Voters cool to gov.’s idea to charge doctors and hospitals

Sacramento —  Turns out Gov. Arnold Schwarzenegger faces a tough sell convincing not only doctors and hospitals they should pay higher taxes to help finance universal healthcare. Californians from other walks of life also think it’s a bad idea.

“It’s a stupid idea,” says Claire Fitzmaurice of Irvine, a retired accountant. “Listen, they’re not going to be paying. They’re just going to add it on. And patients are going to pay the fee.”

Schwarzenegger spins it as a fee. Tax or fee, it’s arguably the most controversial piece of his universal healthcare plan, which still hasn’t been honed in detail.

The governor has proposed tapping 2% of doctors’ revenues and 4% of hospitals’ to finance $3.5 billion of his plan’s $12-billion government cost.

Fitzmaurice is one of 2,000 Californians -- including 1,122 likely voters -- polled recently by the nonpartisan Public Policy Institute of California. Respondents liked other features of the governor’s proposal, but spurned the tax on doctors and hospitals. The poll results are being released today.

“It’s going to wind up being a tax on me,” Fitzmaurice complained in an interview. “One way or the other, the physicians and hospitals are going to make their money.”

A lot of people apparently agree.

People were asked whether they thought it was a good idea or a bad idea to require physicians and hospitals to pay the state a fee to help cover the cost of healthcare. Only 30% of voters answered that it was a good idea; 63% said it was bad.

Even Democrats leaned against the notion: 42% for, 50% against. Republicans were strongly opposed -- 24% for, 71% against -- showing why GOP lawmakers are so leery.

Mark Baldassare, the policy institute’s pollster, says that “for many people the issue of cost is even a greater healthcare concern than access. Most already have coverage.”

I called other voters who were polled and got some different takes, as well.

“If you require doctors and hospitals to pay a fee, they might be reluctant to provide services to the poor community,” said a community activist, the Rev. K.W. Culloss of the First Antioch Missionary Baptist Church in Los Angeles.

Here’s a suggestion: Exempt Medi-Cal payments from any fees. That, coupled with the governor’s proposal to significantly increase shamefully low Medi-Cal reimbursements, would provide some incentive for treating the poor.

Cory Gatrall, a paralegal from L.A.’s Fairfax area, commented: “I think a lot of hospitals are facing huge financial problems and even bankruptcy as it is. And I’m not sure that charging hospitals is the way to go.”

Actually, hospitals that treat a lot of Medi-Cal patients would benefit from the higher reimbursements. So they’re cautiously lining up behind the governor’s program. Same with doctors who care for the poor.

Jennifer Goshay, a graphics artist in Berkeley, said: “The responsibility should be the state’s and the insurance companies’. Insurance needs to be reformed. Hospitals already are going broke.”

Schwarzenegger isn’t exactly proposing insurance reform. But his plan would require that insurers spend 85% of their premiums on patients.

Baldassare believes that with good salesmanship, Schwarzenegger could overcome the anti-tax sentiment and push a publicly supported plan through the Legislature. That’s because there’s a strong, overriding desire for healthcare reform. Taxes could be accepted as part of a package, the pollster says, “particularly if people are convinced it’s not going to have a dramatic effect on the cost of their coverage.

” ... I was struck by how many expressed the belief that major changes are needed.”

In the poll, 70% of the people who already have medical insurance said that the system needs “major changes.”

Among voters, two-thirds favored two of the governor’s ideas: forcing all Californians to have health insurance while subsidizing the poor, and requiring employers that don’t offer coverage to pay a fee into a state insurance pool. Even most Republicans thought those were good ideas.

Schwarzenegger wants companies with 10 or more employees to spend at least 4% of their payroll on workers’ healthcare, either through a private plan or a new state pool. He estimates the employer fee would raise $1 billion.

But there’s another feature of the governor’s plan that voters strongly oppose, besides the doctor and hospital taxes. It’s providing insurance for illegal immigrants. Nearly two-thirds object to that.

Perhaps people don’t realize that, by federal law, illegal immigrants already are entitled to costly care at overflowing emergency rooms. When their treatment isn’t paid for, everyone else gets stuck with the bill: taxpayers, medical providers, healthcare policyholders.

To their credit, Senate Republicans have proposed shifting all uninsured -- here legally or not -- to an expanded network of nonemergency medical clinics. The care would be more accessible and much less expensive than at ERs.

Schwarzenegger reportedly likes that idea. But he’ll need to sell it. In fact, he’ll need to hardsell the whole complicated, costly concept of universal healthcare.

He should lose all the rhetoric about last year’s global warming bill and “post-partisanship” -- a grating word -- and stop trying to play in presidential politics.

Focus on crowded prisons, storing more water and reforming healthcare. That’s a full plate.

Bargain with legislators and bring around Claire Fitzmaurice.

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