Prescription for Latinos: No on Prop. 166 : Initiatives: By pressuring small business and ignoring community clinics, the measure would hurt the working poor.

Health insurance in the state of California has become an increasing luxury for a precious few in large employer sectors of the economy. But even there, the continuity of some benefits is being questioned, as evidenced by the recent announcement of McDonnell Douglas that retiree health insurance benefits would run only four more years before permanent termination.

For Latinos in California--over 40% of whom lack health insurance--the specter is even more grim. More and more Latinos face an increasingly hostile health care delivery system as state budget cuts threaten the viability of community clinics and county services.

A key to unlocking this dilemma for Latinos and others will be the development of a well-thought-out financing scheme to incorporate more of the state’s uninsured population, particularly those trapped between poverty and the middle class, that is, the working poor.

Although numerous health care financing measures have been discussed at both the state and federal level, we will have the opportunity Nov. 3 to determine the future of health care financing and delivery of services for the state.

Concerned with the rising number of uninsured residents, the California Medical Assn. has placed Proposition 166, the Affordable Basic Health Care Act of 1992, on the ballot. A recent review of the proposition by the Latino Coalition for a Healthy California resulted in an unequivocal thumbs down for this proposal. The key weaknesses cited:

* Millions of uninsured Latinos and others would stay uninsured, since part-time employees working less than 17.5 hours per week, those working for new employers, independent contractors and the unemployed would not be covered.

* The regressive financing measures recommended in the initiative would seriously weaken small employers, the major source of employment for Latinos in the state. Costs to businesses have been projected at billions of dollars, most of which would impact small firms. Latino employees would be forced during this severe recession select between a job or health insurance. Is this a real choice?

* The recommended benefit package does not provide needed care for the relatively youthful Latino population. For example, preventive services such as family planning and contraception and outpatient medications are not included. As the quality of care is decreased for those who can only afford basic coverage, basic benefits will become more substandard.

* The plan does not address the development of community-based health delivery systems, which have served Latinos well. These health centers have relied on piecemeal funding to provide services to the underserved and uninsured. Shifting resources away from the current safety net for Latinos without a proven alternative does not increase access.

* The Health Care Coverage Commission that will oversee the new law consists of 12 members, six appointed by the governor and three each by the Assembly Speaker and the state Senate. Five of the appointees must represent doctors or hospitals, outweighing the two seats allotted to consumers. No Latinos are included, even though they will be disproportionately affected.

There is no doubt that health care financing reform is needed. But should we allow something as precious as our children’s health to be determined by one special interest group that largely has ignored health needs of Latinos?

Should Latinos be willing to undermine the community clinics which, though short on staff and dollars, have served us in migrant camps and urban barrios? Should we place the small employers of working-poor Latinos in the unsavory position of trading jobs for health insurance? Finally, should we not have a right, as the largest minority population in the state, to participate in this reform process?