Statewide Health Care Plan Expected on Ballot in Fall

Public interest groups backed by an alliance of physicians said Monday they will turn in enough signatures today for a November ballot initiative calling for a comprehensive California health-care system that would remove private insurance companies from coverage.

The proposed “single-payer” plan, to be financed by taxes and patterned after a system used in Canada, would provide medical benefits to all state residents, proponents said.

More than a million signatures have been collected--well over the 677,000 needed to qualify the measure for the Nov. 8 general election, sponsors said. The signatures will be turned in to voter registrars in all California counties for verification.

“People are for this. People are for health care reform. They want to see the doctor of their choice,” said Dana Hohn, in charge of volunteer signature-gathering in Los Angeles County for Californians for Health Security, the group that organized the petition drive.

The insurance industry is expected to put up the strongest opposition to the proposed initiative.

“It guarantees people insurance, but it does so at a tremendous cost in terms both of tax dollars and giving up control of a very intimate part of their lives to a government agency,” Alan Katz, a San Fernando Valley-based legislative chair of the National Assn. of Health Underwriters, said of the single-payer plan.

Among the groups backing the three-month petition drive are the California Council of Churches, numerous labor unions, the California Nurses Assn., the California Physicians Alliance, the Gray Panthers senior-citizens’ group, the California Teachers Assn. and several consumer organizations.

Supporters hope the strong volunteer effort will help swing national health care debate to the single-payer concept, which so far has received no support from President Clinton.

The President made the proposed California initiative possible, however, by putting in his national health reform plan a provision allowing states to adopt their own health-insurance programs, including the single-payer type.

The plan would require key legal waivers by Congress and the California Legislature before it could be implemented. The single-payer plan, which would cost an estimated $105 billion a year when fully implemented in 1996, would replace Medi-Cal and Medicare, as well as the private insurance system. It would extend coverage to the estimated 6 million Californians now without health insurance.

Though it would be financed by tax increases, supporters said many Californians would see no increase in net expenditures on health care because they would no longer have to pay health insurance premiums, or put out their own money for prescription drugs, long-term care or other medical bills not covered by many insurance programs.

Under the plan, Californians would receive a comprehensive package of health benefits, including mental health, long-term care, and prescription drug coverage, regardless of health or employment status. The state would negotiate doctors’ fees and hospital rates and would allow consumers to choose physicians, hospitals or health maintenance organizations.

To finance the plan, every California employer would be required to pay a 4.4% to 8.9% payroll tax, depending on the number of employees. Sponsors contend that employers would pay about the same as they now pay for employee health insurance premiums; employers who now provide no health insurance for employees would pay more.

The plan also would boost the state’s income tax another 2.5% to 5%, but supporters say the increase would be offset by elimination of insurance premiums.

The initiative also would add a $1-a-pack tax to the price of cigarettes.

To oversee the program, the system calls for a health commissioner to be elected statewide. The health commissioner’s office would be similar to the office of the state insurance commissioner established under Proposition 103, the insurance reform initiative aimed at automobile insurance and approved by voters in 1988.

Just two years ago, California voters overwhelmingly rejected Proposition 166, a universal health insurance measure sponsored by the California Medical Assn., a physicians’ group.

Backers of the single-payer initiative, many of whom opposed Proposition 166 on the grounds that it would have allowed insurance companies to maintain their grip on the health system, believe Californians may be ready to support a universal health plan.

Martha Kowalick, a nurse and Oakland-based statewide coordinator of the initiative campaign, said: “This plan covers everybody better for less cost than any other plan that is being circulated. And it keeps intact people’s choice.”

Sponsors of the proposed initiative said they spent about $780,000 on the signature drive, although many names were collected by volunteers.

“We did over 100 house parties, where we took in contributions from $25 to $500,” Kowalick said. The California Physicians Alliance raised $150,000 and collected 10,000 signatures, she said.

A national poll conducted by The Times in April found that most Americans prefer to keep health insurance in non-government control, but the results were inconclusive because it was unclear how well such a system was understood by voters.

Katz, the National Assn. of Health Underwriters legislative chairman, predicted that initiative sponsors will unfairly “paint the insurance companies as the bad guys and argue that eliminating them is going to solve all the problems” in the health-care system.

“Californians would have no choice but to take the plan that the government provides,” he added. “I don’t think (voters) will go for that.”