Medical Assn. Backs Mandatory Insurance : Health: County group says persuading voters to approve a ballot measure forcing employers to provide coverage will be a ‘hard sell.’

Facing long odds in a conservative county, the Orange County Medical Assn. launched a campaign Monday to support a ballot measure requiring all employers statewide to provide workers with health insurance.

Local medical association officials vowed an all-out effort to solicit support and monetary contributions from the county’s 4,000 physicians, help that will be needed to persuade residents to cast their ballots in November for the so-called Affordable Basic Care Proposal.

Association representatives will present their case before service clubs, chambers of commerce and public interest organizations, said Dr. Richard Frankenstein, chairman of the county association’s legislative committee.

“I think Orange County has a conservative reputation and anything that deals with a government mandate will be hard to sell,” acknowledged Frankenstein.

Passage of the ballot measure, according to its proponents, would provide rudimentary health care to more than 300,000 of the approximately 480,000 Orange County residents who currently are uninsured and either go without care or are obliged to seek attention in hospital emergency rooms when their problems become severe.

If passed, critics say, the proposal would place financial burden on the county’s many small to medium-size businesses, many of which currently do not provide health insurance benefits. It would be phased in between Jan. 1, 1994, and 1997.

California would become only the second state in the nation after Hawaii to require health coverage.

Strong opposition to the measure has come from the national medical insurance industry, which, Frankenstein said, is expected to spend millions of dollars in a media blitz to defeat it.

But Frankenstein said he believes the owners of some smaller businesses will welcome the opportunity to obtain insurance at a more affordable rate. And the greater availability of health insurance, he speculated, could give a boost to the county’s entrepreneurship.

“I think there are some people who would start a small business but stay with large corporations because of the problems of obtaining insurance,” he said.

The ballot measure, written by the California Medical Assn., would provide primary and preventive medical care to workers at a monthly cost of $100 per employee, with employers paying at least 75% of that cost and employees paying up to 25%.

Under the proposal, employees no longer could be denied coverage for “pre-existing conditions,” and rates would be determined by communitywide experience rather than by the claim history of individual employers. Proponents say this would prevent rates from skyrocketing if a few employees in a small group become chronically ill.

Frankenstein stressed that the proposed insurance package would restrict members to obtaining their care within a prearranged network of physicians, hospitals and other providers, and they each would be limited to $50,000 worth of services a year.

Under the plan, he said, workers still would not be insured for such catastrophic illnesses as cancer or AIDS and, after exhausting their own resources, would have to depend on state and local programs for the indigent.

But he said the ballot measure is expected to save the state $7 billion a year, including a savings to the Medi-Cal program of $200 million.

Frankenstein said that only five years ago, the physician community probably also would have resisted expansion of government intervention in medical insurance.

“There certainly has been a willingness of physicians to look at things differently because of the increasing problems their own patients are having getting insurance,” he said. “It is no longer just the desperately poor who are uninsured. Middle to upper middle income persons also cannot afford to self-insure for health insurance.”