A year can sure make a difference.

This time last February, state Sen. Sheila Kuehl was launching another seemingly quixotic quest to fix the state's ailing health care system by offering a California version of the socialized medicine predominant in Canada and Great Britain.

Its passage by the Democratic-controlled Legislature prompted an expected veto by Republican Gov. Arnold Schwarzenegger.

But in 2007, health care reform is the cause c & #233;l & #269;bre from Sacramento to Washington D.C., with Schwarzenegger unveiling a $12 billion market-based reform plan. His plan even includes a requirement that employers either provide health coverage or pay a fee the kind of mandate anathema to Republican lawmakers. Competing with it are proposals from the Senate and Assembly's top Democrats. And even President Bush in his State of the Union address included modest though controversial proposals for change on a national scale.

At this point, several L.A. business leaders have all but conceded that some measure of health care reform is on its way.

"We believe there's finally a collective will to pass something and to take some steps forward," said Los Angeles Area Chamber of Commerce President Gary Toebben, who has been entertaining a succession of state politicians in his office eager to explain the merits of their respective plans.

Kuehl, (D-Los Angeles), who will be a key gatekeeper in the debate as chairwoman for the Senate Health Committee, is philosophical about the reality that whatever reform package passes will likely fall short of her dream. She's introduced another single-payer bill but acknowledges there's more momentum for a market-based approach.

"Out of the conference committee I would hope there would be something that would move us along toward universal health care," Kuehl said. "I haven't seen any plan, except for mine, that actually achieves this in an affordable way that preserves quality and choice. The alternatives all give up one thing or another that preserves the profit and administrative overhead costs for the insurance industry."

Kuehl's approach would have virtually shut the nation's private health insurance industry out of one of its most lucrative markets, and given the government tremendous leverage to negotiate cost concessions from drug companies and providers.

Schwarzenegger's plan requires all Californians to obtain insurance through private companies or public programs. Employers of 10 or more people would be required to either offer health coverage or contribute to a statewide pool that would subsidize coverage for low income residents.


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