Republican health care ideas

State Sen. George Runner (R-Lancaster) visited the editorial board recently to discuss Republican ideas on health care. With the Democrats in control of both houses of the state legislature and the Republican governor frequently at odds with his own party, Runner talked about alternative plans and Gov. Schwarzenegger’s health care reform proposal. Some highlights:

What hath Massachusetts wrought?

George Runner: This is a much different kind of discussion than say, “Oh, well, they did it in Massachusetts.” We’re not even sure what they did in Massachusetts yet, so...

Eryn Brown: Right. Right. What do you think of um, San Francisco’s new clinics that they’ve opened up?

George Runner: Well I, I guess I’m not real familiar specifically with that. I think anytime people provide faster access, that’s a good thing, and, and you know I think that could help, be helpful. I think the problem in Massachusetts or — the story now is the lawsuit that they’ve got going on with their employers. But yeah, I, I think healthcare delivery just needs to be thought about differently. I mean we still are trying to, I think we still are trying to help — deliver healthcare the way we did with, when, you know, you had your family doctor and you could go to your family doctor. It just isn’t going to be that way. That’s why we, for instance one of our ideas — given that everybody has it — is you’ve got to have better um, information technology uh, because you go to the same doctor that has your file, that has had your file for the last 12 years. Somebody’s got to be able to have, be able to access your health information because the last time you went you went to your clinic, and this time you’re going over to somebody else, and, and they’ve got to have access to your medical record.

Evolving health care and GOP ideas

Eryn Brown: Do you think delivery has to change for people in all, in all the different strata? For instance, I’m assuming delivery has to change for people who are uninsured or MediCal patients. How about people with private insurance? I mean, there’s also an argument that delivery probably has to change at least — some, some level.

George Runner: Well, I think it has. My gosh, look at, I mean, truly, if you’re a Kaiser member, your delivery’s different, than, than it was when, if you had your family doctor. So I mean, I think, I think in the, I think there are models out there that will be like that. Actually one of the other issues, for instance, one of the parts of our plans is we think hospitals oughta be able to hire doctors. See, right now they can’t.

Jon Healey: Why not?

George Runner: Because again, the law just doesn’t allow for the hospitals to hire doctors. California Medical Association doesn’t like that. Um, well, and that’s why even Kaiser, you know, the hospital, Kaiser, they’re, they have a separate functioning management organization between their doctors groups and their hospitals.

Eryn Brown: The CMA likes a fee, a fee structure.

George Runner: Yeah, right, right. And, and, and they don’t want to think of their doctors as independent, and they don’t want to be unemployed, but, but I gotta tell you, that’s one of the ways that that we think helps put together a better medical plan. On the change.

Eryn Brown: Hm. Mhmm. Is that one of the bills?

George Runner: Uh huh, it’s one of the bills. Uh, one of our bills too is we believe that nurse practitioners ought to be able to operate clinics. CMA hates that idea. They think doctors need to do it. Well, other states have nurse practitioners doing that. So, there’s a, there’s a lot of, there’s a lot of stuff that gets stepped on if we want to do this. But all of those are issues that we can do, again, without, like, throwing out the whole system. And, and uh, dealing with that I mean, truly, one of the issues or one of the side issues — I don’t know what we did with the bill but even things like retro, earthquake retrofit for hospitals: If you’re gonna spend a couple billion dollars, I’d say don’t do it on the hospital building, I’d do it on healthcare IT systems. You’ll save a lot more lives. Uh… and, you know, so those are the kind of issues I think you can, we can, address at that point... IT, we think, is a very key issue. There’s no incentive for docs, or pharmacies, or hospitals to do it on their own. Um, it doesn’t save them any money. It probably cost them money, but it doesn’t give better healthcare outcomes, so again that’s some of the issues we should, we should be trying to, to, to address on that issue

Jon Healey: And you can do that on a statewide basis? Because when I think about that, and health coverage in general, that’s something that definitely uh, would use a national approach because of the mobile population.

George Runner: Well, could be. But for most — I mean you’re always going to have people moving in and out of state. But for the most part, a lot, most population doesn’t move out... Most people spend most of their life in the one place, and uh…. So I mean, you’re right, any of these are all better with a national hitch, you’re right. Absolutely right. If you had a national IT system, it would be better. And quite frankly, the federal government has much better ways to give the incentive, economic incentives, in order to help get established. Or, mandate for everybody. Cause again, think about it, if California does some kind of mandate for IT, and all of a sudden it becomes too expensive for whoever it is, they decide, I don’t want to do business in California. That’s why the national solution really has to be a part of that formula.

Paying for the governor’s proposal

George Runner: I think that, I think what the governor would like to do is see if there can be some compromise bills that would give kind of his vision of universal care, that he would then have to fund... I mean I think if there’s a plan that comes out that’s going to come out that way. It’s going to come out as a simple majority vote bill then to be funded through some series of tax issues that’ll go by initiative onto the ballot.

Eryn Brown: Do you think those have a prayer?

George Runner: I think they’ll be very difficult tasks. I think they’ll be very difficult tasks. That’s why, I think that’s what frustrates me personally, is that we really do have the opportunity to create some better healthcare systems and plans, more people covered. I hate to see us lose all that for the sake of something that I think is going to be very difficult to deliver.

Eryn Brown: And it...

Jon Healey: Given that uh, we haven’t had, uh, initiatives yet on, uh, sweeping overhaul, don’t you think that you kinda have to see them fail…that people won’t give up on them until they actually see them fail?

George Runner: Well, could be, could be. That’s part of the challenge you have, again, yeah.

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