A True Health Crisis

Legislation to protect thousands of Californians from economic ruin in the event of serious illness is taking form in Sacramento, raising the possibility that a critical failure of the health care system will at last be remedied. The concern Gov. Deukmejian has already demonstrated for filling gaps in the state’s health services at least assures the proposal of a sympathetic consideration by the executive branch.

Assemblyman Alister McAlister (D-Fremont) has won overwhelming Assembly approval for his bill, AB 600, with Senate committee action scheduled for Aug. 21. The evidence of support is hardly surprising given the gravity of the problem.

The bill would create a health insurance program for those not now protected by Medi-Cal or Medicare and who have been denied other forms of coverage for any reason. The program would be subsidized by a tax on the earnings of all people in the state, up to a maximum of $170 a year, but in all likelihood substantially less, plus payments by those obtaining the insurance.

The insurance would cost as much as four times regular health insurance, include a $1,000 deductible and 20% co-payment charges on all services, with a lifetime limit of $1 million. Burdensome as that is, it would be welcomed by many of the more than 500,000 people in the state now denied insurance. They live in constant fear of having to exhaust their lifetime savings and sell their homes to finance health care in the event of devastating illness.

Objections to the proposal on grounds that it represents a tax increase are expected to yield to the evidence that the total impact of the bill would be to lower taxes, easing the burden on both the welfare system and Medi-Cal. The present situation, in which there simply is no provision for health insurance for some people, has stirred deep concern because of the evident injustice and inequity. Eligibility for health insurance for many now depends on their work situations. Most large employers cover all workers with health insurance regardless of medical history. But persons in small groups, or those seeking individual coverage, may find themselves excluded because of a medical history that makes them high risks.

AB 600 makes special provision for pre-existing medical problems, including heart attacks, cancer and diabetes. Protection in the event of recurrence of the pre-existing ailment would commence for all policyholders after a six-month waiting period, but immediate coverage would be offered as an option with an additional premium.

This legislation would not complete the task of assuring all Californians basic health care insurance. Many who should have its protection would not be able to afford it, an issue that must be addressed in the months ahead. But it would provide health insurance for many who want the protection but have been denied it. The protection of health insurance is not a luxury; it is a necessity.