`POST-PARTISAN' TEAM MOLDED ARNOLD'S HEALTH PLAN.

Byline: HARRISON SHEPPARD Sacramento Bureau

SACRAMENTO -- Gov. Arnold Schwarzenegger's health care plan was molded by a team of staffers as politically varied as California itself -- a fact that could accelerate the ambitious proposal's journey from idea to reality.

While Schwarzenegger faces plenty of opponents a month after unveiling the plan, their tone has been more conciliatory than confrontational. This, analysts say, is no accident.

By stuffing his health advisory team with staffers who represent the often conflicting interests of employers, medical associations, insurers, unions and patient-advocacy groups, the governor has been able to pre-empt a lot of the criticism that could have doomed the plan. It's also an example of the governor's new style of ``post-partisan'' governing.

``(There) were often very robust policy debates, out of sight of the governor and sometimes in front of the governor,'' said Daniel Zingale, one of Schwarzenegger's key advisers on health care. ``He has an Arthurian style of governing, where he likes people to disagree in front of him. There was more of that than I've ever seen anywhere.''

The rancor that might normally accompany such a far-reaching and expensive plan -- addressing one of society's most pressing problems -- is so far absent.

In fact, a number of medical groups -- including many that object to his proposed fees on doctors and hospitals -- said this week that they will form a coalition to support the governor's principles, if not his exact plan.

Diversity in action

The governor's policy team is ``a very diverse group'' representing most of the major points of view, said Barbara O'Connor, director of the Institute for the Study of Politics and the Media at California State University, Sacramento.

``Having them vet the plan up front and then work it along the way I think produces things like this (medical group) coalition and pre-empts a lot of partisan coalitions (in opposition).''

Schwarzenegger's policy team was led by Health and Human Services Secretary S. Kimberly Belshe, and Zingale, a senior adviser to the governor who also serves as chief of staff to first lady Maria Shriver.

Working with them were Cabinet Secretary Dan Dunmoyer and health policy staffers Herb Schultz, John Ramey, Richard Figueroa and Ruth Liu.

Zingale is a Democrat who was once a senior aide to former Gov. Gray Davis, while Belshe is a moderate Republican who previously worked under Gov. Pete Wilson. Dummoyer is a more conservative Republican who previously worked for the Assembly Republican caucus and was head of an insurance industry trade group.

`Give and take'

Members of that team had fought on opposite sides over a previous major health care proposal, Senate Bill 2, a labor-backed effort that required businesses to provide health insurance for employees. Schultz and Zingale both worked in the Davis administration to support and craft the measure, while Ramey was hired by the California Chamber of Commerce to help repeal it through Proposition 72 in 2004.

``We have very candid and robust conversations about the policy strengths and weaknesses,'' Belshe said. ``The plan reflects a lot of back and forth, a lot of give and take.''

Schwarzenegger started laying the internal groundwork for the health plan in early 2006, when he indicated to his staff a renewed interest in tackling the issue, Belshe said, even as publicly he was focusing on promoting his infrastructure bond proposal.

Reaching out

To get the effort started, he held a health summit in the summer of 2006 with experts and interest groups and then assembled the policy team by the fall. The team first met as a full group in early September.

Over the course of assembling the plan, the team also sought feedback from a variety of groups, including potential critics such as the California Medical Association and the California Chamber of Commerce.

``They reached out to us as they did a lot of groups, from consumer groups to health care delivery people to hospitals, to unions,'' said chamber President Alan Zaremberg. ``I think the governor was pretty inclusive in reaching out to everybody. But it's his own plan.''

They also reviewed past health care proposals and plans from other states such as Massachusetts, where a Republican governor and Democratic Legislature last year agreed on a plan for nearly universal coverage.

Ambitious plan

The $12 billion plan they ultimately came up with seeks to insure nearly every Californian with the following key provisions:

Require every Californian to purchase health insurance.

Expand Medi-Cal reimbursements to health providers.

Expand government health insurance programs.

Require insurers to issue coverage to all.

Pay for the plan primarily through a 2 percent of revenue fee on doctors, a 4 percent fee on hospitals and a 4 percent of payroll fee on businesses that do not provide insurance for employees.

Expand wellness/preventive efforts to prevent diabetes, obesity and other health problems.

When it came time to unveil the plan, the governor chose to highlight his collaborative style in an unusual format. Rather than a typical press conference in which only supporters were allowed to speak, he invited more than a dozen interest groups -- including the chamber, the CMA, organized labor, health insurers, outside experts and major employers such as Safeway Inc. -- to participate in a panel discussion before the media.

harrison.sheppard(at)dailynews.com

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2 photos

Photo:

(1 -- color) BELSHE

(2 -- color) ZINGALE