Bad Medicine for a Serious Ailment : Statewide Prop. 166 only looks like health care reform

Proposition 166 calls itself the “Basic Health Care Coverage” initiative. If only it provided the basic health care its title promises. As with many things in politics, 166 is not what it seems to be.

Prop. 166, an initiative statute on the November ballot that requires only a majority vote for approval, promises more than it can deliver. It would mandate that employers provide medical insurance for all employees working more than 17 1/2 hours a week.

The California Medical Assn., its sponsor, knows that Americans, in this state and elsewhere, are deeply concerned about the cost and availability of medical care. Prop. 166 would seem to answer those worries.

But a look beyond the surface makes it clear that Prop. 166 has four glaring shortcomings: It does nothing to guarantee insurance coverage for the millions who are unemployed; it does nothing to induce doctors and other health care providers to contain the rising costs of medical care; it would encourage burdened employers to simply cut the hours of employees to less than 17 1/2 hours a week to escape the mandate, and it cannot legally require employer-provided insurance until the state receives a waiver from the federal government. So 166 could pass yet change nothing until such a federal waiver were granted.

Thus the proposition, even if approved, still would have a lot of ifs and maybes.

Californians have been down this road before. Remember Proposition 103, the 1988 automobile insurance initiative that was going to wipe the state clean of all of those insurance premium inequities? When the promised miracle didn’t happen, cynicism deepened among many voters who thought they had passed a measure to truly reform the car insurance industry. Now 166 too promises something that voters desperately want--affordable quality health care--that it can’t deliver.

Proposition 166 is written with the assumption that the state could get an exemption from a federal law called the Employee Retirement and Income Security Act of 1974, which prohibits states from requiring employers to provide health insurance. This assumption is a tremendous leap of faith, because Congress has granted only Hawaii such an exemption--and that took nine years.

What the passage of Prop. 166 surely would do is send the false message that Californians had begun to deal seriously with the health care crisis. All that 166 would guarantee is that all employers, large and small, would face taking on the health care expenses of employees and their dependents. An analysis by the UCLA School of Public Health concluded that jobs would be lost because some employers would simply cut back on employees and/or their work hours to avoid the additional costs. Obviously, a measure that links medical insurance to jobs--and then costs jobs--is no bargain.

Added to Prop. 166’s problems are projections by Consumers Union that employees could still wind up with significant costs, when deductibles and co-payments are added.

Chances are that health care reform eventually will get the attention it deserves from Washington. In the meantime, California voters ought not to set themselves up for false hope and add to the state’s job woes. Prop. 166 is the wrong prescription, and wrong prescriptions can be dangerous.