Gov. Arnold Schwarzenegger hasn't come up with a concrete plan to help Californians contend with spiraling health care costs. He says he'll unveil one next year if he's re-elected.
To date, his position on health care largely has been defined by his opposition to ideas that impose new costs on businesses and government.
But to demonstrate that the issue is important to him, Schwarzenegger on Monday sat for four hours in a room with about 200 experts on health care and health costs, including union heads, CEOs of big businesses, directors of health-insurance companies and consumer advocates.
The event -- pointedly called a summit on health care affordability, rather than coverage -- underscored the largest division between two sides in the debate: those who believe the solution is to expand the number of people, especially the working poor, who have health insurance and those who believe the answer is to cut costs by making health care more efficient and requiring consumers to pay more up front to discourage them from using health services if they don't really need them.
Though he hasn't explicitly outlined his position, the Republican governor suggested Monday that he falls more into the second category. At the end of the four-hour session, he said he was particularly struck by the market-based solutions, such as technological innovation and "patient responsibility" that some of the speakers advocated.
"We all have the same goal, which is to make health care affordable, accessible and make it more efficient," he said.
Schwarzenegger has also made it clear that he opposes a Democratic measure in the Legislature, Senate Bill 840, that would insure all Californians through a "single-payer" system operated by the state, calling it a "tax increase."
The governor said he called Monday's meeting as a first step toward formulating a plan for solving the health care crisis in a state where insurance premiums are up 55 percent in the past five years and 20 percent of residents -- nearly 7 million people -- are uninsured.
His political opponents called it an election-year ploy.
Schwarzenegger's Democratic challenger in the general election, state Treasurer Phil Angelides, followed the governor to UCLA to hold a health care summit of his own. And about two dozen members of the California Nurses Association picketed Schwarzenegger's event, saying his policies were unfriendly to consumers.
"What he's talking about when he talks about universal health care is all the health care an individual can afford," said CNA President Rose Ann DeMoro, whose organization has not yet endorsed a candidate in the gubernatorial race. "There's no drug company or insurer that this governor doesn't love."
To date, the governor has blocked health care solutions that would require both private industry and government to pick up the costs. He vetoed a Democratic bill that would have expanded public health insurance programs so all children in the state would be insured. He supported the repeal of Senate Bill 2, a state law requiring all large businesses to provide coverage to their workers.
Until last week, when he changed his stance, he opposed using the state's purchasing power to financially punish drug companies that did not discount their products for the uninsured. Acting on a request from hospitals concerned about the financial impact, the governor tried to overturn a requirement that hospitals have one nurse on duty for every five patients.
The nurses stymied that effort in court.
Angelides on Monday staked out several positions in direct opposition to Schwarzenegger, saying he would work to pass legislation covering all children and requiring large employers to provide insurance.
"As governor, I won't wait until 100 days before the next election to discuss ways to contain costs and expand health-care security for California families," he said in a statement released by his campaign.
Schwarzenegger's campaign fired back with a news release saying Angelides' proposals would lead to $7 billion in tax increases.
Schwarzenegger's event included participants from all ends of the political spectrum, including Safeway CEO Steve Burd and Andy Stern, national president of the Service Employees International Union. But Democratic Mayors Gavin Newsom of San Francisco and Antonio Villaraigosa of Los Angeles, who were invited, did not attend.
Nonetheless, the governor said the solution must be bipartisan.
One of the featured speakers was Timothy Murphy, the head of the Office of Health and Human Services in Massachusetts, where Democrats and Republicans just enacted a universal health insurance program for all residents that expands government coverage for the poor, requires citizens to pay for coverage if they can afford it and works to bring down the price of health insurance for individual buyers who can't get it through their jobs.
The key to getting it done was blending many approaches, Murphy said.
"You need to be able to compromise and trade," he said.
