'First step toward reversing health care crisis'.

HERE In California there are 7 million people who do not have health insurance. To put that in perspective, that is more people than the entire population in the state of Massachusetts.

The exploding cost of health care, coupled with a disturbing trend of growing companies slashing health benefits, is crippling California. We are already at the point where people are choosing between buying groceries for their family and buying needed prescription medications for chronic illnesses. We cannot stand by and wait any longer while the ranks of the uninsured grow even larger.

A study by the UCLA Center for Health Policy Research found that three-fourths of uninsured non-elderly Californians are in working families. More than 80 percent of uninsured employees have no access to employment-based insurance coverage because they either worked for an employer that did not offer health insurance, or they were not eligible for benefits from their employer.

Some of the state's largest and most profitable companies are not providing health coverage to its employees. Instead they shift the burden to the state, while increasing profits and putting a tremendous strain on California's finances.

One company, Wal-Mart Stores Inc., has been the poster child for this type of corporate strategy. Researchers at the University of California at Berkeley determined that the healthcare expenses of uninsured Wal-Mart employees were costing the already economically strapped state $32 million a year in taxpayer funds. The study also found that taxpayers fund another $52 million for Wal-Mart employees in the form of food stamps, subsidized housing and other government assistance programs. That is roughly what California spends on educating 12,000 second-graders for one year.

More than 600,000 of Wal-Mart's 1.26 million U.S. workers get benefits from government programs or through a spouse's employer. Meanwhile, Wal-Mart's profits topped $10 billion last year. This egregious corporate irresponsibility to the community cannot continue.

I have introduced legislation that seeks to require California's largest employers, including Wal-Mart, to pay their fair share when it comes to funding health care for its employees. My bill would make employers of more than 10,000 employees spend at least 8 percent of their total wages on health benefits. There are 21 other state legislatures including Washington, Connecticut and New Hampshire that are considering similar legislation.

Currently, the state spends $13 billion out of its General Fund for Medi-Cal, the state's program that provides health care services to welfare recipients and other qualified low-income persons (primarily families with children and the aged, blind, or disabled). That amount grows each year as caseloads expand by nearly 10 percent and healthcare costs rise 8-10 percent annually.

My legislation is by no means a panacea, but is a first step towards reversing this health care crisis. You have to start at the top with those who are can have the most immediate impact. According to Employment Development Department data, there are 69 companies in California that employ more than 10,000 workers each and more than 1.4 million workers combined. Many of these companies are acting responsibly and are paying their fair share. However, there are those like Wal-Mart that are not. So we start here with the companies that can most readily afford to begin to bridge the health insurance gap.

After this first step is taken, we need to continue to work together to curtail the rise in healthcare costs and increase enrollment into cheaper and more accessible healthcare plans.

My home city, San Francisco, is in the midst of crafting an ambitious plan to provide health care for all uninsured San Francisco residents. We in the Bay Area have proven time and again to be a bit more open-minded and generous when it comes to providing social services for the poor, elderly, blind and disabled, and I do not expect the entire state to immediately embrace such a mandate right now.

However, we will continue to plug away at this crisis and make incremental practical adjustments. My legislation begins this process.

Carole Migden is the Democratic state senator representing San Francisco.