Broad guidelines begin to emerge, but few details

SACRAMENTO - Subterranean work toward overhauling California's health care system is about to break the surface after months of work.

Gov. Arnold Schwarzenegger said in his State of the State address in January that he wanted 2007 to be a year for health care reform, a proposal picked up by the Legislature, which passed legislation doing so earlier this month.

Staffers in the Senate and Assembly have been busily creating a compromise bill, and Senate Leader Don Perata and Assembly Speaker Fabian Nuñez are expected to present the unified proposal today.

The announcement will begin what is expected to be a summer's worth of debate between the governor, the Democrats who control the Legislature and the Republican minority. A final bill is expected to emerge in September.

The issue is especially relevant in San Joaquin County, where the number of uninsured has increased from an estimated 81,000 in 2001 to 89,000 in 2005, according to the California Health Interview Survey.

While many details are still to be worked out, some broad avenues for reform are emerging:

» Insurance companies will be required to cover all comers regardless of their prior conditions. Companies have been known to reject customers with anything from asthma to cancer; some have even rejected pregnant women.

» All but the smallest employers will have to provide insurance for their employees, either through the private market or by paying into a state fund that will then contract on the private market for inexpensive coverage. How much firms will have to pay remains to be seen.

» Individuals will lose the right to live without health insurance. Everyone will need coverage under the proposals, even if it is a cheap, "catastrophic" coverage plan that only kicks in should a policyholder suffer a major accident or illness.

The goal of the reform effort is to have all groups share a little of the overall burden to ease costs systemwide. People with insurance are less likely to use expensive emergency rooms, employers will no longer get to skip offering coverage, and insurance firms will no longer be able to reject unhealthy customers to keep their costs down.

All this is exciting to Stockton physician Javal Jamshidi, president of the San Joaquin County Medical Society. Jamshidi and his Medical Society colleagues are part of a coalition of business interests, insurance companies, doctors and unions running ads urging lawmakers to do something meaningful to make the system simpler and less expensive.

"This is way overdue for California and the entire nation," Jamshidi said. He said he was especially happy to see the insurance companies join the effort, especially since they are typically a doctor's nemesis. "The insurance companies realize that for their own sake of survival, they have to do something."

Contact Capitol Bureau Chief Hank Shaw at (916) 441-4078 or sacto@recordnet.com.

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