Local businesspeople weigh in on health reform.

When Brian Hemsworth started attending the Valley Industry and Commerce Association's Health Care Committee meetings, it was supposed to be a way to find new business.

Hemsworth, president of advertising firm Newman Grace, said the company had made a decision to focus on luring new health care clients. It currently does work for the L.A. County Medical Association and has worked with hospitals before. To Hemsworth, the monthly meetings seemed like the perfect place to meet the right people. After a few months, though, Hemsworth said he's more knowledgeable and concerned about health care in California than he ever expected to be.

"I think it's a critical issue for the health of California business," Hemsworth said. "The state is paying an awful lot into its health care program for its employees, and at companies in general, there's burden on a lot of businesses that provide health care.

"He said that hearing from politicians who are proposing legislative reform has been eye-opening, and he was particularly impressed with a presentation made by Assemblyman Keith Richman to the committee.

"With Keith Richman and Joe Nation, I liked their approach, they said you've got to look at health care not as needing a band-aid. You've got to look at it taking a holistic approach, making sure you approach different areas. People need to be insured, hospitals need to be compensated for what they do or they're going to be shut down, and that's not going to be good for anybody."

The meetings, regularly attended by assembly-members" and state senators' staff representatives, have given health care professionals and concerned businesspeople the chance to weigh in on the most significant health care reform efforts.

Carole Gallien, co-chair of the committee, said that the group's efforts center around understanding and influencing reform efforts at the state and federal level. Local government doesn't afford as much opportunity to solve the crisis, she said.

"The impact (on health care) is being created by federal and state issues, not anything local. The only local effect has been the utilization, which is causing the crisis in emergency rooms," Gallien said.

Gallien said that in the past few months the committee has discussed Assemblyman Paul Koretzs bill to pay for nurse educators, Assemblyman Dario Frommer's plans to set up a Web site sending residents to Canadian pharmacies for prescription drugs and allow some state agencies to buy medicine in bulk to save money and several other bills.

The health care committee through elected officials and their staffs, is witnessing some of the most important reform proposals to hit the legislature this year.

Both Gov. Schwarzenegger and Democrats sitting in the state legislature set their sights on bringing down the cost of prescription drugs earlier this year. Recently, a plan that Schwarzenegger put together with pharmaceutical companies was rejected by the Senate Health Committee.

Assembly Majority Leader Dario Frommer (D-Glendale) wrote a different proposal that offers drug discounts for families with higher incomes than the governor's plan would have included, and includes penalties for drug companies that don't participate.

A representative from Frommer's office said that the Majority Leader's bill may have a much better chance of becoming law now that the governor's plan has been rejected, and that Frommer is willing to perhaps compromise on his bill in order to enact his reform ideas.

Local attempts

In the midst of negotiations in Sacramento, some local efforts to cut the cost of drugs are sprouting up. Earlier this month, Councilman Antonio Villaraigosa won approval for a prescription drug discount program for Los Angeles residents. The plan passed through the city council without opposition less than two weeks before the runoff mayoral election.

Villaraigosa spokesman Nathan James said there's no reason why Villaraigosa's LA-Rx plan should conflict with any state reform efforts.

"I doubt they would conflict. It might be just that in terms of getting something set up, L.A. can move a lot faster. In fact, it may be one of those things where LA can take the lead in creating a proposal that work, and it may end up being one of those things that spreads from the bottom up," James said.

The Foundation for Taxpayers and Consumers Rights approached the councilman with the idea about a year ago, James said, and the drug benefits would be available to every Los Angeles resident, insured or not.

If state legislators' track records are anything to go by, however, it may be up to local efforts to make any kind of progress in the health care crisis. Keith Richman's bill, which so inspired Hemsworth, would have required every Californian to purchase basic catastrophic coverage at a minimum level. Late in April, however, the bill was quashed by the Assembly Health Committee.

The bill, according to Richman, might have taxed health plans in order to pay for subsidies for small businesses. Richman said the tax would not harm health plans or cause rates to rise because the subsidies would have pushed more people into private plans. Premiums would have cost about $50 per month to get a maximum annual deductible of $5,000. People who paid $160 per month would have been given lower deductibles.

The high deductible was criticized by some groups who said it would discourage people from seeking care. Labor groups were especially opposed to the bill, and many are still hoping to push an employer mandate bill back onto the books.

Employer mandates

In November of last year, voters approved Proposition 72, overturning SB 2, which required all employers with between 50 and 199 employees to provide insurance for all employees, and companies with more than 200 employees to offer insurance for employees and their families.

The only major reform plan that would ensure coverage for the 6.2 million Californians that go without health insurance is Sheila Kuehl's Health Insurance Reliability Act, which would cover every resident under a state run system. Kuehl said the state would save billions every year in health care spending by buying prescription drugs and medical equipment in bulk and cuts in health care administrative costs.

Kuehl's plan was inspired by a study released by the Lewin Group that suggested it was possible to insure all residents, and that most people would save money in the process. In February, Kuehl cited a Boston University study which found that 50 percent of health care spending is wasted on administrative costs, insurance companies profits and the rise in the price of pharmaceuticals. The plan has been criticized by groups who claim it would inevitably lead to rationing care, like the California Association of Health Underwriters. The group added that Californians in general are simply not ready to adopt a government run system. Political observers say Kuehl's plan, regardless of its successes in the legislature, is nonetheless unlikely to be signed by Gov. Schwarzenegger.

Organizations like the California Nurses Association and the Los Angeles County Medical Association have been advocates for a number of health related bills, but neither has taken a leadership role in the overarching crisis. The CAN was active in pushing for a law that required more nurses and state hospitals and it's fought for more money for nurse education programs and increase workplace safety, among other issue. LACMA has lobbied for a measure that would have increased emergency room funding for hospitals and acts as a reimbursement advocate in doctors' dealing with insurance problems. Neither claims to have the answers for all of California's health care needs.

Still, even if Californians are forced to wait to for groundbreaking legislation that will solve the rising costs of healthcare, there is progress to be made on other issues.

Donna Deutchman, president and chief executive officer of ONEgeneration, a non-profit group offering senior and child daycare and senior health care services to approximately 28,000 families in the San Fernando Valley, is actively involved in VICA's health care committee.

"We are participants in VICA and the health care committee because the concerns of business and the concerns of nonprofits are really not separate," said Deutchman. "We actively sought VICA's support on two pieces of legislation that we sponsored, authored by Assemblyman Lloyd Levine (D-Van Nuys) over the last two years."

Deutchman lobbied for bills, one which required licenses for Alzheimer's day care resource centers and another that addressed staff ratios issues for other adult day care centers.

Both bills passed Deutchman said.