Worker Health Insurance Plan Greeted Warily

The governor’s proposal to require all employers to provide health insurance for their workers drew mixed reaction from the business community and advocates for the poor in Orange County.

While the governor’s new show of leadership in the health care field was welcomed by many, business leaders were concerned that his proposal might unfairly burden small companies.

Advocates for the indigent objected that the plan would continue to exclude the homeless and other poor people without jobs from health insurance coverage. And they worried about a provision to have the county’s financially strapped health care program help fund the new benefits.

“On the positive side, it is about time that the Deukmejian Administration acknowledged there is an enormous problem” of people without medical insurance, said Dr. Howard Waitzkin, chairman of the Orange County Task Force on Indigent Health Care. “But there are a number of negative aspects about the proposals that we have to be skeptical about.

“Any proposal that links mandated health insurance to employment will leave part of the population either uncovered or undercovered,” he complained. He also said the Deukmejian proposal would “perpetuate a two-class system of health care” by encouraging small firms to adopt bare-bones benefit plans with managed care provisions designed to contain costs. By contrast, he predicted, larger companies will continue to provide their workers with health plans that offer richer benefits and a greater choice of providers.

Tom Uram, director of the Orange County Health Care Agency, said he would “favor anything that would increase the number of people covered by health insurance.” An estimated 250,000 to 400,000 county residents have no insurance.

“What I am glad for is that the governor did not wait for the initiative process to force a health insurance program for these folks,” Uram said.

But Uram wants to know more about the plan. He is concerned about a provision to use some of the county’s indigent care funds to finance the new program. “It may be a little like a shell game,” he said, “because they take money from us to do this.”

Uram said he also would oppose implementation of new health benefits through expansion of the existing Medi-Cal program, because most doctors refuse to participate in that federal health system for the poor.

Larry Ball, Orange County regional manager of the Merchants and Manufacturers Assn., said he was “a bit shocked” by the Deukmejian proposal. He said he is “opposed to mandates because I have yet to see any program managed by the government that is managed very well.”

Jim Meuse, president of the Orange County Employers’ Health Coalition, said his first impression of Deukmejian’s plan is that “it probably is workable.” He said he is happy that it provides for “a rather modest cost and scope of benefits.”

But Meuse cautioned that the proposal is likely to be heavily amended in the Legislature. “As the level of benefits increases to satisfy the various constituents, the end result could be too costly even for the large employer,” he warned.

Michael Metzler, president of the Greater Santa Ana Chamber of Commerce, said the chamber opposed a previous employee insurance proposal sponsored by Assembly Speaker Willie Brown (D-San Francisco). He said the Deukmejian alternative is preferable because it provides for cost containment and requires Medi-Cal malpractice claims to be settled through arbitration.

PLAN CRITICIZED: Critics call governor’s proposal unfair, unworkable. A3