bastion of altruism; its ranks include some of the country’s biggest health insurance companies, managed-care giant Kaiser Permanente, drug manufacturers and medical equipment makers. Other members, such as Safeway and PepsiCo, are eager to stem the growth in their health insurance costs, which have risen in part because their payments subsidize care for the poor and the uninsured.

What makes this coalition different is that it unites two former adversaries -- firms that have traditionally opposed constraints on healthcare spending and businesses that have been pressing government to do just that. And although the group has no labor unions on board, its goal is now the same as Big Labor’s. That alignment is new and propitious.

Now comes the hard part. The coalition postponed the policy heavy lifting by instead advocating broad principles. Some of those -- which are consistent with Gov. Arnold Schwarzenegger’s reform proposal -- shouldn’t be controversial. For example, the group calls for giving individuals as large a deduction for health insurance expenses as businesses receive and providing more financial incentives to lead a healthy lifestyle. But the coalition also wants to make insurance mandatory, and it would divide the cost for that coverage among consumers, government and businesses.

It would have been more admirable had the group come up with ways to achieve those ends. But at least it is pushing for a genuine overhaul rather than just tinkering around the edges of a system that’s badly broken.