Policy Today magazine cover
September 20, 2006
California Ed.

California Senate Minority Leader Dick Ackerman spoke with PT following the Assembly's passage of SB 840, a bill that would institute a single payer health care system in California

PT: You voted against SB 840. Could you tell us about what you believe is wrong with the bill and its structure?

Ackerman: It's basically socialized medicine, and it has been tried by a number of other countries around the world without success. I was walking the halls the other day when I saw the health committee from the British Parliament. They were here studying our health system. They have a two-tiered system in which the people who can afford it go to the private doctors and the rest go to the bottom rung. You don't get speedy care; people are in lines with substantial waits just to have MRIs and other procedures that we can get right away. They basically told me that it just doesn't work, so they're looking at ways to make it more like some of the American systems.

PT: Other opponents of the bill have argued that it would create another layer of bureaucracy and increase inefficiency. How have the bill's supporters rebutted these claims in the Legislature?

Ackerman: I haven't heard any suggestion that they have. They just say that the current system doesn't work, we have too many uninsured and we have to guarantee coverage for everyone. They say it's going to be great, but hard evidence from around the world suggests that it doesn't work. These aren't third-world countries that we're talking about—they're advanced, sophisticated nations. Yet whenever anyone from around the world needs quick, quality medical care, they come to the United States.

PT: Why did the bill receive more support than some of the more modest, practical approaches put forward by legislators like Assemblymen Richman and Nation? Is there a fear of aiming too low, or is it purely political?

Ackerman: I couldn't tell you. A lot of people want the government to run everything. They think the best way to fix the problems in the world is to have government run all aspects of our daily life. A lot of the problems we've had with the health care system in California are a result of too much government. Our nurse staffing ratios are a good example of a policy that makes it more difficult to provide inexpensive, quality medical services
to people.

PT: OK. Let's focus on cost control then for a second then. Can you give us a brief run down of practical solutions for cutting health care cost in California?

Ackerman: Tort reform is a big one. You may not get recovery every time something goes wrong in an oper-ation, and people need to accept that. We pay much higher prices for drugs in California as well, because of malpractice law-suits. But no drug is going to be 100% effective for 100% of the people. The drug companies try to tell people that, but when it happens, they get sued anyway.

PT: The governor has said that he sees the government acting more as a "facilitator" than as a "provider" of health care. What exactly would that system look like?

Ackerman: When I was growing up, we had a straight fee-for-service system and everyone had their own doctor. Now we have a lot of HMOs which are very good. We have some very good examples, like Kaiser, which are doing a very good job. So I think the government can encourage those types of situations without trying to direct the market where to go.

PT: What type of legislation is necessary to move government into that role?

Ackerman: There's a whole bunch of stuff we can do. We have this law on the books  that says that every hospital that's less than five to 10 years old is going to be a tear-down and built-up for seismic retrofitting. But there's no standard to build it to—people are guessing an 8-8.5. If you have that kind of an earthquake, everything is going to be down anyway and it's not going to matter if the hospital is standing or not. It's an impractical expenditure of resources.

PT: The governor has announced that he will veto the bill when it reaches his desk. What's the way forward from here? Will SB840 push the subject of health care reform to the front of the agenda for the next legislative session?

Ackerman: We need to get the brains together and say, "OK, what makes sense? How can we actually improve the system here to make it more efficient and therefore reduce cost?" But people don't want incremental things; they want the whole tamale each time.

PT: Senator Ackerman, thank you for your time.

Dick Ackerman is California's Senate Minority Leader. He represents the state's 33rd senatorial district and serves on the Judiciary, Labor and Industrial Relations, and Local Government senate committees.