Wofford Victory Fuels Call for Calif. Health Reforms : Medical care: Strong advocacy of national health insurance helped Democrat score upset in Pennsylvania.

Pennsylvania Democrat Harris Wofford’s effective use of health insurance reform as a campaign issue has emboldened California lawmakers and activists striving to make medical care available to every resident of the state.

Although opinion polls have been showing for some time that voters want broader access to health care, along with cost controls on doctors and hospitals, the legislative and executive branches of state government have yet to agree on any significant plan for change.

“The lesson from Pennsylvania is: The time is now for universal health care,” said Michael Weinstein, president of a Los Angeles foundation that cares for AIDS patients and author of a health insurance initiative proposed for the November, 1992, ballot. “To be on the side of universal health care is to be on the winning side.”

Wofford’s upset victory over former U.S. Atty. Gen. Dick Thornburgh has been attributed to several factors, including unease over the economy and Wofford’s message that his opponent, and the Bush Administration, have catered to the interests of the wealthy and ignored the middle class.

But the centerpiece of Wofford’s domestic agenda was a push for national health insurance, and California advocates for major change in the health care system chose Wednesday to focus on the role that played in his victory.

“This result reinforces the belief I have had for a while that this issue is now at a boiling point,” said Assemblyman Burt Margolin (D-Los Angeles), the Assembly’s leading supporter of a health insurance overhaul. “The level of anger and frustration is soon going to reach a point where political leaders can no longer ignore the message.”

Margolin favors a so-called “pay or play” system in which employers would be required to provide health insurance for their workers or pay taxes that would finance coverage for all those who cannot obtain it. Republican lawmakers and two GOP governors--George Deukmejian and now Wilson--have resisted the idea because of fears that such a system would bankrupt many small businesses.

Weinstein’s initiative, which is still in its preliminary stages, would order the Legislature and the governor to adopt a pay-or-play system, leaving it to lawmakers to iron out the details.

Another, more sweeping proposal would scrap the current system of privately financed health care in favor of a tax-supported program similar to that in Canada. Under that system, advocated in California by a coalition of labor, consumer and religious groups known as Health Access, a government commission would bargain with private doctors and hospitals to get the best rates for consumers. The insurance industry, which now acts as an intermediary, would be bypassed.

Health Access argues, and some studies have shown, that such a system would dramatically reduce administrative costs while still giving patients their choice of physician or hospital. The Canadian system and the U.S. Medicare and Medicaid programs, while criticized for other reasons, all have been shown to operate with lower overhead than the private health insurance industry.

Maryann O’Sullivan, executive director of Health Access, said she believes voters are not going to favor expanding the existing, employer-based system because to do so would mean raising taxes on everyone to finance care for those who now are left out. A single-payer system, she argues, would cover everyone by simply redirecting what Californians already are spending for health care, trading higher taxes for reduced or eliminated private health care costs.

“Wofford tuned into what people are really feeling these days,” she said. “There is intense insecurity about the ability to get health care when we need it.”

Gov. Wilson said in a speech last week that expanding access to health care and lowering its cost are major goals of his Administration. He has ruled out supporting a Canadian-style system, he said, and favors building upon the current job-based system of providing health benefits.

But the governor cautioned that the state’s fiscal predicament--another multibillion-dollar deficit is looming--makes it almost impossible to enact a comprehensive new program.

Bill Livingstone, the governor’s press secretary, said Wednesday that the Administration does not necessarily agree that the Pennsylvania election represents a message on the voters’ desire for universal health care. But even if it did, Livingstone said, Wilson will continue to pursue a measured approach to change, which he has begun with programs aimed at pregnant mothers and their children.