March 11, 2004
Bill Seeks to Cure Health-Care Plague
"Whoever enlarges on the telling of the deliverance from Egypt, that person is praiseworthy." These words, included in the Passover seder, which will soon be read by Jews all over the world, remind us that the story of Exodus is meant to be applied to our lives today.
The Bible tells us that Moses and Aaron went to Pharaoh again and again, telling him that God said to let the people go. But Pharaoh's heart was hardened. He refused to free the Israelites, and God afflicted Egypt with plagues.
After each plague, every one worse than the one before, Pharaoh's counselors begged him to change his mind. But Pharaoh's hardened heart interfered with his reason. Even though he brought nothing but calamity on his country, he would not accept the changes that were needed to make the suffering stop.
Today we are beset with a series of health-care plagues, each seeming worse than the one before. The number of Californians without health-care insurance coverage hovers between 6 million and 7 million people -- that's about one in five of us. About 85 percent of those people are working in jobs where health care is not provided. Nationwide, health-care costs are the second largest cause of personal bankruptcy.
For those people who do have health-care coverage, premiums, co-pays and out-pocket-expenses due to lack of adequate coverage are out of control. There is an over-reliance on emergency-room care by the uninsured, as well as the underinsured, who often wait so long to seek care, their once-treatable chronic condition has worsened.
Treatable high blood pressure leads to strokes; diabetics discover their condition only after a coma. This results in pain for the patients and their families, and, since emergency-room treatment is much more expensive than preventive care, there is an increased burden on California's health-care budget.
Hospitals, doctors and clinics are passing on the costs of treating patients who cannot pay their bills to those patients who are insured. Insurance companies drive up the costs of premiums for hospitals and cut back on reimbursements. In some cases, hospitals are seriously considering shutting down.
Jewish tradition is clear about the importance of health care as a shared social concern. Maimonides put health care first on his list of the 10 most important communal services that a city had to offer to its residents.
As Conservative Rabbi Elliot Dorff reminds us in his teachings, Jewish tradition says that it is a positive commandment to save the life of a person in danger from illness, as it falls under the general obligation of saving life: "Thou shalt not stand idly by the blood of your fellow," (Leviticus 19:16).
So great is the mitzvah of saving life that Jews are directed to violate the Sabbath to fulfill it. The Shulchan Arucha calls for communities to take financial responsibility for those unable to pay for health care themselves.
In 1976, the Reform movement's Central Congress of American Rabbis adopted a resolution, affirmed in 1991, in favor of "universal access to health care benefits, including access to primary and acute health care, immunization services, early diagnostic and treatment programs, provider and consumer education, programs of extended care and rehabilitation, mental health and health and wellness promotion. Such a program should provide for education, training and retraining of health-care workers, as well as just compensation and affirmative action in hiring. An effective plan will provide for cost containment, equitable financing and assure quality of services."
That resolution could have served as a model for Senate Bill 921, a comprehensive health-care reform bill that I introduced last year, and which, after having passed the state Senate, is now up for consideration by the Assembly.
Senate Bill 921 will put no new burden on the state's General Fund. In fact, it will save billions of dollars in health-care costs by reducing the 25-27 percent of every California health-care dollar that is now spent on administration to between 3-5 percent.
Senate Bill 921 will save that money by creating a single, streamlined claims and reimbursement system in place of the fractured, hodgepodge of public and private systems we have now. It will replace all of our current inflated premiums, deductibles and co-pays with a single means-based premium that each of us can afford, while covering everyone under the same generous and flexible plan, which includes medical, dental, vision, mental health service and prescription drug coverage. Senate Bill 921 will also provide every Californian with the freedom to choose his or her own health-care providers.
Senate Bill 921 also relieves employers of the exclusive responsibility for their employees' health coverage. Like individuals, businesses will be assessed a means-based premium as their only contribution to this plan. Like individuals, businesses will pay what they can afford, and they will find themselves on a level playing field with regard to health-coverage expenses.
They will also find their expenses for workers' compensation dropping dramatically, because this bill folds the medical portion of workers' comp into the state insurance plan. This deep reform will save money for employers, while improving actual care for people who are injured.
Senate Bill 921 will provide every Californian with prescription drug coverage, because it mandates the state to buy pharmaceutical drugs and durable medical equipment directly from the companies, in bulk.
In this season, as we approach our time to celebrate the Exodus of the people of Israel from their confinement in Mitzrayim, we have an opportunity to reflect on the tight spots we find ourselves in today and how we can free ourselves. One of the saddest things about Pharaoh's hardened heart is that it would not let him see that the compassionate option really was the most sensible option as well.
State Sen. Sheila Kuehl (D-Los Angeles) represents the 23rd Senate District. She and other experts will take part in Zey Gezunt, a panel on health care, SB 921, on March 18 at 7 p.m. at Temple Beth Am, 1039 S. La Cienega Blvd. Los Angeles. The forum is free. For more information, call (310) 441 9084.