Universal health care for Arizona proposed Lawmaker aims to spur dialogue
The Arizona Republic
Jan. 29, 2006 12:00 AM
The top Democrat in the State House of Representatives thinks so.
Rep. Phil Lopes will introduce ambitious legislation this week to create a state health plan to cover all state residents. Everyone who has lived here for more than a year would be insured - sick or healthy, employed or unemployed, young or old, rich or poor.
The plan would do away with health care financing as we know it, pooling existing health care dollars from employers, Medicaid, Medicare and other payers to create a comprehensive insurance system. And Lopes says it can be done with the $30 billion now in the system and without new taxes or state funding.
But while Lopes' plan is sure to appeal to state residents fed up with the rising costs of health care and shrinking insurance protection, it is unlikely to even get a legislative hearing, let alone attract enough support in the Republican-led state Legislature to pass.
And it is destined to face the same opposition that has torpedoed every attempt to create a national health system in the U.S. over the past century: From insurance companies, which would see profits slashed. From hospitals and other health care providers, which would be subject to much tighter government regulations and price controls. And from citizens wary of government intervention. The government, or at least a quasi-governmental commission, would be involved in your health care and the "free market" would no longer reign.
Lopes, a former health planner from Tucson, is not naïve enough to believe his plan will be implemented here, at least not this year. But he is pressing forward because he believes it is time for the state to start a dialogue for the future, especially since more than one-third of the state population is either uninsured or on Medicaid.
"The system is broken, and everything we've tried in the last 25 years has not worked," Lopes said, vowing to introduce this bill every session until he is term-limited in four years or voted out. "It is time to talk about some serious solutions."
Lopes modeled his legislation after a plan that has been batted around in New Mexico for more than a decade. Set to be unveiled at a press conference with doctors and health care leaders later this week, Lopes' proposal will be the most far-reaching in a series of health care bills introduced so far this legislative session.
Other proposals are more incremental and would be unlikely to make a significant difference in state coverage rates or insurance costs. Those proposals include changes to state mandates on what insurance has to cover and tax credits or vouchers to help small businesses purchase insurance for employees.
This week, President Bush is expected to make health care reform a key component of his domestic agenda in his State of the Union address. The administration's plans are likely to hinge on tax breaks to purchase health insurance and the continued expansion of consumer-directed health plans. Those include health savings accounts, through which patients have more control but also absorb more financial responsibility for their health care.
John Rivers, president and chief executive of the Arizona Hospital and Healthcare Association, said initiatives likely to be supported by the president will "improve things only very, very little" and will do nothing to solve some of the biggest problems in the system, such as helping low-income workers afford coverage.
But Rivers and his association aren't on board with Lopes' plan either, primarily because of strict controls on hospital budgets and expansions.
"The bill essentially regulates health care as a public utility, and that is not something that we can support," Rivers said, though he added that the association does support "the goal" of universal health care. "Ingrained in the public's consciousness is a belief that people should have access to health care whether they have insurance or not. But there is widespread disagreement over how to pay for that."
The United States is the only industrialized nation in the world without a national health system. We also spend about twice as much of our Gross Domestic Product on health care as other nations, yet we consistently rank low on health indicators such as infant mortality and life expectancy compared with other industrialized nations.
-- Yeah, SURE this country is more conservative.... Socialism is the only way to really and truly help the citizens. -DC
But the subject is extremely dicey politically and there is pervasive skepticism that the state or country can afford it.
Dr. Eve Shapiro, a pediatrician from Tucson, is the state spokeswoman for Physicians for a National Health Program and a supporter of the Lopes plan. She insists there is enough money in the system; there are just a lot of profits in the system that interest groups work hard to protect.
"Politically it hasn't been able to be successful because of lobbying by vested interests like insurance companies," she said.
"It works around the world. . . . We have a very inefficient system. And every other country achieves better outcomes at a lower cost because they have a national system."
But government-heavy regulation is just not the American way. At least so say many opponents.
"The government never does things as well as the private sector," said Rep. Doug Quelland, a Phoenix Republican who is the chairman of the House Health Committee. Quelland wouldn't comment on Lopes' plan, since it hadn't yet been introduced, but said if it was anything like the Clinton health plan, he "wouldn't even entertain it" by giving it a hearing in his committee. And what about widespread public support for a universal system, such as found in the Republic poll? People "would favor free insurance for their automobiles, too, that doesn't mean we can afford it."
--Classic case of corporate greed and partisanship keeping the people from getting what they need. -DC
Opposing the concept
But supporters of health reform say they want the debate and the conversation and the thoughtfulness about health care to continue.
Dr. Merlin "Monty" DuVal, a Phoenix resident who was the founding dean of the University of Arizona's College of Medicine and a health official in the Nixon administration, supports Lopes' plan.
Although he doesn't think it is perfect, he wants people to talk about it.
"We have to take steps to get to universal health insurance," DuVal said. "This would be one place to start the conversation."