Why Medical Students Believe in SB 840 by Senator Kuehl and How It Can Save California $8 Billion per Year and Guarantee Quality Comprehensive Health Care for All

Thus, we know (versus those whose arguments are based in rhetoric and ideology) that we are doing things the wrong way in this country. And, better, we know the fix—because Uncle Sam has provided it, in the form of the five Institute of Medicine (IOM) Guiding Principles of Healthcare Reform (Report #6):

1. Universal – Everybody in, Nobody out.
2. Continuous – “womb-to-tomb” or “cradle-to-grave;” i.e. lifelong and guaranteed
3. Affordable –predictably so, both to individuals and families
4. Sustainable to society, specifically in two ways:
a. Everyone contributes, because everyone benefits.
b. Simple – eliminate complex billing, underwriting and regulatory requirements, which not only increase administrative costs, but also negatively impact health outcomes.
5. High quality care – patient-centered and evidence-based, where the goal is improved health of the population.

SB 840 is the only California proposal that meets all five IOM criteria, making it the “gold-standard” of healthcare reform proposals. Better yet, it’s also “gold” in another sense: the landmark Lewin Group (itself a subsidiary of a private health insurance company, so not likely any gratuitous assumptions) analysis predicts $8 billion savings in the first year, reaching a cumulative $340 billion in the first 10 years. SB 840, then, will be the next California “gold rush”!

Now the Hope. Not the hip type of Hope of recent presidential debates (as refreshing as it is to hear), but rather an historical Hope, one that invokes MLK’s clarity on this issue over 45 years ago when he said, “Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.” An historical Hope that understands the provision of healthcare to all members of society as the next in queue of great US social struggles: civil rights, women’s suffrage, the end of slavery.

This is the Hope that knows we are the correct path of history; that healthcare as a defining right will become the norm of society and the law of the land. This Hope knows it is a matter of time—but where the unit of measure is body bags: per the updated IOM data, 22,000 people each year (the equivalent of a “9/11” every two months) die a “preventable, premature” death because of lack of access to care. Measured, also, by how much money we insist on channeling towards the most inefficient bureaucracy in America—the private health insurance industry.

This is also the Hope with a twinkle in its eye; that believes history has arrived, and that we have an opportunity now to redefine our values to in accordance with the structure of the IOM. This Hope knows that because two-thirds of the American public wants guaranteed healthcare for everyone, the entire focus of the national debate on healthcare—currently centered around “individual mandates” and “personal responsibility,” mere pithy obfuscations designed to permit the continued preeminence of the status quo--could turn on a dime, if either leading presidential candidate showed the leadership to say, “Let’s do this the right way; let’s demand and create a system that guarantees high-quality care for all residents of this fine country.” And for less than we spend now--the best of both worlds: social politics that is fiscally conservative.

Finally, Hard work. As health professional students, we work our butts off. There’s always more to study, another patient to see—perhaps it’s you or a family member--who could benefit from our attention and help. The most difficult part about our education now, though, is the extent to which our non-system of care interferes with all of our best efforts to fulfill the reason almost all of us entered this profession—to help, to heal, rooted in a general love of humankind. The world we are about to enter now is so chaotic, so skewed by irrational financial incentives, that we are tinkering on the point where even the mere participation in our current non-caring, non-healthy, non-system (remember Walter!) can be considered a human rights violation. Not to mention a HUGE misuse of our time and skills: instead of providing care to patients (i.e. YOU), we spend an ever-increasing effort asking “pretty please” of corporate America—via thousands of rule books, known as private health insurance plans--to perform what we have already determined is medically necessary.

The logistics of Lobby Day (a full-day training on Sunday; Monday noon rally; over 100 legislative visits; a closing Candlelight Vigil in honor of those who have perished or been harmed by our profit-motive driven health insurance industry) required hundreds and hundreds of hours of work—all of them above and beyond our academic and clinical requirements. As rigorous the demands of our formal education, we realize that the work we invest now in actually designing a healthcare system that allows US to take care of YOU is an investment with incredible dividends—for us and for society. Thus, we traveled to Sacramento—first, in 2006; again in 2007, and now in 2008. And we will travel again, in greater numbers, with more vehement and articulate voices, until we have a system in which we are willing to work and live—one which places patients ahead of profits; that establishes health of a population, not quarterly reports to Wall Street, as the primary outcome.

Our voice is unequivocal: NOW is the time to create a provider and patient-centered system that is predictably affordable and provides high quality healthcare for everyone in our society. In California, SB 840 is a necessary first step towards that reality. It’s time to start walking.

Please peruse the photo album of our Lobby Day.

A 4-min video, mostly of Sen Kuehl’s speech at our Rally on Lobby Day.

For information about SB 840, visit Senator Kuehl’s page.

To get involved, please contact your local HealthCare for All chapter.

Parker Duncan, an MS4/MPH(c) at UC Irvine. He was the co-coordinator of Lobby Day 2008 for the California Alliance Legislative Action for Universal HealthCare
and is a student board member of the California Physicians Alliance. Photos courtesy of Khanh Trinh, UCSF, MS3.